HITECH in healthcare refers to the Health Information Technology for Economic and Clinical Health Act, a 2009 federal law that promoted adoption and meaningful use of certified electronic health record technology and strengthened HIPAA compliance by expanding obligations for Business Associates, establishing federal breach notification requirements, increasing enforcement funding and oversight, and enhancing civil and criminal enforcement tools tied to protected health information.
HITECH was enacted as part of the American Recovery and Reinvestment Act of 2009 and paired health information technology adoption goals with privacy and security requirements. The law created Medicare and Medicaid incentive programs administered by the Centers for Medicare and Medicaid Services to support implementation and use of certified electronic health record technology, and it authorized related standards and certification functions through federal health information technology programs.
HITECH changed HIPAA compliance by extending direct legal responsibility to Business Associates for specified HIPAA Security Rule requirements and for certain HIPAA Privacy Rule provisions through the HIPAA Rules. Business Associates became subject to enforcement actions for noncompliance, and covered entities were required to obtain more explicit contractual assurances through Business Associate Agreements that reflect the expanded compliance scope.
HITECH also established a federal breach notification framework for unsecured protected health information. Covered entities became responsible for providing notice to affected individuals following a breach, providing notice to the HHS Secretary, and providing notice to the media for breaches affecting 500 or more residents of a state or jurisdiction, using timelines and content requirements defined in the HIPAA Breach Notification Rule. Business Associates became responsible for notifying covered entities of breaches of unsecured protected health information they discover. The “unsecured” standard is tied to whether the information is rendered unusable, unreadable, or indecipherable to unauthorized persons through methods identified by federal guidance adopted under the HIPAA Breach Notification Rule framework.
HITECH increased enforcement activity by directing additional resources and oversight to the HHS Office for Civil Rights and by requiring periodic audits of covered entities and business associates. HITECH also strengthened penalty exposure by implementing the statutory tiered civil money penalty structure used for HIPAA administrative simplification violations and by reinforcing the role of corrective action measures such as policies, procedures, safeguards, online HIPAA training, risk analysis, risk management, and ongoing monitoring.
HITECH addressed patient rights and transparency in ways that connect to electronic records. The HIPAA Rules, as modified and implemented after HITECH, expanded an individual’s right to receive an electronic copy of protected health information when the information is maintained electronically, and it supported tighter controls over certain disclosures, including restrictions on disclosures to health plans when an individual pays out of pocket in full for a service and requests the restriction.
In operational terms, HITECH drives a combined compliance and technology posture. Covered entities and business associates using electronic systems to create, receive, maintain, or transmit electronic protected health information need administrative, physical, and technical safeguards consistent with the HIPAA Security Rule, breach response procedures aligned to the HIPAA Breach Notification Rule, and workforce practices that enforce the HIPAA Privacy Rule limitations on use and disclosure, including the HIPAA Minimum Necessary Rule where applicable.