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Editor’s Note: This guide was originally published on August, 2022. It was comprehensively revised and updated on January 2026, to include the latest HHS regulations, the new February 2026 NPP requirements, and modernized encryption standards for rehab clinics.
Making sure you are following all the rules and regulations regarding HIPAA compliance as a new therapy practice owner can be stressful and confusing! In this article, we’ll go over the main policies of HIPAA compliance and the updated tools you can use to maintain regulations within your physical, occupational, or speech therapy practice.
What is HIPAA and Why Is It Important?
The Health Insurance Portability and Accountability Act (HIPAA) was created in 1996 and requires covered entities to protect patient health information.
As therapists and assistants, we are subject to HIPAA requirements. While the core mission of protecting ePHI (electronic Protected Health Information) remains the same as it was in 2022, 2026 updates place a much heavier emphasis on patient data autonomy and cybersecurity transparency.
What penalties could you face in 2026?
The Office for Civil Rights (OCR) has increased enforcement focus. While they still offer a “correction period” for unintentional errors, the fines for willful neglect (such as not having a signed BAA or failing to perform a Risk Assessment) have risen with inflation:
Minimum Fine: ~$140 per violation for reasonable compliance.
Maximum Fine: Up to $2.1 million annually for systemic neglect.
The takeaway? Government organizations understand HIPAA is complex, but in 2026, they expect you to have a documented digital defense.
Key HIPAA Compliance Steps for 2026
1. The Mandatory Risk Assessment Plan
It is mandatory to create a plan for protecting your patients’ information. You must document:
Your Risks: Where is your data vulnerable? (e.g., mobile tablets, old backup drives).
Your Procedures: How do you handle a request for records?
Your Policies: Are your staff trained annually?
2026 Requirement: You must now explicitly document how you protect sensitive records, including Substance Use Disorder (SUD) data and reproductive health info.
2. Encryption: Moving from "Addressable" to "Required"
In our original 2022 guide, encryption was often seen as an “extra” step. In 2026, it is essentially mandatory.
Communication: Standard texting is a violation. HelloNote includes secure, encrypted messaging within its EMR platform to keep your patient chats private.
Data at Rest: Any records stored on your computer or cloud must be encrypted using at least 256-bit standards.
3. Secure Record Storage & Password Management
Action Required: By February 16, 2026, all therapy practices must update their NPP. This is a significant change from our 2022 guide. Your updated notice must now:
Clearly explain protections for SUD records (42 CFR Part 2 alignment).
Inform patients of their right to opt out of certain data uses.
Provide a statement regarding the potential for data re-disclosure.
What to do if you discover a breach?
If you have a breach, notification within 60 days is required.
Update for 2026: If your Business Associates (like a billing company) experience a breach, they are now often required to notify you within 24 hours.
You must provide a description of the breach, the type of PHI involved, and the steps the individual should take to protect themselves.
Frequently Asked Questions
Q1: What is the biggest HIPAA change for my practice in 2026?
The most urgent update is the February 16, 2026, deadline to revise your Notice of Privacy Practices (NPP). You must update your NPP to reflect new protections for sensitive data, specifically alignment with 42 CFR Part 2 regarding Substance Use Disorder (SUD) records and new “Right of Access” timelines.
Q2: Do solo practitioners really need to do a Risk Assessment?
Yes. In 2026, the OCR is strictly enforcing the Security Risk Analysis (SRA). Even if you are a solo provider, you must document your asset inventory (laptop, tablet, EMR) and your plan to mitigate risks like data loss or unauthorized access.
Q3: Is standard SMS texting finally banned for patient communication?
While not explicitly “banned,” using standard unencrypted SMS for clinical communication in 2026 is considered high-risk and non-compliant unless the patient has signed a very specific “unencrypted communication waiver.” It is highly recommended to use the HelloNote Secure Messaging Portal instead.
Q4: How has the "Right of Access" changed for my patients?
Patients now expect faster access to their digital records. While the federal limit is still generally 30 days, 2026 best practices (and proposed rule changes) encourage providers to fulfill digital requests within 15 days whenever possible to avoid “Information Blocking” complaints.
Q5: Can I use AI-powered transcription or "Scribes" for my therapy notes?
Yes, but only if you have a signed Business Associate Agreement (BAA) with the AI vendor. In 2026, you must also ensure the AI tool does not use your patient’s ePHI to train its general models, as this could lead to an impermissible disclosure.
Summary
HIPAA compliance is a journey, not a destination. While the policies change every year, many standards can be met easily with a robust EMR system. HelloNote is happy to help you navigate these 2026 updates so you can focus on what matters most: your patients.
Is your clinic ready for the February 2026 deadline? Schedule a HelloNote Demo to see how our EMR automates your compliance.
