HIPAA vs HITRUST: Differences, Use Cases, and Interconnection
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HIPAA vs HITRUST: Differences, Use Cases, and Interconnection
When it comes to safeguarding protected health information (PHI), the regulatory and compliance field can be both complex and critical for any organization handling patient data. Two prominent names in this space are the Health Insurance Portability and Accountability Act (HIPAA) and the HITRUST Common Security Framework (CSF). Both are vital for healthcare organizations, cloud-based SaaS providers offering secure customer support desks, and any business associates involved in processing or storing sensitive patient data.
Understanding HIPAA
HIPAA is a U.S. federal law enacted in 1996 with the primary goal of ensuring the privacy and security of health information. It sets national standards for the protection of electronically protected health information (ePHI). HIPAA consists of rules such as the Privacy Rule, the Security Rule, and the Breach Notification Rule. Compliance with HIPAA is mandatory for covered entities (like healthcare providers, health plans, and clearinghouses) and their business associates.
Organizations that fail to comply with HIPAA face potential fines, legal consequences, and reputational damage. For that reason, many healthcare providers, insurers, and their partners invest significantly in robust security measures, including advanced security controls for their cloud-based applications and customer support desks.
Understanding HITRUST
HITRUST CSF is a robust, certifiable security and privacy framework. It was created to help organizations across various sectors, including healthcare, streamline compliance with multiple regulatory standards and frameworks such as HIPAA, ISO, NIST, and PCI. Although it's not a legal requirement, HITRUST certification provides assurances that an organization's security program meets rigorous benchmarks for risk management and regulatory compliance.
The HITRUST CSF is scalable based on an organization's size, complexity, and type of data it processes. This makes it particularly appealing for healthcare and related industries aiming to combine multiple security and privacy guidelines under one unified framework. For SaaS providers offering HIPAA compliance support within a secure customer support desk, pursuing HITRUST certification can be an excellent way to showcase their commitment to comprehensive security.
Key Differences Between HIPAA and HITRUST
- Legal vs. Voluntary: HIPAA is a federal law, mandatory for covered entities and business associates in the U.S. healthcare industry. HITRUST, on the other hand, is a private initiative and voluntary framework, though increasingly required by large healthcare organizations as a best-practice standard.
- Scope: HIPAA focuses on the privacy and security of PHI. HITRUST CSF is broader, integrating multiple standards and regulations, including HIPAA, PCI, NIST, and ISO.
- Certification: You can achieve HITRUST certification through a validated assessment, whereas there is no formal "HIPAA certification" from the government. HIPAA compliance is demonstrated through audits and risk assessments, but there's no official certification body for HIPAA.
- Guidance Detail: HIPAA sets general requirements and objectives, offering flexibility but often leaving room for interpretation. HITRUST CSF provides a more detailed framework with prescriptive controls and assessment methods, helping organizations explicitly meet various compliance requirements.
Who Uses HIPAA vs. HITRUST?
HIPAA is used primarily by healthcare providers, health plans, clearinghouses, and any business associates with access to PHI. These include cloud-based customer support desk platforms that handle patient-related inquiries or store patient data on behalf of these covered entities. Any organization that deals directly or indirectly with PHI in the United States must comply with HIPAA.
HITRUST, while heavily adopted in the healthcare sector, extends beyond just healthcare. Many organizations that value comprehensive security controls, such as financial services firms, also use HITRUST for risk management. However, it remains most popular in healthcare because it aligns strongly with HIPAA and other healthcare regulations.
Why Do They Exist and How Are They Connected?
Both HIPAA and HITRUST exist to protect sensitive health information:
- HIPAA: Enforces the minimum necessary standard of privacy and security for PHI across the U.S. healthcare industry.
- HITRUST: Consolidates various industry regulations, including HIPAA, into one framework, ensuring that organizations can demonstrate compliance with a wide range of requirements.
They are deeply connected because the HITRUST CSF includes HIPAA requirements. Organizations that implement HITRUST effectively cover the necessary safeguards to meet HIPAA standards, although they still must ensure all HIPAA-specific rules are properly addressed.
What is HIPAA?
HIPAA (Health Insurance Portability and Accountability Act) is a U.S. federal law passed in 1996 that sets national standards for protecting sensitive patient health information. It applies to covered entities (healthcare providers, health plans, and healthcare clearinghouses) and their business associates. For details on protected health information, see our article on What is PHI and which information is protected.
HITRUST vs. HIPAA: Compliance and Certification
One fundamental difference between HIPAA and HITRUST is how compliance is determined:
HIPAA Compliance
- No official certification program
- Self-assessment or third-party audits
- OCR evaluates during investigations
- No expiration or renewal process
HITRUST Certification
- Formal certification process
- Requires authorized external assessors
- Validation by HITRUST Alliance
- Certifications valid for two years
Looking for another comparison? Learn about the differences between HIPAA and SOC2 compliance frameworks.
Frequently Asked Questions
1. Is HIPAA compliance mandatory?
Yes. HIPAA is a federal law in the United States, and any covered entity or business associate that handles protected health information must comply.
2. Can I be "HIPAA certified" like I can be HITRUST certified?
No. There is no official HIPAA certification program from the U.S. government. You can have a HIPAA audit or assessment, but only HITRUST offers a formal certification process.
3. Do I need both HIPAA and HITRUST for my organization?
Depending on your organization's risk management strategy and client demands, you may benefit from HITRUST certification while remaining HIPAA-compliant. HIPAA compliance alone is mandatory if you handle PHI, but HITRUST is often pursued to prove compliance with multiple frameworks.
4. Who oversees HIPAA enforcement?
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) enforces HIPAA, investigating breaches and non-compliance issues.
5. Is HITRUST only for U.S.-based healthcare organizations?
No. Although HITRUST was originally developed with U.S. healthcare regulations in mind, it is now used by organizations globally that want a unified framework for managing data security across multiple standards.
6. How often do organizations need to re-certify for HITRUST?
HITRUST certification typically needs to be renewed every two years, although interim reviews are required to maintain certification status.
7. Does using a SaaS customer support desk require HIPAA or HITRUST compliance?
If your SaaS customer support desk handles PHI on behalf of covered entities, HIPAA compliance is a must. Pursuing HITRUST certification can further assure clients of robust security controls.
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