What is Compliance as a Service?

Complying with complex industry regulations such as the Health Insurance Portability and Accountability Act (HIPAA) can be a challenge, which is why many healthcare organizations and business associates choose compliance as a service (CaaS). In this post we will explain the advantages and disadvantages of CaaS, why it may be a good choice for your business, and how CaaS works. This post is written for healthcare providers and vendors looking to work in the healthcare industry in the United States, but the principles apply to other regulated industries and compliance with state and federal laws other than HIPAA.

What Exactly is Compliance as a Service?

HIPAA Rules introduce minimum standards for privacy and security, stipulate transaction and code sets that must be used, lay down the requirements for reporting data breaches, and explain the rights that patients and health plan members have over their healthcare data.

While these requirements are all explained in detail in the 115 pages of the combined HIPAA text, the language is often complex, several provisions are open to interpretation, the security measures that need to be implemented can vary considerably from organization to organization, and HIPAA does not come with an instruction manual.

Ensuring compliance with all aspects of HIPAA can therefore be a time consuming, labor intensive, costly, and difficult task. Add to that the harsh penalties for even accidental violations of HIPAA Rules, and it is not surprising that many healthcare organizations and vendors seek assistance through compliance as a service.

In simple terms, compliance as a service is provided by third-party compliance experts who will help ensure you are fully compliant with certain regulations. This service may be provided for a specific set of regulations such as HIPAA, FERPA, CCPA, or Sarbanes-Oxley, or a combination of state and federal regulations.

Many cloud service providers also offer this service. With cloud service providers, what they are offering is a platform or service that has been pre-configured to ensure compliance. They essentially take the complexity out of compliance by providing a platform or service that meets the requirements of certain regulations.

In both cases, the service does not guarantee compliance. There will still be work required to achieve and maintain compliance and it will still be possible to violate regulations. These services simply reduce the burden of compliance by eliminating much of the work, reducing effort you will need to put in. Ultimately, it will still be entirely your responsibility to achieve and maintain compliance. If you fail a compliance audit, it will be you and not the service provider that will be fined, although you may have grounds to take legal action against the service provider in certain circumstances.

Benefits of Compliance as a Service

There are several important benefits to using compliance as a service. The most important being you will be confirmed as compliant with all aspects of HIPAA Rules and will not misinterpret what is required of you and your business.

While you may be able to achieve compliance on your own, any error or omission could have major financial consequences. The HHS’ Office for Civil Rights has an audit program and conducts compliance reviews following a data breach. The number of data breaches now occurring makes a compliance review more likely than ever before.

HIPAA does not include a private cause of action, so a healthcare organization or business associate cannot be sued for noncompliance with HIPAA Rules, but lawsuits can be filed if there have been violations of state laws. If a lawsuit establishes HIPAA Rules have not been followed, that may influence the outcome of the legal action.

Getting help complying with HIPAA can save a considerable amount of time, money, and effort, especially for small- to medium-sized organizations. Compliance as a service providers will not only help you achieve HIPAA compliance, they will also help you remain compliant. These services will reduce the compliance burden and give you peace of mind that not only will you survive an audit or compliance review, it will run far more smoothly.

How Does Compliance as a Service Work?

Companies offering HIPAA compliance as a service will provide a framework that you can adopt to achieve compliance, and often computer software to guide you on your journey to compliance. Throughout the process, compliance experts will be available to explain any provisions that are unclear and will tell you how certain aspects of the regulations apply to your business. They will also explain best practices to adopt to achieve compliance faster and maintain your compliant status over time.

Typically, once you have completed the process your good faith efforts toward compliance will be assessed by the service provider and you will be confirmed as having met all requirements to the regulations.

Certified as HIPAA Compliant?

After successfully completing the compliance process you may receive some kind of “certification” showing you are HIPAA compliant; however, there is no HIPAA compliant certification that is recognized by industry regulators. The reason is because any certification only demonstrates that you are compliant at a specific moment in time – the point when certification was issued. The very next day you could do something that violates HIPAA, which would make that certification invalid.

Compliance is not a one-time checklist item; it is an ongoing process. You should therefore view these services as a way to simplify compliance and help you navigate the complex compliance landscape with minimal effort, which will allow you to continue to focus on your business goals.

HIPAA compliance as a service could potentially save you millions of dollars, not only by streamlining the compliance process and reducing the time and effort involved, but also helping to maintain compliance and helping to prevent regulatory fines.