The 7 Most Common HIPPA Violations (And How to Avoid Making Them)

Are you constantly plagued by the fear of HIPAA violations, dreading the thought of unintended slip-ups that could potentially elicit enormous fines, end your career, or harm your organization's reputation or, even worse, your patients? 

You're not alone. And if it hasn't crossed your mind yet, with the enormous number of cyber breaches, we're here to encourage you that HIPAA security should be given a bit more attention than it was 10+ years ago. 

In 2022 alone, the OCR estimates that over 40 million health records were compromised and exposed. Unfortunately, this number is only increasing.

Navigating the complicated realm of HIPAA rules can be a nerve-wracking experience for even the most seasoned healthcare professionals. Especially in this rapidly changing age of technology, electronic health records, and telemedicine. 

But fear not! This article aims to uncover the most common HIPAA violations to help you  drastically reduce the likelihood of mistakes and confidently check-off compliance in your workplace.

Unpacking the HIPAA Compliance Conundrum

HIPAA, or the Health Insurance Portability and Accountability Act, is a federal law that sets standards for protecting sensitive patient data. Any healthcare provider or related business dealing with protected health information (PHI) must ensure proper measures are in place to protect this data.

While it may feel and sound onerous, it's a wonderful thing. You can know that whenever you or a loved one seeks medical care, everything is legally required to be private. This way, no one suffers embarrassment, financial or vocational damages, or retaliation. What happens with your doctor stays with your doctor.

Violating HIPAA regulations isn't a trivial thing. The consequences can be severe, ranging from significant fines to criminal charges and even the potential of permanently damaging your patients' trust in an entire health organization. In recent years, HIPAA violation fines have ranged from $100 to $1.5 million per year per violation type, emphasizing the gravity of such offenses.

Decoding the 7 Most Common HIPAA Violations

Educating yourself on the most common HIPAA violations can be a vital first step toward ensuring compliance:

1. Unauthorized Access: This is when someone without the right clearance accesses a patient's PHI. This can occur both at the level of individual employees and also at organizational levels. Unless you or another provider are directly involved in someone’s medical care (or billing), they are not allowed access to their medical records.

A recent example of this kind of HIPAA violation can be traced back to Quest Diagnostics, a medical testing company. This violation impacted about 11.9 million patients, exposing their financial data, social security numbers, and medical information. Their third-party billing partner suffered an unauthorized breach, which unfortunately put Quest Diagnostics in a world of trouble. 

Another heavy precedent was set by the University of Rochester Medical Center (URMC), which had to bear a harsh penalty of $3 million for a HIPAA violation. The case involved the loss of an unencrypted flash drive and an unencrypted laptop leading to unauthorized access. The Office for Civil Rights (OCR) investigation revealed URMC had failed to conduct enterprise-wide risk analysis, a core requirement of the HIPAA Security Rule, which could have prevented the breach.

2. Sharing of PHI: Unintentional sharing or discussing of PHI can also constitute a violation — like a doctor accidentally revealing information about a patient's condition to a non-related third party. This most commonly happens when providers discuss patients in open places where others can hear.
3. Data Breaches: They can result from a lack of proper security measures, like solid firewalls, encryption methods, or password practices.
4. Mishandling of Records: This includes things like leaving records unattended or discussing sensitive information in public places. Something as small as leaving a computer screen logged in and open where others can view PHI counts as a violation.
5. Improper Disposal of PHI: Disposing of PHI without following proper procedures, such as shredding paper documents or wiping electronic records, is a common violation. All too often, providers accidentally throw away printed PHI, when it should be placed in bins designated for shredding.
6. Unsecured PHI: Unsecured PHI includes any information that is not secure at rest or in transit and is vulnerable to unauthorized access. This commonly happens when emailing PHI, for example, in an unencrypted way.
7. Employer HIPAA Violations: Employers can also be guilty of HIPAA violations if they disclose PHI unnecessarily or without explicit permission. Very strict guidelines must be followed when sharing PHI between business entities and associates.

The Staggering Breach Report

As a recent example, July 2021 was a significant month for healthcare data breaches, with 70 incidents reported by entities covered under HIPAA and their respective business associates. Remarkably, this marked the fifth consecutive month where an average of 2 or more breaches were reported daily.

What's even more concerning is the increase from the previous month in the number of records impacted by these breaches in July, with an astonishing rise of 331.5%, affecting over 5.5 million records.

Here's an alarming statistic - from August 2020 through July 2021, there was a whopping total of 706 reported healthcare data breaches, jeopardizing approximately 44.4 million individuals' data. The monthly average paints a similar picture, with nearly 59 data breaches and close to 3.7 million potentially compromised records.

