HIPPA Security Rule Compliance for Dental Practices: Protecting Your Patients' Data - And Yourself.
Dave Argentar • September 17, 2019
The care that dentists need to provide their patients doesn’t end when they get up from the chair. Dental offices, and the computers, networks, servers, and files maintained within (and outside of) their walls contain patient information that must be kept secure and protected from data breaches and unauthorized disclosure. If your practice doesn’t have the systems, protocols, and policies in place to comply with HIPAA’s multitude of patient privacy and security requirements, even inadvertent and seemingly “harmless” violations can lead to significant financial and legal headaches.
HIPAA security compliance simply cannot be an afterthought for dental practices, nor is it a matter of “set it and forget it.” It requires constant vigilance, proactive planning, and regular audits and updates. This is particularly true when it comes to ensuring the security of electronic health records. Dentists need to commit people, time, and resources to the protection of patient information and should regularly consult with attorneys who can assist them in making their HIPAA compliance efforts robust and effective.
HIPAA Application to Dental Practices
After HIPAA became law in 1996, the U.S. Department of Health and Human Services (HHS) issued a set of national standards governing the use and disclosure of patients’ protected health information (PHI). Commonly known as the Privacy Rule , the Standards for Privacy of Individually Identifiable Health Information apply to “covered entities” as defined in HHS regulations.
The odds that your dental practice is a “covered entity” under HIPAA sit pretty close to 100%. If you send claims, eligibility inquiries and requests, pre-determinations, claim status inquiries, or treatment authorization requests to third parties through electronic means, you must comply with HIPAA.
HIPAA obligations don’t end at the Privacy Rule, which limits how and to whom PHI can be disclosed. Dental practices must also comply with the Security Rule ( Security Standards for the Protection of Electronic Protected Health Information ) as well as the Breach Notification Rule.
The HIPAA Security Rule
While the Privacy Rule addresses who may have access to PHI, the Security Rule sets the standards for ensuring that only those authorized individuals can access that information. One important distinction between the Privacy Rule and Security Rule is that while the former applies to PHI in whatever form – paper, oral, electronic - the Security Rule only covers electronic health records (ePHI). Since dental practices increasingly rely on electronic means to create, store, and transmit records, ensuring that your practice satisfies the Security Rule’s mandates is the centerpiece of any HIPAA compliance program.
The safeguards required under the Security Rule are divided into three categories:
· Administrative – As defined in the rules, these are policies and procedures designed “to manage the selection, development, implementation, and maintenance of security measures to protect electronically protected health information and to manage the conduct of the covered entity’s workforce in relation to the protection of that information.”
Practices must sufficiently implement and monitor their “performance of security management process, assignment or delegation of security responsibility, training requirements, and evaluation and documentation of all decisions.”
The essence of administrative compliance is people: people who are in charge of security, people who are trained about security, and people who are responsible for administering, monitoring, and auditing security compliance.
· Physical Access Controls – This involves safeguards established to control physical access to data and information and the systems which store them. This includes such essential elements as:
o Facility Access Controls – policies and procedures that limit physical access to all areas and devices where ePHI is stored, such as locked doors, restricted areas, surveillance systems, security guards, etc.
o Workstation Access and Security – policies and procedures that specify the proper functions to be performed on workstations, how employees should perform those functions, and physical workstation security.
o Device and Media Controls – thumb drives, laptops, phones, tablets, and other devices represent a significant vulnerability for unauthorized access to or distribution of ePHI. Dental practices need to establish policies and procedures that govern how hardware and electronic media containing ePHI can enter or exit dental offices. These controls must include disposal, media reuse, accountability, and data backup and storage.
· Technical controls – this involves “the technology and the policy and procedures for its use that protect electronic protected health information and control access to it.” Firewalls, encryption, data security measures, and other systems put in place to prevent data breaches, cyberattacks, and unauthorized access to ePHI fall into this category.
Your Practice Could Be Held Responsible for Any HIPAA Violations by a “Business Associate”
Many if not most practices contract at least some of their billing, claims management, and other back-office responsibilities to third-party vendors. If a practice fails to obtain “satisfactory assurances” from a “business associate” that it is HIPAA-compliant before retaining their services, and a PHI breach subsequently occurs, the practice entity may be considered liable for any damages that result
That is why every dental practice that shares PHI with outside contractors enter into a written HIPAA-Compliant Business Associate Agreement with such vendors. These agreements should specify:
·the types of PHI that the practice will provide to the business associate;
·the permissible uses and disclosures of PHI by the business associate;
·the measures that the business associate must implement to protect PHI;
·the actions that the business associate will take in the event of a data breach.
