HIPAA Violations: Examples, Penalties +5 Cases to Learn From

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In the United States, the Health Insurance Portability and Accountability Act (HIPAA) was established to ensure the privacy and security of patient’s medical information. However, despite the strict guidelines and regulations set forth by HIPAA, violations of patient privacy still occur in various forms. HIPAA violations can result in hefty fines, legal action, and damage to a healthcare organization’s reputation. In this blog, we will discuss the different examples of HIPAA violations, their potential consequences, penalties, and how healthcare providers can avoid them.

What Is A HIPAA Violation?

A HIPAA violation is any action or omission that violates the Health Insurance Portability and Accountability Act (HIPAA) rules and regulations. HIPAA violations can also occur due to hacking or other cybersecurity breaches that compromise the privacy and security of patient’s medical information. Depending on the severity and nature of the violation, consequences can range from monetary fines to criminal charges.

The severity of the violation and the resulting consequences depend on various factors. This includes the extent of the harm caused, the level of intent or negligence, and the organization’s efforts to correct the violation and prevent future occurrences.

What Are The Common Examples Of HIPAA Violations?

The Common Examples Of HIPAA Violations

There are several common examples of HIPAA violations that can occur in healthcare settings. Some of these examples include:

  • Unauthorized Disclosure of PHI: One of the most common HIPAA violations is the unauthorized disclosure of patients’ protected health information. This can occur when a healthcare provider shares a patient’s medical information with an unauthorized individual or entity.
  • Failure to Implement Reasonable Safeguards: HIPAA requires healthcare providers to implement reasonable safeguards to protect patients’ PHI from unauthorized access, use, or disclosure. Failure to do so can result in HIPAA violations.
  • Failure to Provide Patients with Access to Their Medical Records: HIPAA requires healthcare providers to give patients access to their medical records upon request. Failure to do so can result in HIPAA violations.
  • Cybersecurity Breaches: With the increasing use of electronic health records (EHRs) and other digital tools in healthcare, cybersecurity breaches have become a common cause of HIPAA violations. These breaches can result in the unauthorized access or disclosure of patients’ PHI.
  • Mishandling of PHI: Mishandling of PHI can occur in various forms, such as leaving patient files in an unsecured area, disposing of patient information improperly, or failing to properly de-identify PHI before using it for research purposes.
  • Retaliation Against Whistleblowers: Retaliating against employees who report HIPAA violations is also a violation of the law.

Above all, these are just some common examples of HIPAA violations. It’s essential for healthcare providers to understand and comply with HIPAA regulations to protect patient’s privacy and avoid potential consequences.

What Are The Penalties For Violating HIPAA?

Violating HIPAA can result in a range of penalties, depending on the severity of the violation and the organization’s efforts to correct the violation and prevent future occurrences. The penalties for violating HIPAA fall into four tiers, as follows:

  • Tier 1: The minimum penalty for violating HIPAA is $100 per violation, with an annual maximum of $25,000 for repeat violations of the same provision.
  • Tier 2: Penalties range from $1,000 to $50,000 per violation, with an annual maximum of $1.5 million. This tier applies to violations that the covered entity or business associate was not aware of and could not have reasonably avoided.
  • Tier 3: Penalties range from $10,000 to $50,000 per violation, with an annual maximum of $1.5 million. This tier applies to violations that the covered entity or business associate should have known about but did not act on in a reasonable manner.
  • Tier 4: Penalties range from $50,000 to $1.5 million per violation, with an annual maximum of $1.5 million. This tier applies to violations that the covered entity or business associate willfully neglects to address.

In addition to monetary penalties, HIPAA violations can result in negative publicity, legal action, loss of business, and damage to an organization’s reputation. Therefore, it’s crucial for healthcare providers to ensure compliance with HIPAA regulations to protect patient’s privacy and avoid potential consequences.

5 Cases To Learn From HIPAA Violation

There have been several high-profile HIPAA violations over the years that healthcare providers can learn from to avoid similar mistakes. Here are five examples:

  • Anthem Inc. (2015) – Firstly, hackers gained access to nearly 80 million individuals’ personal and medical information through a phishing attack on an employee’s email account. The incident resulted in a $16 million settlement with the Office for Civil Rights (OCR).
  • Cottage Health (2013-2015) – Two separate data breaches compromised the personal and medical information of nearly 55,000 patients due to the provider’s failure to secure its servers and a third-party vendor’s failure to properly configure its security settings. The incidents resulted in a $3 million settlement with the OCR.
  • New York-Presbyterian Hospital and Columbia University (2010) – A misconfigured server allowed unauthorized access to nearly 7,000 patients’ personal and medical information, resulting in a $4.8 million settlement with the OCR.
  • Presence Health (2013-2015) – Two separate data breaches compromised nearly 10,000 patients’ personal and medical information due to the provider’s failure to properly secure its ePHI and protect against unauthorized access. The incidents resulted in a $475,000 settlement with the OCR.
  • University of Mississippi Medical Center (2013): Finally, a stolen laptop containing unencrypted patient data compromised nearly 10,000 patients’ personal and medical information, resulting in a $2.75 million settlement with the OCR.

Above all, these examples demonstrate the importance of implementing strong cybersecurity policies and procedures, properly securing servers and devices, and properly training employees to prevent data breaches and unauthorized access to patients’ medical information.

How To Avoid Violating HIPAA Regulations?

Avoid Violating HIPAA Regulations

To avoid violating HIPAA regulations, healthcare organizations should take the following steps:

  • Implement strong cybersecurity policies and procedures: Healthcare providers should implement policies and procedures to protect patient data, including encrypting data at rest and in transit, regularly patching software and systems, and monitoring for unauthorized access.
  • Train employees: All employees should receive regular training on HIPAA regulations, security best practices, and the proper handling of patient information. This should include training on how to identify and report potential security incidents.
  • Secure devices: Healthcare providers should secure all devices that store or transmit patient data, including laptops, smartphones, and tablets, by using encryption, password protection, and remote wipe capabilities.
  • Control access to patient data: Healthcare providers should limit access to patient data to only those employees who need it to perform their job duties. This can be achieved through the use of access controls and user permissions.
  • Conduct risk assessments: Finally, healthcare providers should conduct regular risk assessments to identify potential vulnerabilities in their systems and processes and take steps to address them.

Overall, by taking these steps, healthcare providers can help protect their patients’ personal and medical information and avoid violating HIPAA regulations.

Conclusion

In conclusion, HIPAA violations can have serious consequences for healthcare providers, including costly settlements and damage to their reputations. It is crucial for healthcare organizations to take measures to protect patient’s personal and medical information and ensure compliance with HIPAA regulations. By learning from past HIPAA violations and taking proactive steps to prevent future breaches, healthcare providers can protect their patients and their own organization from potential harm. If you are looking to implement any of the Infosec compliance frameworks such as SOC 2 compliance, HIPAA, ISO 27001, and GDPR compliance, Impanix can help. Book a Free consultation call with our experts or email us at  [email protected] for inquiries.