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5 HIPAA Violation Examples and How to Avoid Them
Rob Scott
Home care agencies have an ethical and professional responsibility to protect sensitive health information and patient privacy. Failure to comply can not only damage the patient-provider relationship but also lead to HIPAA violation penalties ranging from $100 to over $4 million and license revocation.
To help you meet regulatory compliance standards, we will discuss 5 HIPAA violations and how to avoid them. But first, let’s quickly review the basics of HIPAA.
HIPAA Basics
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was originally passed to ensure ongoing health insurance coverage between jobs, guarantee coverage to employees with pre-existing conditions, and prevent employees from staying at a job solely to avoid losing health benefits.
Over time, Congress introduced new measures to HIPAA, aiming to address healthcare insurance fraud, enhance efficiency, and protect health information. Today, HIPAA consists of the following core standards:
Privacy Rule: Addresses how covered entities can use and disclose protected health information (PHI).
Security Rule: Focuses on protecting electronic PHI (ePHI) by setting physical, technical, and administrative safeguard standards.
Breach Notification Rule: Mandates covered entities and business associates to notify affected individuals, the Secretary, and the media (if applicable) of any breach of unsecured PHI.
Enforcement Rule: Details how the Department of Health and Human Services (HHS) will investigate and penalize violations of HIPAA rules.
Administrative Simplification Rules: A set of rules that aim to standardize and streamline healthcare business processes and reduce paperwork.
What Is a HIPAA Violation?
A HIPAA violation is when a covered entity, such as a home care agency, fails to meet the requirements outlined by HIPAA. Regardless
The following examples are common HIPAA violations that occur within the healthcare of whether it was intentional or by accident, failure to comply with HIPAA is still considered a violation.
5 HIPAA Violation Examples and How to Avoid Themindustry. We’ve provided best practices to mitigate these violations and ensure a HIPAA-compliant home health agency.
1. Failure to Perform Organization-Wide Risk Assessments
Organization-wide risk assessments help healthcare organizations identify any flaws or vulnerabilities in their security measures and systems. Failing to perform these assessments not only violates HIPAA but also greatly increases the risk of breaches.
An organization-wide risk assessment may include:
Improving or implementing authentication protocols
Reviewing incident response plans
Auditing security flaws and vulnerabilities
Reviewing employee HIPAA training
The simple solution to avoiding this violation is scheduling risk assessments once or twice per year or as needed. They can be conducted in-house or by a third-party auditor. An audit by an external third party is recommended as they can provide evaluations and guidance from an unbiased perspective.
2. Unauthorized Access or Disclosure on Healthcare Records
Unauthorized access or disclosure of PHI is a serious and frequently occurring HIPAA violation. Examples include employees talking about a patient's PHI to unauthorized individuals (e.g., family, friends, or fellow staff members), posting PHI on social media without consent, or snooping on healthcare records for reasons outside the Privacy Rule.
This violation is severe and can result in the termination of employment and harsh financial penalties. In some cases, the employee who committed the violation can face criminal charges and jail time.
To prevent or reduce the chance of this HIPAA violation occurring, you need to restrict PHI access to only those who require it to perform their duties. You must also emphasize the importance of patient confidentiality in staff communications and training.
3. Failure to Secure PHI
Data security and privacy are major concerns for healthcare organizations, especially when health information is transferred between multiple professionals and organizations. Unsecured PHI is a prime target for cybercriminals and one of the leading causes of data breaches. So, you must stay on top of security practices for all digital and paper forms of PHI.
For example, you may be using Gmail as your primary form of communication with patients, but is Gmail HIPAA compliant? Initially, no. You must go through a series of steps to ensure compliance. This simple mistake can be the difference between compliance and violation.
Best practices for securing PHI include:
Regularly updating software systems
Encrypting all PHI at rest and in transit, such as login credentials and two-factor authentication (2FA)
Implementing strict access controls
4. Lack of HIPAA-Certified Employee Training
HIPAA requires healthcare organizations to provide HIPAA training to all relevant employees or staff who handle PHI. This is a crucial aspect of protecting PHI and preventing any accidental violations.
To avoid this violation, schedule and conduct annual HIPAA training. Tailor the training to your organization, providing agency-specific examples, scenarios, and solutions. The HIPAA training program should include, but is not limited to, the following:
Privacy, Security, and Breach Notification Rules
Policies and procedures to maintain HIPAA compliance
Security and cybersecurity best practices
Risk assessment procedures
What to do if a breach or HIPAA violation is suspected
Violation examples
5. Loss or Theft of Devices
With the growing number of tablets, smartphones, and wearable devices entering the healthcare industry, loss and theft of devices containing PHI occur more frequently. When these devices are lost or stolen, the security measures implemented on them are the only barriers between the PHI’s protection and unauthorized access.
Below are best practices for handling and protecting devices:
Implement device handling, storage, and loss or theft of device protocol training
Never leave devices open/unlocked or unattended
Store devices in a safe or unit with a lock when not in use (only share combination with authorized personnel)
Enforce a sign-in/sign-out policy to track when the device is being used and by whom
Install security cameras where devices are stored and commonly used
Implement tracking software, strict access controls, and encryption on all devices
Conclusion
Complying with HIPAA regulations is not just a legal requirement but a declaration of morality and respect. As a home care provider, patients trust you with their sensitive health information, space, and well-being. So, choosing the best methods of care is of the utmost importance.
ShiftCare offers HIPAA-compliant home care software with features that streamline admin tasks, provide excellent support, and reduce costs, allowing patients to receive exceptional care.
Try ShiftCare for free and discover how your agency can meet HIPAA compliance with home care software.