HIPAA Compliance Questions? Call Grogan, Hesse & Uditsky Today
At Grogan, Hesse & Uditsky, P.C., we focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you.
If you have questions or concerns about your practice’s compliance with HIPAA, please call us at (630) 833-5533 or contact us online to arrange for your free initial consultation.
Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices, and this blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals.
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Dental practices that choose to lease rather than purchase and own their business location have several options for setting up shop. While plenty of practices operate out of stand-alone buildings, even more lease space in retail shopping centers, professional buildings, or office complexes. The terms of that lease – from the rent to the term to build-out, termination, or assignment rights – can have an outsized impact on the growth and success of a practice. But one lease provision, in particular, can determine whether your practice faces stiff and unwanted competition from another practice just steps from your office’s front door: the exclusivity (or exclusive use) clause. What Is An Exclusive Use Provision in a Dental Practice Lease? As the name implies, an exclusive use clause in a lease limits the landlord’s ability to lease space in the same complex or building to another tenant engaged in the same type of business. 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On July 4, 2025, the One Big Beautiful Bill Act (OBBBA) was signed into law. One may question whether this sprawling piece of legislation deserves to be called “beautiful,” but it undoubtedly earns the “big” in its name, especially for small businesses like dental practices. That is because it contains several provisions that could have a significant impact on the tax obligations of practices and their owners. Most notably, the OBBBA solidifies significant tax reforms and exemptions that were part of the 2017 Tax Cuts and Jobs Act (TCJA). Here are seven aspects of the OBBBA that are of particular interest to dental practices and their owners. 1. Permanent Qualified Business Income (QBI) Deduction The 20 percent small business tax deduction (also known as the section 199a deduction) for sole proprietorships, partnerships, S-corporations, and LLCs, which was scheduled to expire at the end of 2025, is made permanent and extends the amount of income subject to the phase-out rules. Specifically, the income threshold for single taxpayers is expanded by $25,000 and for joint filers by $50,000. The bill also includes a new minimum deduction of $400 for taxpayers with at least $1,000 of qualified business income from one or more actively conducted trades or businesses in which they materially participate. 2. Expanding Section 179 Expensing The bill increases the Small Business Expensing Cap from $1.22 million to $2.5 million. It also brings back and makes permanent “bonus depreciation,” which allows for an immediate write-off of 100 percent (versus 40 percent) of the cost of new qualified property acquired after January 19, 2025, such as equipment, vehicles, and software. 3. 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For QSBS acquired after July 4, 2025, the holding period required to qualify for the QSBS gain exclusion drops from five years to three years. After three years, a 50% exclusion is available, increasing to 75% after four years, and reaching 100% exclusion after five years. 4. Enhancing the Employer-provided Childcare Credit Section 45F of the tax code, which is designed to incentivize businesses to invest in childcare, now provides qualifying small businesses (gross receipts of $25 million or less for the preceding five years) with a maximum tax credit of up to $600,000 per year on up to 50 percent of qualified childcare expenses provided to employees. This credit is effective beginning in 2026. 5. Employer-provided Student Loan Repayment Assistance The OBBBA makes the employer-provided student loan repayment benefit permanent, allowing employers to contribute up to $5,250 per year towards employees' student loans, tax-free for both the employer and employee. 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We focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you. Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices, and this blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals.
