Health Insurance Portability and Accountability Act (HIPAA) is a United States federal law enacted in 1996 that protects sensitive patient health information from being disclosed without the patient’s consent or knowledge. It combines provisions related to insurance portability, administrative simplification, and health information privacy and security.
It is a US-based concept and is not relevant in India. In India, the Insurance Regulatory and Development Authority in India (IRDAI) and the Digital Personal Data Protection Act, 2023 (DPDP) work together to serve the same purpose as the HIPAA does along with a few other organizations.
In today’s world, keeping your personal health information secure is more critical than ever. In the U.S., HIPAA establishes strict guidelines for storing and protecting personal medical data.
At Ditto, we help our customers navigate India’s insurance regulations and data protection laws, enabling them to choose the right policies with confidence. We also ensure that their personal and health information remains safe and secure.
This guide will help you understand:
- Who HIPAA applies to and what qualifies as protected health information (PHI).
- The roles and responsibilities of healthcare providers, insurers, and business associates.
- Practical steps to maintain HIPAA compliance and build patient trust.
Still unsure about buying an insurance policy without any privacy breach? Book a free call with us and let our experts guide you in making an informed decision.
Does India Have a HIPAA-Style Law?
India doesn’t have one “HIPAA-style” law, instead, it’s a combination of laws & guidelines. Let’s take a look at them:
In India, IRDAI ensures that insurance companies handle policyholder information securely, while the DPDP Act regulates personal data collection, storage, and use. Together, they create a robust framework to protect sensitive health and financial information, much like HIPAA does in the U.S.
Note:
The DPDP Act, 2023, is not yet fully operational. Enacted on 11 Aug 2023, it will come into force only after the final Rules are notified, expected by late September 2025.
Once live, the Data Protection Board can impose fines of up to ₹250 crore per breach, depending on the nature of the violation and the circumstances.
What is the Purpose of HIPAA?
The principal aim of HIPAA is to protect the privacy of Protected Health Information(PHI). Protected Health Information (PHI) refers to any personal details about your health, medical care, or payments that can identify you. It's created or handled by healthcare providers, insurers, or their partners and is protected under U.S. law to ensure your privacy.
Point to be Noted:
Under HIPAA, privacy, use, and disclosure have distinct meanings:
- Privacy Rules: Ensure patients give written consent before their personal health information is used or shared.
- Use: Refers to how healthcare staff handle and apply patient information within their organization.
- Disclosure: Involves sharing patient information with individuals or organizations outside the healthcare facility.
Under HIPAA, PHI is linked based on a list of 18 identifiers that must be treated with special care. HIPAA establishes standards to protect patient health information and guide healthcare practices. Its primary purposes include:
- Protecting Patient Privacy: Ensure confidentiality of health information and empower patients to control its disclosure.
- Securing Health Data: Mandate safeguards for transmitting, storing, and accessing protected health information (PHI) to prevent unauthorized use.
- Standardizing Compliance: Guide healthcare providers, insurers, and related organizations in implementing consistent privacy and security practices.
- Supporting Legal and Ethical Responsibilities: Educate healthcare professionals on their data protection and breach management obligations.
- Fostering Trust in Healthcare: Strengthen patient confidence through reliable data handling and adherence to regulatory requirements.
Did You Know?
On July 25, 2025, Star Health & Allied Insurance was fined ₹3.39 crore for violating IRDAI’s 2023 Cyber Security Guidelines. This was the first significant cyber enforcement action against an insurer in India.
What Are the 5 Main Components of HIPAA?
Title I (Health Care Access, Portability & Renewability)
Protects your insurance coverage when you change jobs or have pre‐existing conditions.
Title II (Preventing Health Care Fraud & Abuse; Administrative Simplification; Medical Liability Reform)
Introduces the Privacy Rule, Security Rule, national identifiers, and standards for electronic data.
Title III (Tax-Related Health Provisions)
Focuses on tax treatment of health insurance and medical expenses.
Title IV (Application & Enforcement of Group Health Plan Requirements)
Addresses rules for group health plans and policy structures.
Title V (Revenue Offsets)
Miscellaneous provisions, including employee benefits and company-owned life insurance rules.
Point to be Noted:
HIPAA enables policyholders in the U.S. to maintain and transfer their health coverage and records, even when changing jobs or employment.
Similarly, in India, the IRDAI enables retail health insurance portability, allowing policyholders to retain continuity benefits, such as waiting-period credits.
