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HIPAA → 4 Rules

5 HIPAA rules, from privacy to security and more

Whether you’re in the healthcare industry or your business model lends to clients in the Healthcare Industry, HIPAA is likely at the forefront of your thoughts. But what is it, and how does it affect your data specifically?

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is legislation establishing rules, regulations, and potential levies around treatment and use of Protected Health Information (PHI).

That’s a mouthful! Translated into lay-speak that sentence amounts to this: If you touch private medical data, it’s your job to ensure it is kept safe.

Often there is a misconception about lines of responsibility which has caused several well-documented issues including tens of millions of dollars in fines and settlements.

Avoiding these fines and settlements is of paramount importance to the health of your business. The first step is learning your responsibilities. HIPAA compliance is broken into four rules which govern four major points of compliance. Each aspect requires its own processes and procedures to maintain that compliance.

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1. HIPAA privacy rule

The HIPAA privacy rule establishes national standards for the use and disclosure of protected health information (PHI) by covered entities and their business associates.

The privacy rule defines PHI broadly, including any information that can identify a patient and relates to their physical or mental health, healthcare services, or payment for healthcare. This includes not just obvious data like names and Social Security numbers, but also medical record numbers, addresses, and even certain biometric data.

For healthcare organizations, this means access to PHI must be limited to the minimum necessary to fulfill a specific purpose. Non-treatment uses—like marketing—require explicit patient authorization. The rule also grants patients the right to review their own records, request corrections, and obtain copies.

Operationally, this shifts data governance from a purely technical matter to a policy-driven framework. Even if your infrastructure is technically secure, sharing PHI without proper consent could violate the privacy rule. Policies, training, and system-level safeguards must all work together.

Steps to compliance

What it means for HIPAA-compliant hosting

If your website, patient portal, or database stores PHI, hosting providers must also follow privacy rule requirements. This includes signing a business associate agreement (BAA), ensuring secure authentication, and configuring access controls so only authorized personnel can access patient data.

2. HIPAA security rule

The HIPAA security rule requires covered entities and business associates to protect electronic protected health information (ePHI) with administrative, physical, and technical safeguards.

While the privacy rule governs when and why PHI is used or shared, the security rule governs how it is protected in electronic form. The three safeguard categories are:

The security rule is intentionally flexible, allowing organizations to choose technologies and procedures suited to their size, complexity, and resources—provided they effectively reduce risk to ePHI.

Patients benefit from reduced exposure to cyberattacks, accidental data loss, or unauthorized internal access. The rule ensures healthcare technology is designed with security as a core requirement, not an afterthought.

Steps to compliance

What it means for HIPAA-compliant hosting

HIPAA-compliant hosting must support these safeguards natively or allow you to implement them. This includes secure data center access, network segmentation, encrypted storage, and the ability to restrict database queries to authorized applications or users.

3. HIPAA breach notification rule

The HIPAA breach notification rule requires covered entities and business associates to notify affected individuals, the U.S. Department of Health and Human Services (HHS), and in some cases the media, after a breach of unsecured PHI.

A “breach” is defined as the acquisition, access, use, or disclosure of PHI in a manner not permitted by the privacy rule that compromises its security or privacy. The rule mandates notification within 60 days of discovery and includes specific content requirements for those notifications.

Not every incident qualifies as a breach—risk assessments can determine whether the probability of compromise is low enough to exempt an event from reporting. But any delay or mishandling of notification can lead to significant penalties.

For patients, timely notification allows them to take steps to mitigate harm—such as monitoring accounts, changing passwords, or disputing fraudulent activity—before damage escalates.

Steps to compliance

What it means for HIPAA-compliant hosting

Hosting environments should include breach detection capabilities, such as log monitoring, intrusion detection systems, and automated alerts for suspicious activity. The ability to produce access logs quickly is critical for investigating and documenting potential breaches.

4. HIPAA transactions rule

The HIPAA transactions rule standardizes the electronic exchange of healthcare-related administrative and financial data using specific formats and code sets.

This rule applies to common transactions like claims submission, eligibility verification, referral authorization, and payment remittance. The goal is to make these processes faster, more accurate, and more cost-effective by enforcing the use of standardized electronic data interchange (EDI) formats, primarily ANSI X12.

For IT leaders, this rule affects not only billing systems but also any hosted application that interfaces with payers, clearinghouses, or other covered entities via electronic transactions.

Patients benefit from more efficient claims processing, fewer administrative errors, and faster reimbursements—reducing delays in care caused by payment disputes.

Steps to compliance

What it means for HIPAA-compliant hosting

Hosted platforms handling these transactions must be capable of securely processing and transmitting standardized data formats without altering content. Hosting providers may need to support secure EDI gateways, encrypted file transfer protocols, and transaction logging.

5. HIPAA identifiers rule

The HIPAA identifiers rule standardizes and protects unique identifiers for individuals, providers, employers, and health plans in transactions and recordkeeping.

Identifiers like the National Provider Identifier (NPI), Employer Identification Number (EIN), and standard health plan identifiers are essential for ensuring accurate data exchange. Misuse of these identifiers can result in misdirected care or billing errors.

For covered entities, proper use of these identifiers is mandatory in HIPAA-standard transactions, and unauthorized disclosure is prohibited. These identifiers often appear alongside other PHI, increasing their sensitivity.

Patients benefit from reduced errors in health record matching and claim processing, ensuring care and billing are linked to the correct individual or provider.

Steps to compliance

What it means for HIPAA-compliant hosting

Hosting environments storing these identifiers must treat them as PHI, implementing the same encryption, access control, and audit measures used for other sensitive health data. Databases should be configured to restrict query access to identifier fields and log any access attempts.

HIPAA rules and hosting FAQs

Yes. Any hosting provider that stores, processes, or transmits ePHI must support compliance with the Privacy Rule, Security Rule, Enforcement Rule, and Breach Notification Rule. Their infrastructure, policies, and personnel must be aligned with HIPAA standards.

HIPAA doesn’t specify which database technology to use. Rather, it sets the security standards that must be met. Whether you’re using SQL, PostgreSQL, or a NoSQL database in a private cloud or dedicated environment, compliance depends on how that environment is configured and managed.

Here’s what that means in practice:

The Privacy Rule applies to all types of PHI and governs how it can be used and shared. The Security Rule applies only to ePHI and requires specific safeguards to ensure its protection. Both are essential for HIPAA compliance.

Shared hosting environments typically can’t guarantee the isolation and access controls required by HIPAA. For compliance, organizations generally need dedicated servers, private clouds, or virtual private servers (VPS) that can be configured to meet HIPAA standards.

If a provider is involved in a compliance failure and lacks proper documentation or audit readiness, both the provider and the covered entity could face investigations and penalties. It’s critical to choose a hosting partner with a proven track record and full transparency.

No. Even a suspected unauthorized access event that compromises unsecured PHI can trigger the rule’s notification requirements. Hosting providers must be equipped to detect, respond, and report incidents quickly to minimize exposure.

Additional resources

What is HIPAA-compliant hosting? →

A complete beginner’s guide

Scaling a compliant cloud →

How to scale up without compromising security

HIPAA guide for small business →

A complete resources for medical SMBs

Jerry Vasquez brings decades of leadership experience to his role as Product Manager at Liquid Web, focusing on networking and security products. When not working or sleeping, Jerry can usually be found eating and having a good conversation with good people.

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