You may have heard of HIPAA certifications. But you might not know that HIPAA certifications aren’t a government-approved sign of HIPAA compliance.
HIPAA compliance and HIPPA certifications refer to two tangential – but still different – things; the U.S. government issues no official HIPAA certification, yet many organizations claim to be “HIPAA certified.”
These certifications make healthcare providers and their vendors assume they meet compliance requirements - when they might not.
What does HIPAA-certified truly mean? And how do healthcare organizations verify if they meet the necessary HIPAA requirements?
At Intelligent Technical Solutions (ITS), we help healthcare organizations and their vendors understand and achieve HIPAA compliance by implementing security controls, conducting risk assessments, and offering ongoing cybersecurity support.
In this article, we’ll break down:
- key differences between HIPAA certification and HIPAA compliance,
- why compliance matters,
- if getting HIPAA certifications is worth it, and,
- how businesses can achieve HIPAA compliance.
We invited Sean Harris, Senior VP of Cybersecurity at ITS, to share his thoughts about HIPAA compliance and provide industry insight into this topic.
By the end of this article, you’ll have a more straightforward path towards your HIPAA compliance – and certification – goals.
What is HIPAA Compliance?
HIPAA (Health Insurance Portability and Accountability Act) is a U.S. law designed to protect Protected Health Information (PHI). HIPAA compliance means adhering to the Privacy, Security, and Breach Notification Rules to ensure sensitive health data is handled, stored, and transmitted securely.
“HIPAA compliance is not just about checking a box — it’s about implementing real security measures to protect sensitive patient data,” Harris said. “Many businesses think they’re compliant, but without an actual audit, they could leave major gaps in their security.”
To achieve HIPAA compliance, an organization must:
- Perform regular risk assessments
- Implement security controls (e.g., encryption, access controls, network security)
- Develop policies and procedures for handling PHI
- Train employees on data protection best practices
- Have an incident response plan in case of a breach
HIPAA compliance is an ongoing process. You’ll have to constantly update your security measures and policies to address evolving threats and regulatory changes.
READ: eBook - HIPAA Compliance Checklist
What is HIPAA Certification?
Unlike HIPAA compliance, HIPAA certification is not an official government requirement. There is no government-backed certifying body that issues HIPAA compliance certificates.
As Sean Harris explained, “HIPAA certification isn’t real—at least, not in the way most people think. The government does not certify organizations as HIPAA compliant. Any certification is provided by third-party vendors, not a federal agency.”
The Office for Civil Rights (OCR) has also clarified that HIPAA compliance is determined through audits and investigations, not certifications.
That said, it’s still worth getting third-party organizations if you want an objective look at your IT infrastructure. Some third-party organizations offer training and assessments based on HIPAA regulations and then issue a certificate of completion.
If you still want a trusted certificate of HIPAA compliance, Harris said that some organizations get HITRUST certifications.
“HITRUST is an independent entity that provides certification based on HIPAA,” Harris stated. “Some organizations may require HITRUST certification if partnering with them involves PHI.”
Why Does HIPAA Compliance Matter More Than HIPAA Certifications?
“HIPAA violations are serious business,” Harris warned, “If a breach happens, the government isn’t going to ask for your HIPAA certificate — they’re going to conduct an audit to determine if you implemented the required safeguards.”
Failure to comply with HIPAA leads to severe legal and financial consequences. Organizations that experience a data breach due to non-compliance can face:
- Civil penalties ranging from $100 to $50,000 per violation
- Criminal charges for willful neglect of HIPAA rules
- Public disclosure on the OCR’s “Wall of Shame”, which lists significant data breaches involving PHI
A well-known example of a HIPAA violation is the Anthem data breach, where 78.8 million patient records were exposed due to poor security controls. The company paid a $16 million fine, marking one of the largest HIPAA settlements in history.
READ: HIPAA Non-Compliance: What Happens? (& Why You Should Comply)
Are HIPAA Certifications Still Worth It?
HIPAA certifications can be worth it, depending on your needs. You might opt for third-party HIPAA certifications to:
- Objectively evaluate your IT network
- Train employees on HIPAA best practices
- Show due diligence when working with healthcare partners
- Market yourself as HIPAA-certified for partner organizations
It does not guarantee compliance. If you want to protect your business from HIPAA violations, true compliance requires ongoing security monitoring, audits, and policy updates.
As Harris puts it, “Getting a certification is easy. Proving compliance in an actual audit is a different story. If you want real protection, focus on compliance, not just a piece of paper.”
How to Make Your Business Truly HIPAA Compliant
If your business handles PHI, you must focus on actual compliance rather than a certification. Here’s how you meet these HIPAA standards:
1. Conduct a HIPAA Risk Assessment
A HIPAA risk assessment by a verified third-party IT specialist helps identify vulnerabilities in your data security practices. This should be done annually and after major IT system changes.
2. Implement Strong Security Measures
Encrypt all PHI data, restrict access to authorized personnel, use multi-factor authentication (MFA) for added security, and regularly update and patch systems to stay compliant and protect sensitive information from potential threats.
3. Train Employees on HIPAA Compliance
Human error is one of the leading causes of HIPAA violations. Providing ongoing security awareness training helps prevent phishing attacks, accidental data leaks, and improper data handling.
4. Develop an Incident Response Plan
If a data breach occurs, your organization should have a clear incident response plan to mitigate damage and report the breach promptly. Especially since the global average cost of a data breach in 2023 was $4.45 million, a 15 percent increase over the last three years. There’s too much on the line to be caught unaware.
5. Work with a HIPAA-Compliant MSSP or MSP
Partnering with a managed security service provider (MSSP) or managed IT service provider (MSP) ensures your IT infrastructure meets HIPAA standards.
“Having an experienced cybersecurity team in place makes all the difference when it comes to compliance,” Harris said. “An audit could also help while working with an MSSP/MSP, for extra reassurance.”
Need help to achieve HIPAA compliance?
HIPAA compliance is required by law and involves implementing security controls, policies, and procedures to protect PHI. Third parties offer HIPAA certification and serve as an objective assessment, but it does not replace compliance.
Compliance is the only way to avoid HIPAA fines and protect patient data. Certification can supplement compliance efforts, but it should never be a substitute.
At ITS, we provide HIPAA compliance assessments, cybersecurity solutions, and employee training to help businesses meet regulatory requirements and avoid costly penalties.
Want to achieve HIPAA compliance? Contact ITS today for a consultation and risk assessment to secure your business and stay compliant.
If you want more information about HIPAA compliance before reaching out, check out the following resources:
- 7 Best Security Practices for HIPAA Compliance [Updated]
- 10 Ways MSPs Help with HIPAA Compliance
- How Much Does HIPAA Compliance Cost?
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