In June 2021, the most significant breach occurred via a hacking incident at a Wisconsin-based healthcare provider, Forefront Dermatology. This unfortunate event exposed the protected health information of 2.4 million individuals. Not far behind was a New York-based business associate, Practicefirst, who experienced a ransomware attack, putting the data of 1.2 million individuals at potential risk.

Notably, the majority of these breaches resulted from hacking or IT incidents, including ransomware attacks. A staggering 96.82% of all breached records in July 2021 can be attributed to such incidents.

How Do They Find Out About HIPAA Violations, Anyway?

Well, organizations that are covered by HIPAA often discover violations through their regular internal audits. Bosses may figure out which employees are involved, and sometimes, employees themselves report their own or a coworker's slip-up.

The HHS Office for Civil Rights (OCR) also steps in to enforce HIPAA Rules and look into complaints, including security breaches involving a big chunk of records (think 500 or more). They keep a close watch on covered entities and their business associates by conducting audits. State attorneys general can also investigate breaches based on received complaints or official reports.

What Kind of Penalties Are We Talking About for HIPAA Violations?

The penalties for violating HIPAA can be no joke! Fines can easily reach millions of dollars. There are two main types of HIPAA violations: civil and criminal. Let's dive into each one.

Civil Penalties: When You Didn’t Mean to Mess Up

Civil penalties usually happen when someone unintentionally breaks the HIPAA rules. Maybe they forgot or just didn't know what they were doing was wrong. In these cases, the penalties can look like this:

• If an individual didn't know they were violating HIPAA Rules, they'll get a fine of $100 for each violation.
• If someone had a good reason for their actions and wasn't intentionally neglectful, they'll be fined at least $1,000.
• Even if someone was acting carelessly but fixed the problem later, they'll have to pay at least $10,000 per violation.
• If a person didn't bother to fix their mistakes, expect a fine of at least $50,000 per issue.

As serious as civil penalties can be, things can get even worse if someone has bad intentions. That's when we enter the territory of criminal penalties.

Criminal Penalties: When Things Get Really Serious

Criminal penalties are much more severe than civil ones. Here's what they can look like:

• If someone deliberately gets and shares Protected Health Information (PHI) without permission, they could be fined up to $50,000 and spend up to a year in jail.
• If an individual breaks the rules under false pretenses, they could face a fine of up to $100,000 and up to five years in prison.
• If someone uses PHI for personal gain (like selling it or hurting a patient), they could receive a fine of up to $250,000 and spend up to 10 years in jail.

With penalties as harsh as these, nobody wants to find themselves on the wrong side of HIPAA law. Thankfully, the toughest penalties aren't handed out all the time. They're reserved for cases where people knew what they were doing was wrong. For minor or accidental slip-ups, the penalties tend to be lighter, with some cases being forgiven entirely.

Navigating the HIPAA Compliance Landscape

But it's not all doom and gloom. Following these strategies can assist in avoiding HIPAA violations:

• Conduct Regular Training: Addressing staff knowledge gaps about HIPAA rules can help avoid inadvertent violations. Regular training sessions can be utilized to revise these rules and keep employees up-to-date with any updates.
• Develop Comprehensive Policies: Implement robust policies that handle all aspects of HIPAA compliance, including securing patient records, preventing unauthorized access, and meticulously defining the protocol for PHI disposal.
• Use Encrypted Communications: Ensure all forms of communication, especially digital ones, are encrypted to secure PHI.
• Perform Regular Audits: Regular internal audits can drastically reduce the risk of a data breach by identifying security vulnerabilities.

This website is also a great resource for all the specifics created by the Office of Inspector General.

Suspected HIPAA Violation? Here's What to Do

If you suspect a HIPAA violation, you need to report it promptly. The Department of Health and Human Services Office for Civil Rights enforces HIPAA and handles violations. You can report suspected violations via their online portal. From there, you may be subject to an investigation, which will determine whether a violation occurred and what penalties may apply.

In Conclusion: The Road to HIPAA Compliance

Navigating the complex landscape of HIPAA compliance might seem daunting, but it's not an insurmountable task. Understanding common HIPAA violations and implementing the strategies to avoid them can minimize risk, safeguard your organization against fines, and, most importantly, maintain the trust of your patients. Review your compliance policies today and keep patient safety and privacy at the forefront of your work.

Given the alarming rise in healthcare data breaches and the number of individuals impacted, it's now more crucial than ever for healthcare providers to protect their patients' sensitive data. Don't let your organization become another statistic. Invest in comprehensive HIPAA training for your staff and safeguard the trust patients place in you.

HIPAA Exams offers courses for healthcare workers as well as business associates. Check out our extensive catalog of training programs today!