HIPAA vs. PIPEDA: Similarities, Differences and Compliance Practices

What is HIPAA? 

The Health Insurance Portability and Accountability Act (HIPAA) is a U.S. federal law enacted in 1996. Its primary purpose is to protect the privacy and confidentiality of patients’ health information. HIPAA sets standards for the electronic exchange, privacy, and security of health information. The law applies to healthcare providers, health plans, and healthcare clearinghouses, ensuring that sensitive patient information is handled securely.

HIPAA mandates specific safeguards, including physical, administrative, and technical protections, to ensure that patient data is secure. The Act also grants individuals rights over their health information, allowing them to review their records, request corrections, and set limits on who can access their information. HIPAA compliance is crucial for healthcare organizations to prevent unauthorized disclosures and breaches of patient information.

What is PIPEDA? 

The Personal Information Protection and Electronic Documents Act (PIPEDA) is Canadian federal legislation that came into effect in 2000. PIPEDA governs how private sector organizations collect, use, and disclose personal information during commercial activities. The Act aims to ensure that businesses respect the privacy rights of individuals while collecting, using, or disclosing their personal data.

PIPEDA applies to all private sector organizations in Canada, except those covered by provincial laws deemed substantially similar to PIPEDA. The law requires organizations to obtain individual consent before collecting personal information and to provide clear explanations of how the information will be used. Organizations must also implement appropriate security measures to protect personal data and ensure compliance with the Act’s requirements.

Similarities Between PIPEDA and HIPAA

Protection of personal information

Both HIPAA and PIPEDA emphasize the protection of personal information. HIPAA protects health information, requiring entities to implement safeguards against unauthorized access and breaches. It mandates regular risk assessments and security measures to ensure compliance with its privacy and security rules.

PIPEDA similarly requires businesses to protect personal information during collection, use, and disclosure. Organizations must obtain explicit consent from individuals before using their personal data and ensure the information is securely stored. Both regulations share a common goal of maintaining individual privacy and securing sensitive information.

Rights of individuals

HIPAA and PIPEDA grant significant rights to individuals regarding their personal information. Under HIPAA, patients can access their health records, request corrections, and control certain disclosures of their information. This ensures transparency and gives individuals greater control over their health data.

PIPEDA provides comparable rights, allowing individuals to access their information and request corrections if inaccuracies are found. It also requires organizations to inform individuals about how their data will be used, ensuring transparency.

Enforcement

The U.S. Department of Health and Human Services (HHS) enforces HIPAA, conducting audits and imposing fines for non-compliance. Entities found in violation of HIPAA can face substantial penalties, including monetary fines and corrective action plans.

PIPEDA enforcement is overseen by the Office of the Privacy Commissioner of Canada (OPC). The OPC investigates complaints, conducts audits, and can make recommendations. While PIPEDA does not impose fines directly, the OPC can refer cases to the Federal Court, which can order organizations to correct practices and award damages.

Tips from the expert

Steve Moore is Vice President and Chief Security Strategist at Exabeam, helping drive solutions for threat detection and advising customers on security programs and breach response. He is the host of the “The New CISO Podcast,” a Forbes Tech Council member, and Co-founder of TEN18 at Exabeam.

In my experience, here are tips that can help you better manage compliance with HIPAA and PIPEDA:

Use an integrated compliance management system: Develop an integrated compliance management system that consolidates HIPAA and PIPEDA requirements into a single platform. This system can streamline compliance activities, making it easier to track and report on adherence to both sets of regulations.

Advanced encryption protocols: While both HIPAA and PIPEDA require encryption, go beyond basic encryption by adopting advanced protocols like homomorphic encryption. This allows for data processing without decrypting it, reducing exposure to risks during data analysis and use.

Data minimization techniques: Implement data minimization strategies where only the minimal amount of personal data necessary for the task is collected, used, or retained. This approach reduces the risk of non-compliance and enhances overall data security.

