HIPAA Law Violation: Understanding the Consequences and Prevention

Did you know that in 2022, healthcare organizations reported more than 658 data breaches, affecting over 51 million individuals in the United States? The protection of sensitive patient information is a critical responsibility for healthcare providers and their business associates. That’s where the Health Insurance Portability and Accountability Act (HIPAA) comes in, governing the handling of such information. Unfortunately, HIPAA law violation do occur, leading to serious consequences for both healthcare organizations and their patients. In this article, we will delve into common HIPAA violations, the impact of these violations, prevention measures, and what to do if a HIPAA law violation occurs. So, let’s get started!

What Is Considered A HIPAA Violation?

A HIPAA violation refers to any act or omission by a covered entity (healthcare providers, health plans, and healthcare clearinghouses) or their business associates that fails to comply with the requirements of the HIPAA Privacy or Security Rules, ultimately leading to unauthorized access, use, or disclosure of protected health information (PHI).

Common HIPAA Violation Examples

There are numerous regulations and provisions within the 115-page HIPAA legislation published by the Department of Health and Human Services Office for Civil Rights. As a result, there are countless ways in which HIPAA Rules can be violated. Below are some of the most common examples:

• Disclosing PHI without proper authorization or for unauthorized purposes.
• Accessing PHI without a legitimate reason, such as through inappropriate access to electronic health records or snooping.
• Failing to securely dispose of PHI in paper or electronic form, leads to unauthorized access.
• Not performing required risk assessments to identify potential vulnerabilities and risks to PHI.
• Neglecting to address identified risks or implement appropriate safeguards.
• Not implementing administrative, physical, and technical safeguards to protect PHI.
• Not keeping or monitoring records of who accesses PHI and when.
• Not ensuring that business associates are compliant with HIPAA requirements before sharing PHI with them.
• Denying patients access to their health information, which they have a right to obtain.
• Not implementing measures to restrict access to PHI on a need-to-know basis.
• Allowing continued access to PHI for individuals who no longer require it.
• Sharing more information than necessary to accomplish a specific task or function.
• Not offering regular training to employees on HIPAA regulations and the organization’s policies and procedures.
• Stolen physical or electronic records containing PHI.
• Sharing PHI with unauthorized individuals, either intentionally or unintentionally.
• Posting or sharing PHI on the internet or social media platforms without proper consent.
• Sending PHI to the wrong recipient or handling it in a manner that puts its security at risk.
• Transmitting PHI through insecure methods, such as standard text messaging.
• Not using encryption or other security measures to safeguard PHI, particularly electronic PHI (ePHI).
• Not adhering to the required timeframe for reporting PHI breaches.
• Not maintaining accurate records of compliance activities and efforts to prevent HIPAA violations.

How Are  HIPAA Law Violations Discovered?

HIPAA violations can be discovered through various means, some of which include:

• Internal Audits: Healthcare organizations may conduct internal audits to ensure compliance with HIPAA regulations. These audits can reveal instances of noncompliance or areas that require improvement.
• Complaints from Patients: Patients can file complaints with the Department of Health and Human Services Office for Civil Rights (OCR) if they suspect their privacy rights have been violated. These complaints may lead to investigations that uncover HIPAA violations.
• Whistleblower Reports: Employees or other insiders may report potential HIPAA violations to the OCR or other relevant authorities. Such reports, known as whistleblower reports, can bring violations to light and prompt investigations.
• External Audits and Inspections: The OCR may conduct audits and inspections of covered entities and their business associates to evaluate compliance with HIPAA requirements. These audits can detect violations that might have gone unnoticed previously.
• Data Breaches: HIPAA violations can also be discovered in the aftermath of a data breach. When organizations investigate the cause of a breach, they may uncover instances of noncompliance that contributed to the incident.
• Legal Proceedings: Violations may come to light during legal proceedings, such as lawsuits or other disputes involving healthcare organizations. In some cases, parties may uncover evidence of HIPAA violations during the discovery process or through witness testimony.
• Media Reports: News stories or investigative journalism can reveal HIPAA violations, prompting further investigation and potential enforcement actions.
• Government and Regulatory Agencies: Other government and regulatory agencies, such as the Centers for Medicare & Medicaid Services (CMS) or state attorney general offices, may discover HIPAA violations during their investigations or enforcement activities.

What Are The Penalties For HIPAA Law Violation?

HIPAA violations can have far-reaching consequences for organizations and individuals involved, including:

• Financial Penalties: Organizations found in violation of HIPAA may face substantial financial penalties. Depending on the severity of the violation and the level of negligence involved, fines can range from $100 to $50,000 per violation, with an annual maximum of $1.5 million for violations of an identical provision.
• Reputation Damage: HIPAA violations can lead to a loss of trust from patients, partners, and the general public. This erosion of trust may result in long-term damage to an organization’s reputation, impacting its ability to attract and retain patients, as well as its overall credibility within the industry.
• Criminal Charges: In extreme cases, individuals responsible for HIPAA violations may face criminal charges. Penalties for criminal violations can include imprisonment for up to 10 years and significant fines, depending on the severity of the offense and the individual’s intent.
• Loss of Business: As a result of reputation damage and potential loss of trust from patients, organizations may experience a decline in business. Additionally, if entities repeatedly violate HIPAA or fail to address identified issues, they may lose contracts and face exclusion from participating in federally-funded healthcare programs, such as Medicare and Medicaid.
• Civil Lawsuits: In some cases, patients who have suffered harm due to a HIPAA violation may choose to file civil lawsuits against the responsible organization or individuals. This can result in additional financial penalties and legal fees, as well as further damage to the organization’s reputation.
• Corrective Action Plans:  When discovering a HIPAA violation, the OCR may require the organization to implement a corrective action plan (CAP). CAPs can be time-consuming and expensive, as they often involve significant changes to policies, procedures, and IT infrastructure, as well as ongoing monitoring and reporting to ensure compliance.

How To Prevent HIPAA Violations?

To prevent HIPAA violations, organizations should take the following measures:

• Establishing Policies and Procedures – Develop and implement comprehensive HIPAA-compliant policies and procedures to guide employees on how to handle PHI and maintain privacy and security.
• Regular Employee Training – Provide ongoing training to employees on HIPAA regulations and the organization’s policies and procedures, ensuring they understand their responsibilities and the consequences of violations.
• Risk Management – Conduct regular risk assessments to identify potential vulnerabilities and take appropriate action to address them, such as updating software, implementing new security measures, or adjusting policies.
• Encryption and Secure Communication – Use encryption and secure communication methods, like secure email and messaging platforms, to protect ePHI during transmission and storage.

Conclusion

A HIPAA law violation can have serious consequences for healthcare organizations and their patients. To prevent violations and protect the privacy and security of patient information, it is crucial to understand the regulations, implement robust policies and procedures, and provide ongoing employee training. In the event of a violation, taking prompt action and maintaining transparency is vital to mitigating potential damage and restoring trust.

If your organization is looking to implement any Infosec compliance frameworks, such as SOC 2 compliance, HIPAA, ISO 27001, or GDPR compliance, Impanix can help. Our team of experts dedicates themselves to guiding you through the process and ensuring that your organization meets the necessary standards. Don’t leave your patients’ privacy and security to chance—take action today to safeguard their information. To Book a Free consultation call our experts or email us at  [email protected] for inquiries. Let Impanix be your partner in maintaining the highest level of compliance and trust in the healthcare industry.