What are HIPAA-Covered Entities?
HIPAA applies to specific individuals and organizations, known as covered entities, who handle protected health information (PHI).
HIPAA-Covered Entities
Healthcare providers
Health plans
Healthcare clearinghouses
Business associates
Did You Know?
The Digital Information Security in Healthcare Act (DISHA) Act, designed to protect your digital health data, was merged into India's broader Data Protection Framework. This unified law ensures your health information is used securely, keeps your data private, and avoids overlapping regulations, making healthcare data protection more straightforward and reliable.
What Are HIPAA-Permitted Uses and Disclosures?
HIPAA allows healthcare providers and insurers to use or share PHI without a patient’s written consent in specific cases. Here’s when PHI can be used or disclosed:
- To the individual: When patients request access to their records or a record of disclosures.
- For treatment, payment, and healthcare operations: To coordinate care, process claims, or manage healthcare services.
- With a patient opportunity to agree or object: When informal permission is given verbally or through clear circumstances.
- As a limited dataset: For research, public health, or healthcare operations.
- For public interest or national priorities, such as law enforcement, government oversight, or public health reporting.
Click here to know more about the 12 national priority purposes where the Privacy Rule permits use and disclosure of PHI, without an individual's authorization or permission.
Does HIPAA Apply to Telehealth and Digital Health?
HIPAA applies strictly to telehealth, covering all electronic information exchanges such as video calls, online chats, and remote health monitoring. Healthcare providers must use secure platforms with encryption, strong authentication, and confidentiality agreements to protect sensitive data.
During telehealth sessions, doctors should connect with their patients from private spaces, such as clinics or offices, and patients are encouraged to join from a private setting, whether at home or elsewhere.
If complete privacy is not possible, simple steps, such as lowering your voice or avoiding speakerphones, can help keep personal health information secure.
Even during emergencies, when some HIPAA rules may be temporarily relaxed to support healthcare delivery, privacy and data protection remain top priorities. These safeguards help ensure that virtual care is safe and compliant, maintaining patient trust in digital healthcare.
Ditto’s Take on Customer Privacy
At Ditto, keeping your data safe is our top priority. We never share customer passwords or personal information. Access to personally identifiable information (PII) is strictly limited to the Internal Compliance head and the CTO, with multiple approvals required. PII is never shared with external vendors, and any access is strictly limited to serving our customers efficiently and securely.
Our dedication to client privacy is supported by regulatory audits, including the Insurance Self-Network Platform (ISNP). These audits have consistently reported no issues, demonstrating our firm commitment to protecting customer information.
Why Talk to Ditto for Your Health Coverage?
At Ditto, we’ve assisted over 7,00,000 customers with choosing the right insurance policy. Why customers like Arun below love us:
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Health Insurance Portability and Accountability Act: Final Thoughts
Here’s what you need to know about HIPAA and protecting health information:
- Nearly 30 years ago, HIPAA transformed the way healthcare data privacy operates in the U.S.
- India is now building a similar framework through the DPDP Act, ABDM, and IRDAI guidelines.
- Once the DPDP Rules are enforced and the Data Protection Board is operational, healthcare entities will adhere to HIPAA-like privacy standards tailored for India's digital health future.
Still unsure about buying an insurance policy without any privacy breach? Book a free call with us and let our experts guide you in making an informed decision.
FAQs
What is a business associate under HIPAA, and what contracts are required?
Business Associates are individuals or companies that provide services to Covered Entities and may access PHI, such as cloud providers or billing firms. They must sign a Business Associate Agreement (BAA) outlining their HIPAA responsibilities.
What types of data are protected by HIPAA?
HIPAA protects all health-related data, whether written, spoken, on paper, or electronic. This includes information transmitted within or outside healthcare facilities, and applies to any person or organization handling such data, regardless of its size.
What are the qualifications and responsibilities of a HIPAA security officer?
A HIPAA security officer typically has an IT background and is responsible for creating and maintaining security policies, auditing systems, conducting risk assessments, and ensuring compliance with HIPAA rules.
What happens if there’s a breach of PHI?
The covered entities must investigate breaches, notify affected individuals, and report to federal authorities. Violations can lead to significant fines.
What are legal exceptions to patient confidentiality?
Healthcare professionals may report without patient consent in cases like gunshot or stab wounds, injuries from crimes, abuse of children or older adults, and certain infectious or reportable diseases.
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