Third-party vendor management: Conduct rigorous due diligence on third-party vendors to ensure they comply with both HIPAA and PIPEDA. Include specific contractual obligations in vendor agreements to enforce compliance and mitigate the risk of data breaches.

Incident simulations and drills: Regularly conduct incident simulations and drills that involve scenarios relevant to both HIPAA and PIPEDA. This prepares your organization for real-life incidents, ensuring that your response is compliant with both regulations.

HIPAA vs. PIPEDA: The Key Differences 

Scope and Jurisdiction

HIPAA and PIPEDA differ significantly in their scope and jurisdiction. HIPAA applies exclusively within the United States and focuses on healthcare information. It covers a broad range of entities including healthcare providers, health plans, and clearinghouses. Its jurisdiction is confined to protecting medical information within the healthcare sector.

PIPEDA has a wider application, covering any private sector organization in Canada that collects, uses, or discloses personal information during commercial activities. PIPEDA’s jurisdiction is not limited to healthcare information. Its scope includes all types of personal data, making it broadly applicable across different industries within Canada.

Scope of Protected Information

HIPAA strictly pertains to the protection of “Protected Health Information” (PHI), which includes any information that can be used to identify an individual and relates to their health status, healthcare provision, or healthcare payment information. It focuses specifically on the privacy and security aspects of health-related information.

PIPEDA safeguards a broader range of personal information and is not confined to just health data. This includes any information about an identifiable individual, such as age, name, ID numbers, income, ethnic origin, or blood type. While PIPEDA can encompass health data, its protective umbrella extends to all forms of personal information handled by private sector organizations.

Consent Requirements

HIPAA requires covered entities to obtain consent or authorization from the individual to use or disclose their PHI for purposes other than treatment, payment, or healthcare operations. In certain cases, HIPAA allows for the disclosure of PHI without consent, such as for public health purposes or as required by law.

PIPEDA mandates obtaining meaningful consent from individuals before collecting, using, or disclosing their personal information. This involves being transparent about the purposes for which the information is being collected and ensuring individuals understand and agree to these uses. Consent under PIPEDA can be explicit or implied, depending on the sensitivity of the information.

Breach Notification

Under HIPAA, covered entities and their business associates must notify affected individuals, the HHS, and, in some cases, the media, promptly following a breach involving unsecured PHI. The notification process ensures transparency and allows individuals to take protective actions.

PIPEDA requires organizations to notify individuals and the OPC when a data breach poses a real risk of significant harm. The notification must include details about the breach and the steps being taken to mitigate the risks. Organizations must also maintain records of all breaches, whether or not they pose significant harm, ensuring accountability in their data handling practices.

Penalties for Non-Compliance

Penalties for non-compliance under HIPAA can be severe. The HHS Office for Civil Rights (OCR) can impose financial penalties that vary based on the level of negligence. Fines can range from 100 to $50,000 per violation, with a maximum annual penalty of $1.5 million for repeated violations. Criminal charges may also apply in extreme cases.

PIPEDA’s penalty structure is less direct. While the OPC can recommend changes and compliance measures, it cannot impose fines directly. However, the Federal Court can order organizations to alter their practices and may award damages to affected individuals. Organizations failing to meet PIPEDA’s requirements face public disclosure and potential litigation, which also serve as significant deterrents.

Data Protection and Security Measures

HIPAA requires covered entities to implement administrative, physical, and technical safeguards to protect PHI. These measures include secure access controls, training programs, audit controls, and encryption to ensure data integrity and confidentiality. Regular risk assessments are mandated to identify and mitigate vulnerabilities.

PIPEDA also emphasizes data protection measures, though it is less prescriptive than HIPAA. Organizations must protect personal information with security safeguards appropriate to the sensitivity of the information. This includes physical, organizational, and technological measures, such as securing physical access, employee training, and employing encryption and other cybersecurity practices.

Best Practices for Complying with Both HIPAA and PIPEDA 

Establish Robust Data Protection Policies

To comply with both HIPAA and PIPEDA, organizations should establish data protection policies. These policies should outline how personal data will be collected, used, stored, and disposed of securely. They should also define roles and responsibilities for data protection within the organization.

