Compliance with HIPAA record retention requirements is critical for both medical storage software developers and healthcare providers. In this article, we’ll review what the HIPAA data retention requirements are, the documents that are (and aren’t) subjected to a retention policy, and the possible threats of not complying with them.
HIPAA Medical Records Retention Requirements: How Long to Retain Patients’ Records?
Creating storage software for the US healthcare providers might be extremely beneficial for developers since more and more medical providers decide to automate and digitize the processes. In practice, coming up with a solution that meets all medical care records retention requirements might seem not as simple legal-wise for one has to know both Federal and State medical record storage laws. The story isn’t simple for the health care providers either, as they are responsible for keeping the patient’s information safe and creating such an environment for it that it’s both convenient and legal, and a failure to do so may result in fines, lawsuits, and damaged reputation. Where to start if you belong to either side? Well, we’ve got you covered.
HIPAA Record Retention: The Needed Basics
The Health Insurance Portability and Accountability Act (commonly known as HIPAA) is one of the most important bills when it comes to medical records retention laws one should know. Passed in 1996 to protect the health coverage of the people who were between jobs, this law is currently known as the one that also ensures the medical records retention policy, defines the involved parties and documents, and is the main document the providers use when creating an in-house medical retention policy.
HIPAA log retention procedures and requirements deal with the following documents:
- those that contain personal health information i.e. medical history: registration, examination cards, prescriptions, diagnosis tests, surgeries, etc;
- those that contain personal identification information: invoices, receipts, patients records with Social Security Number, bank accounts detail, billing, etc.
Why is Record Retention Important?
#1 Operational Efficiency
Those providers who cannot access the full medical history of a patient, won’t be able to thoroughly assess their current condition and prescribe the needed medication: it either will take a long time or will cost the patient a fortune. For instance, your physician lacks the knowledge that you’ve had a heart-related disease and prescribes medication that isn’t advised for patients with such conditions. You don’t want to hear the possible scenarios, right?
That’s exactly the point: keeping the records and accessing them at any given time will help the care providers to better examine the condition and eliminate the risks of misdiagnosing the patients or prescribing medication that can have severe side effects.
#2 Data safety
Record retention is also important from the data safety perspective. In case of a breach, damage, or database collapse, it can cause safety and security issues for every party involved. The lack of hack-proof technology on the market costs the health businesses millions of dollars annually, to say nothing about their reputation and cybercrimes like ID thefts. This is why complying with HIPAA log retention requirements is critical to minimize the risks of undesirable outcomes. And this is where we start.
What Are the HIPAA Document Retention Requirements?
There are three main things to consider when it comes to HIPAA retention policy:
- entities that are subject to the policies;
- type of documents that fall under the consideration;
- retention duration (how long Medicare and Medicaid records should be retained for).
Being aware of the HIPAA documentation retention requirements, knowing the most important issues and who the affected parties are, is necessary for creating or using a marketable product that solves a problem without creating a few new ones. Let’s review each of those.
Who Are Required to Comply With HIPAA Record Retention Requirements?
According to the Act, there are a few main healthcare businesses (usually referred to as ‘covered entities’) that have to operate in accordance with the HIPAA medical records retention policies. These Covered Entities are:
- Health plans. They are individual or group health plans that provide or cover the cost of medical care.
- Healthcare providers, which can be both medical doctors and hospitals.
- Healthcare clearinghouses. These are public or private entities that help healthcare providers standardize health data elements.
- Business associates of HIPAA-covered entities. They are defined as a person/entity whose functions/activities involve the use or disclosure of protected health information (PHI) on behalf of, or provides services to, a covered entity.
If your business provides storage solutions that are intended for use by any of the above-mentioned entities, then their functioning, storage, and technologies used should meet the HIPAA requirements for medical records. In this article, we cover the basics and give you the direction pointers to move in if you or your business fall under any group of the mentioned Covered Entities. However, there are way more details to consider, and this is where you can access the full combined text of HIPAA-related regulations to build competitive development or marketing strategy for your product/service.
What Documents Are Subjects to Comply With HIPAA Data Retention Requirements?