Dental practices that choose to lease rather than purchase and own their business location have several options for setting up shop. While plenty of practices operate out of stand-alone buildings, even more lease space in retail shopping centers, professional buildings, or office complexes. The terms of that lease – from the rent to the term to build-out, termination, or assignment rights – can have an outsized impact on the growth and success of a practice. But one lease provision, in particular, can determine whether your practice faces stiff and unwanted competition from another practice just steps from your office’s front door: the exclusivity (or exclusive use) clause. What Is An Exclusive Use Provision in a Dental Practice Lease? As the name implies, an exclusive use clause in a lease limits the landlord’s ability to lease space in the same complex or building to another tenant engaged in the same type of business. Think about why you would choose a particular location for your practice. Aside from the features of the space itself, it is likely because of favorable characteristics like foot traffic, accessibility, parking, and the lack of other similar practices in the surrounding area. If, after conducting demographic research and spending time and resources selecting the perfect location for your practice, your landlord could wipe out those efforts with the stroke of a pen by leasing space nearby to a competing practice, it could be a devastating blow. Negotiating an Exclusive Use Provision Most commercial leases are initially prepared by the landlord. As such, they are unsurprisingly skewed in favor of the landlord’s interests. It is unlikely that a landlord would voluntarily and preemptively tie their hands by limiting the pool of potential tenants. That is why the burden is usually on the tenant to push for and negotiate an exclusivity provision. When negotiating the terms of your dental practice lease (which you should only do with the help and counsel of an experienced attorney), the goal will be to get your landlord to agree not to rent space to other dental practice tenants. If your landlord refuses to limit their ability to lease space to other dentists generally and you nevertheless want to pursue the desired space, you may be able to be more specific and agree to a provision that restricts the landlord’s ability to lease to a particular competing specialty such as pediatric dentists, orthodontists, periodontists, etc. Protecting Yourself From a Landlord’s Breach of an Exclusivity Clause The contracts most likely to be broken are those with few, if any, consequences for violating their terms. That is why the value of an exclusivity provision is directly related to the price that the landlord will pay for entering into a lease with a competitor despite the clause in your lease. Given the potentially catastrophic impact of having a neighbor in the same building siphoning off your patients and diluting your hard-earned goodwill, that price should be significant. Several different penalties can serve to protect your practice from a breach of an exclusivity provision: Rent Abatement. One of the most straightforward and commonly used remedies is rent abatement. If the landlord allows a competing business to open in violation of the exclusive use clause, an abatement penalty can entitle you to a full or partial reduction in base rent or other charges. This abatement typically remains in effect until the violation is cured or the competing tenant leaves. The lease should specify the amount of rent to be abated (e.g., 50% of base rent) and whether the abatement applies to other charges such as common area maintenance fees or percentage rent. Termination Right. A strong lease will give the tenant the option to terminate the lease entirely if the landlord fails to cure the violation within a specified period after notice. This is a significant penalty that underscores the seriousness of the exclusive use protection. Liquidated Damages. Liquidated damages provide a pre-agreed amount that the landlord must pay if it breaches the exclusive use clause. This can be calculated based on the tenant’s projected loss in revenue, estimated lost profits, or some other measurable metric tied to the tenant’s business performance. Injunctive Relief. Ideally, the lease should give you the right to seek injunctive relief from a court to stop the violation of the exclusive use provision, such as requiring the landlord to terminate the lease or evict the competing tenant. Getting a landlord to agree to a strong exclusivity provision with equally strong penalties for breaches of it requires deft and persuasive negotiating skills, and is yet another reason why dental practice owners should never enter into or negotiate a lease without the assistance of experienced counsel. If you are considering a lease for your practice, please contact Grogan Hesse & Uditsky today at (630) 833-5533 or contact us online to arrange for your free initial consultation. We focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you. Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices, and this blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals.
Recent amendments to the Illinois Dental Practice Act (the “Act”), which Gov. JB Pritzker is expected to soon sign into law, will make it easier for newly minted dental professionals to begin practicing while their license applications are pending. The amendments, which would take effect on January 1, 2026, establish the following criteria under which license-pending dentists and dental hygienists can practice under the delegation of a licensed general dentist: The Applicant has completed and passed the IDFPR-approved licensure exam and presented their employer with an official written notification indicating such; The Applicant has completed and submitted the application for licensure; and The Applicant has submitted the required licensure fee. Once obtained, authorization for dentists and dental hygienists to practice under these provisions can be terminated upon the occurrence of any of the following: The Applicant receives their full-practice license; IDFPR provides notification that the Applicant’s application has been denied; IDFPR requests that the Applicant stop practicing as a license-pending dentist/dental hygienist until the Department makes an official decision to grant or deny a license to practice; or Six months have passed since the official date of the Applicant’s passage of the licensure exam (i.e., the date on the formal written notification of such from the Department). IDFPR has yet to post anything on its website regarding these amendments, but we will provide an update if and when it does. If you have any questions about these new provisions regarding the employment of license-pending dentists and hygienists, please contact Grogan Hesse & Uditsky today at (630) 833-5533 or contact us online to arrange for your free initial consultation. We focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you. Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices, and this blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals.
