What is a HIPAA Violation?
When you hear the term “HIPAA violation” it sounds like big legal words but it really means mishandling of patient information. HIPAA stands for Health Insurance Portability and Accountability Act and sets the standard for protecting patient information for covered entities. Any breach of that standard is a violation. Let’s break it down.
HIPAA for Covered Entities
HIPAA was enacted in 1996 to modernize the flow of healthcare information, to specify how personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft and to address limitations on healthcare insurance coverage. It’s to protect patient information from being used or disclosed without consent. The U.S. Department of Health and Human Services (HHS) is responsible for enforcing HIPAA rules.
How to Avoid HIPAA Violations
With so many ways to violate HIPAA it’s hard to know how to avoid them. But, with these simple tips you can avoid HIPAA violations
- Keep learning about HIPAA
- Enable firewalls, virus security, etc
- Secure mobile devices
- Be aware of paper & have a clean desk policy
- Store files correctly
- Keep patient information out of public view
- Use social media wisely
- Have a HIPAA compliant Business Associate Agreement with third-party vendors. This is key to being HIPAA compliant and avoiding fines.
What is a HIPAA Violation?
A HIPAA violation is when you fail to comply with any part of the HIPAA rules and regulations. Common HIPAA violations include:
- Unauthorized access to PHI (snooping) of a family member, friend or other individual without correct authorization
- Discussing PHI in a public place where it can be overheard.
- Forwarding ePHI (electronic PHI) to unsecured mobile devices or saving ePHI to unsecured portable storage devices (USB)
- Falling for phishing scams and giving unauthorized individuals access to patient files
- Using PHI to harm
- Stealing PHI for financial gain
Examples
To make this more real, here are a couple of examples:
- Example 1: A nurse logs into a patient’s electronic health record to check their info and forgets to log out. Another unauthorized person then logs in. This is a clear HIPAA violation due to unauthorized access.
- Example 2: A healthcare provider discusses a patient’s medical condition in a busy elevator where others can hear. This is a HIPAA violation of the privacy rule about discussing information in public.
- Example 3: A clinic loses a patient’s medical records and an unauthorized person gains access to the information. This is a serious HIPAA violation and shows how important it is to secure paperwork and devices with ePHI to prevent impermissible disclosure of PHI.
Consequences of HIPAA Violations: Civil Fines
HIPAA violations can result in severe consequences including large fines and even criminal charges depending on the breach. Civil penalties are tiered based on the severity and nature of the violation including penalties for lack of knowledge, reasonable cause without willful neglect, willful neglect corrected within 30 days, and willful neglect not corrected within 30 days. Fines can be $100 to $50,000 per violation with an annual max of $1.5 million. The Office for Civil Rights (OCR) is responsible for enforcing HIPAA compliance and determining penalties in cases of violations. In extreme cases criminal penalties can include jail time.
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How to Avoid HIPAA Violations
HIPAA compliance is key to avoiding violations and penalties.
Avoiding HIPAA violations means following the rules. Here’s how:
- Training and Awareness: Train all staff on HIPAA and teach them why patient info is important.
- Security Measures: Use encryption, strong passwords and regular audits to protect data.
- Clear Policies: Establish and enforce policies on handling, sharing and disposal of patient info.
- Limit Access: Only give access to patient info to those who need it to do their job.
Bottom Line
In short, a HIPAA violation is any non-compliance with HIPAA that results in unauthorized access or disclosure of patient info. By knowing what is a violation and securing your data, healthcare providers can protect patient info and avoid the serious consequences of breaches. Remember, protecting patient info isn’t just a law – it’s patient care and trust.