Documenting and regularly updating these policies ensures that they remain effective and relevant. Policies should be communicated clearly to all employees and stakeholders, and training programs should be implemented to ensure everyone understands their responsibilities. This proactive approach helps to prevent data breaches and ensure compliance with both regulations.

Implement Audit Controls

Implementing audit controls is essential for monitoring and maintaining compliance with HIPAA and PIPEDA. These controls involve systematically reviewing access logs, user activities, and data transactions to detect unauthorized access or suspicious behavior. HIPAA mandates audit controls to ensure the integrity and security of PHI. This includes using software tools to monitor access patterns and generate alerts for potential breaches.

Under PIPEDA, audit controls should also be implemented to track data access and usage. Organizations need to maintain logs that record when and by whom personal data is accessed, altered, or deleted. Regular audits of these logs help identify any irregularities or non-compliance with data protection policies.

Conduct Regular Risk Assessments

Regular risk assessments are vital for identifying and mitigating potential threats to personal data. Under HIPAA, conducting thorough risk assessments is mandated to uncover vulnerabilities and implement necessary safeguards. This process helps healthcare entities maintain the confidentiality, integrity, and availability of PHI.

Similarly, under PIPEDA, organizations should perform regular assessments to evaluate the risks associated with their data handling practices. These assessments should include evaluating technological threats, organizational weaknesses, and physical security gaps. 

Implement Strong Safeguards

Implementing strong safeguards is essential to protect personal data and ensure compliance with both HIPAA and PIPEDA. HIPAA requires covered entities to employ administrative, physical, and technical safeguards, such as encrypting data, using access controls, and conducting regular audits to secure PHI.

PIPEDA also calls for organizations to implement security measures based on the sensitivity of the personal data. This includes employing encryption techniques, automatic log-off systems, and secure data disposal methods.

Ensure Consent Mechanisms are Robust

Ensuring robust consent mechanisms is crucial for compliance with both HIPAA and PIPEDA. HIPAA requires explicit consent for the use or disclosure of PHI, except in specific situations such as treatment, payment, or healthcare operations. Clear and unambiguous consent forms help meet this requirement.

PIPEDA mandates meaningful consent, which means individuals must be fully informed about how their data will be used. Organizations should provide clear, concise explanations and obtain explicit or implicit consent based on the context and sensitivity of the information.

Develop an Incident Response Plan

Developing an incident response plan is a best practice for handling data breaches and ensuring compliance with HIPAA and PIPEDA. The plan should outline steps for detecting, reporting, and responding to data breaches promptly. This includes notifying affected individuals and relevant authorities as required by the respective regulations.

Regularly testing and updating the incident response plan ensures its effectiveness. Training employees on their roles and responsibilities during a data breach is also critical. A well-defined and practiced incident response plan helps minimize damage, ensures regulatory compliance, and maintains customer trust in the event of a breach.

HIPAA Compliance with Exabeam

Noncompliance with HIPAA can result in heavy fines from OCR and other consequences. When patch management, access controls, and monitoring are not fully implemented with the right solution stack, it leaves the organization vulnerable to ransomware and other attack vectors that can impact patient care. 

Exabeam Security Operations Platform telemetry combines logs with context, security intelligence feeds, and AI analysis to identify anomalous behaviors that indicate potential attacks. Pre-built Dashboards make HIPAA Compliance reporting easier. Whether you are using a framework like NIST or MITRE ATT&CK^Ⓡ, Exabeam offers a clear path to track your compliance and governance request needs — while all establishing what normal looks like in your environment and for every entity logged in. 

The Outcomes Navigator offers continuous visualization and insight into your detection coverage and improvements made, which provides suggestions for improvements in log parsing as well as showing which sources and detections are most effective against which parts of the ATT&CK framework and use cases are most indicative of network penetration, persistence, and lateral movement.