⚠️ January 2025 HIPAA Security Rule Updates Now in Effect
Healthcare Compliance Guide

HIPAA vs HITECH vs HITRUST

Understanding the differences between healthcare compliance frameworks and how they work together to protect patient data.

The Quick Answer

HIPAA is federal law that requires healthcare organizations to protect patient data. HITECH (2009) strengthened HIPAA with higher penalties and EHR requirements—it's now part of HIPAA compliance. HITRUST is a voluntary certification framework that helps you prove your compliance.

Think of it this way: HIPAA/HITECH tells you what to protect, and HITRUST tells you how to prove you're protecting it.

Understanding Each Framework

Each framework serves a different purpose in the healthcare compliance landscape.

HIPAA

Health Insurance Portability and Accountability Act

Federal LawEst. 1996Mandatory

The foundational federal law requiring healthcare organizations to safeguard patient data. HIPAA defines the 'what' of healthcare compliance.

Key Points

  • Applies to Covered Entities (healthcare providers, health plans, clearinghouses)
  • Extends to Business Associates handling PHI
  • Privacy Rule governs use and disclosure of PHI
  • Security Rule protects electronic PHI (ePHI)
  • Breach Notification Rule requires reporting incidents
Penalties

Up to $2.13M per violation category per year

Enforcement

HHS Office for Civil Rights (OCR)

HITECH

Health Information Technology for Economic and Clinical Health Act

Federal Law (HIPAA Amendment)Est. 2009Mandatory

Strengthened HIPAA enforcement and promoted adoption of electronic health records. HITECH modernized HIPAA for the digital age.

Key Points

  • Part of American Recovery and Reinvestment Act (ARRA)
  • Dramatically increased penalties for HIPAA violations
  • Extended HIPAA requirements to Business Associates directly
  • Promoted 'Meaningful Use' of Electronic Health Records
  • Established Breach Notification requirements
  • Created HIPAA Safe Harbor for organizations with recognized security practices
Penalties

Tiered penalties up to $2.13M per violation category

Enforcement

HHS Office for Civil Rights (OCR)

HITRUST

Health Information Trust Alliance Common Security Framework

Private Certification FrameworkEst. Founded 2007Voluntary

A voluntary certification framework that provides a standardized approach to demonstrating compliance. HITRUST is the 'how' to HIPAA's 'what'.

Key Points

  • Voluntary certification (not required by law)
  • Harmonizes 60+ regulatory frameworks including HIPAA, NIST, ISO, PCI
  • Provides certifiable proof of security controls
  • Three assessment levels: Self, Validated, and Certified
  • 99.41% breach-free rate among certified environments
  • Often required by healthcare partners and payers
Penalties

No legal penalties (contractual consequences only)

Enforcement

HITRUST Alliance (private organization)

Side-by-Side Comparison

A detailed comparison of HIPAA, HITECH, and HITRUST across key dimensions.

AspectHIPAAHITECHHITRUST
Legal StatusFederal lawFederal law (amends HIPAA)Private framework
Year Established199620092007
Mandatory?YesYesNo (but often contractually required)
Applies ToCovered Entities & BAsCovered Entities & BAsAny organization seeking certification
Certification AvailableNo official certificationNo official certificationYes (3 levels)
Government EnforcedYes (HHS OCR)Yes (HHS OCR)No
Audit RequirementSelf-compliance requiredSelf-compliance requiredThird-party assessment required
Cost to ComplyVaries (internal costs)Varies (internal costs)$40,000 - $200,000+ for certification
TimelineOngoingOngoing6-12 months for initial certification

How They Work Together

These frameworks complement each other to create a comprehensive compliance approach.

1. HIPAA

Establishes the legal requirements for protecting patient health information.

The Law

2. HITECH

Strengthens HIPAA with increased penalties and breach notification requirements.

The Enforcement

3. HITRUST

Provides a certifiable framework to demonstrate compliance with HIPAA and more.

The Proof

Important Note for 2025

The January 2025 HIPAA Security Rule updates make HIPAA more prescriptive, with mandatory MFA, encryption, and annual audits. These changes align HIPAA closer to frameworks like HITRUST. Organizations that have already implemented HITRUST controls will likely find the new HIPAA requirements easier to meet.

Frequently Asked Questions

Do I need HITRUST if I'm already HIPAA compliant?

Not necessarily. HIPAA compliance is legally required, but HITRUST certification is voluntary. However, many healthcare organizations, payers, and partners now require HITRUST certification as a condition of doing business. If your customers or partners require it, you'll need to pursue certification regardless of your HIPAA compliance status.

Is HITECH separate from HIPAA?

HITECH is technically a separate law, but it amended and strengthened HIPAA. Today, when people refer to 'HIPAA compliance,' they're really talking about HIPAA as modified by HITECH. You don't need to think of them as separate compliance obligations—HITECH is baked into modern HIPAA requirements.

Can I get 'HIPAA certified'?

No. There is no official HIPAA certification issued by the government. Organizations self-certify their compliance by implementing required safeguards and maintaining documentation. However, you can get HITRUST certified, which demonstrates your compliance with HIPAA and other frameworks.

Which framework should I prioritize?

Start with HIPAA/HITECH compliance—it's legally required. Once you have solid HIPAA controls in place, consider HITRUST if your business partners require it or if you want third-party validation of your security posture. HITRUST builds on HIPAA, so the work overlaps significantly.

How does HITRUST help with HIPAA compliance?

HITRUST provides a prescriptive, certifiable framework that maps directly to HIPAA requirements. While HIPAA tells you what to protect, HITRUST tells you exactly how to protect it with specific controls. A HITRUST certification provides documented evidence that you've implemented appropriate safeguards.

What are the 2025 HIPAA updates?

The January 2025 HIPAA Security Rule updates include mandatory multi-factor authentication (MFA), encryption requirements for all ePHI, 24-hour breach notification to HHS, annual security audits, and network segmentation requirements. These updates make HIPAA more prescriptive and align it closer to frameworks like HITRUST.

Start Your Compliance Journey

Take our free assessment to understand your current HIPAA compliance status and identify gaps to address.