There are two types of documents that are governed by HIPAA data retention regulations:
- Medical records – any types of file that document the patient’s history, clinical findings, exam results, undergone treatment, pre- and post-operative care, and medication;
- Non-medical HIPAA-related documents – those that should be issued during the process of securing, storing, processing, or destruction of medical records.
Any of the mentioned documents are legal documents, which means that their creation, use, storage, sharing, and distribution are regulated by state and federal laws. The security and safety of the information from paper and electronic medical records and non-medical documents are safeguarded by the HIPAA Privacy Rule and HIPAA Safety Rule. Our advice? Do a thorough research of the legal perspective before jumping into signing a contract with the medical institution, developer, or business associate to prevent facing some serious consequences.
HIPAA Document Retention Requirements: How Long to Keep Medical Records?
While the ways and standards of how to keep, transmit, and process the medical and non-medical documents are the same country-wide, the retention period for medical records and non-medical documents varies state-to-state. There are no statewide HIPAA medical records storage requirements about the duration of retention, and in many cases, it’s the state legislature that defines it, and the HIPAA doesn’t overrule the state laws in this case. If it all seems too confusing for you now, we feel you – it’s not the easiest part when it comes to creating or providing medical storage solutions, and there are still a few key things to consider to see the full picture. Namely – the factors that affect the duration of retention, which are the following:
- type of medical record – i.e. vaccination report, employee medical record, abortion, and others;
- state where the medical record is created.
Let’s view a few examples from the list of Federal Record Retention Requirements (Appendix A). For instance, information from the critical access hospitals (CAHs) should be kept for six years from the last day of entry or more if the state law requires it. In the meantime, the register file can be destroyed when no longer needed country-wide. The retention time of storing the data on ambulatory surgical services, in turn, isn’t specified at all for any state.
As you can see, the federal retention requirements of medical records are somewhat vague.
The local regulation, on the other hand, define other periods:
- Physicians of Florida should store the patient’s records for 5 years since the last visit date, hospitals – for 7;
- in Nevada – minimum 5, if the patient was minor – until they reach 23 years of age;
- in North Carolina – minimum 11, if the patient was minor – until they reach 30 years of age.
We recommend double-checking the local requirements and laws just to be on the safe side. Here you can read about the minimum medical record retention periods for records held by medical doctors and hospitals state by state.
What about Non-medical HIPAA-Related Documents?
This is where the situation is more straightforward and where the state laws are preempted by HIPAA in case they offer shorter retention terms.
According to Subpart C Security Standards for the Protection of Electronic Protected Health Information (CFR §164.316(b)(2)(i)), all the policies and procedures that are conducted by any Covered Entity to comply with this subpart to be in written (or electronic) form, and ‘(ii) If an action, activity or assessment is required by this subpart to be documented, maintain a written (which may be electronic) record of the action, activity, or assessment.’
Basically, all the written or electronic files that were issued as a result of actions conducted by any Covered Entity that involve the use or processing of the patients’ data have a very specific HIPAA retention period – 6 years. Below are the documents that fall under this regulation:
- Permission for PHI disclosure
- Privacy Practice Notices (if applied)
- Risk Analyses and Assessments
- Disaster Recovery and Back-Up Plans
- Agreements with Business Associates
- Data Security and Privacy Policies
- Staff Sanction Documentation
- Incident and Breach Notification Files
- Complaint and Resolution Files
- Physical Security Maintenance Log
- Log records for viewing of PHI
- IT System Audits
The list of documents that are governed by HIPAA record retention policies can be endless, depending on the business conducted by either Covered Entity or Business Associates. However, it shouldn’t stop or demotivate you – there is a way out! The best step you can take is to consult with the local health care providers, lawyers, or consultants concerning your particular case to make everything possible to fully understand the requirements and leave no space for unwanted consequences.
When it comes to developing, selling, or implementing the software aimed at facilitating legal documents processing (such as medical records), it’s paramount that all the requirements are followed at every step of the way. Knowing the tech standards and retention requirements give developers, business associates, and healthcare institutions the advantage of developing, providing, or using the best-in-class services that benefit every involved party without putting anything at risk. And while record retention requirements are a part of the broader HIPAA compliance policy, your software solution or services provider has to consider it before anything else. This is what we do in Empeek, and what you should do, too.