I recently did a deep dive into the actual size of the HIPAA industry. During those eight hours of research, I came across some interesting sub-sectors of HIPAA and also found myself with more unanswered questions. One of the sub-sectors of U.S. labor I had questions about are Special Education teachers. This post is about whether Special Education teachers face HIPAA compliance or not.
Before we dive in, let's do a quick overview of HIPAA. HIPAA, or the Health Insurance Portability and Accountability Act of 1996, covers both individuals and organizations. Those who must comply with HIPAA are called Covered Entities. Covered Entities include health plans, clearinghouses, and certain health care providers. Since Special Education educators are not considered health plans or clearinghouses, let's focus on health care providers.
For those of us familiar with HIPAA, these professions are obviously HIPAA Covered Entities. What we're trying to discover however, is whether a Special Education teacher also falls into this category.
The Centers for Medicare and & Medicaid Services (CMS) recently put out a tool called the Covered Entity Guidance tool. Let's use it to dig a little deeper into whether or not Special Education teachers face HIPAA compliance or not. Let's begin with the first question asked by the tool: "Does the person, business, or agency furnish, bill, or receive payment for, health care in the normal course of business?" In the case of Special Education teachers, I would say this is a yes. Health care is often furnished by Special Education teachers. The second question asked by the Covered Entity Guidance tool is: "Does the person, business, or agency transmit (send) any covered transactions electronically?" If the answer here is yes for Special Education teachers, then they would be considered a Covered Entity and fall under HIPAA. But wait! There's more to it. We need to account for another federal regulation- FERPA.
In addition, FERPA applies to all agencies and institutions that receive federal funding. This includes elementary and secondary schools, colleges, and universities. It should be noted however, that FERPA does not apply to private schools.
With a general overview of HIPAA and FERPA under our belt, we're getting closer to our answer of whether Special Education teachers face HIPAA compliance or not. I dig some more digging on Google and found a document called the Joint Guidance on the Application of the Family Educational Rights and Privacy Act (FERPA) And the Health Insurance Portability and Accountability Act of 1996 (HIPAA) To Student Health Records. I then found a key finding on page two: In addition, records that schools maintain on special education students, including records on services provided to students under the Individuals with Disabilities Education Act (IDEA), are “education records” under FERPA. This is because these records are (1) directly related to a student, (2) maintained by the school or a party acting for the school, and (3) not excluded from the definition of “education records.” There we have it: Special Education teachers do not fall under HIPAA compliance regulations. If they teach under an organization that receives federal funding however, they must comply with FERPA regulations. Mahalo to the Wrightslaw Way blog, which provided key elements to my research.
SEE RELATED: How Large is the HIPAA Industry?
Special Education is commonly abbreviated as special ed, SpecEd, SPED, or SpEd in a professional context. It is also known as special needs education, aided education or exceptional education.