The Health Insurance Portability and Accountability Act (HIPAA) is a law that aims to protect the information of patients and has been in effect for over 20 years now. Although the law may be common for healthcare providers, violations and misconduct are still inevitable.
People may think that a violation will only matter if it’s on a large scale. Big or small, violations are still violations. It is still damaging to the privacy of the owner of the records.
With the law being enforced for a long time and the violations still rampant, it is time that people became aware of the violations that they commit but don’t know about.
In line with this, we have broken down the ten usual HIPAA violations. We don’t just look at the violations but also at how to comply with the requirements and the penalties that come with each violation.
What Are HIPAA Violations and How Are They Discovered?
HIPAA laws are there to ensure that patient records are secure. The failure to comply, even if there is no harm done, is already considered a violation.
Penalties are also imposed as a result of noncompliance, which is why entities make sure that they are HIPAA compliant.
The primary enforcer of HIPAA rules is the HHS Office for Civil Rights. They are also the ones responsible for the investigations whenever complaints and reports about misconduct are filed.
These reports and complaints can be filed by the healthcare providers themselves. These entities often conduct their internal audits, which in turn allows the entity itself to identify these misconducts.
The OCR will then conduct another internal audit of the entity after receiving such reports. The state attorneys general also has the power and means to conduct an investigation whenever a complaint about noncompliance or a breach is filed.
What Are Some of the Common HIPAA Violations?
Violations are the result of non-compliance. These HIPAA violations do not only include the internal use of healthcare information without the knowledge and consent of your patients.
Failing to train your members regarding the HIPAA compliance requirements, failing to document the training, and withholding information about breaches from those affected are considered HIPAA violations.
Other HIPAA violations are listed below. With these examples below, you can get an idea of what constitutes an HIPAA Violation and make yourself aware so you can avoid it in the course of your healthcare practice.
1. Failure to Perform an Organization-Wide Risk Analysis
This is one of the common HIPAA violations that result in a financial penalty. This assessment should be done to assess the vulnerability of the entity. If the risk analysis is not done regularly, then this could lead to issues of vulnerability of the entity to confidentiality and integrity unresolved.
2. Improper Disposal of PHI
HIPAA rules require that healthcare information be securely stored and properly destroyed. There are paper records and ePHI records. For paper records, it is recommended that they be shredded. In ePHI, securely wiping data or destroying the electronic device where information is stored is considered a way of disposal.
3. Snooping on Healthcare Records
Violation of patient privacy includes accessing the patient’s records for other reasons aside from treatment, payment, healthcare operations, and reasons permitted by the privacy rule. Violation of this rule could lead to criminal charges and financial penalties.
4. Failure to Manage Security Risks or Lack of a Risk Management Process
Assessing and performing risk analysis doesn’t stop when you find issues within your entity. You need to come up with a risk management process to resolve the issue and make sure it won’t occur again. Knowing the risks and doing nothing about them may result in a penalty.
5. Insufficient ePHI Access Controls
The HIPAA compliance manual has required limited access to controls when it comes to electronically available records. The only people who ought to have access are those who have authority over the entity.
6. Entity Not Following the 60-Day Deadline for Issuing Breach Notifications
The HIPAA rules require entities to report any notice of breach or misconduct within 60 days. A penalty will be given to the entities that fail to comply with this requirement.
7. Denying Patient Access to Healthcare Records or Exceeding Timescale for Providing Access
Patients have the right to access their records and be given copies of them upon request. Failure to give patients the records within 30 days and the overcharging for these records are again penalizable.
8. Failure to Take Measures in Safeguarding ePHI on Portable Devices
You can prevent data breaches by encrypting your data. Encryption is not required by HIPAA Law but it cannot be ignored as the entity has to perform certain measures to ensure the data of their patients.
9. Impermissible Disclosure of Protected Health Information
Any disclosure of patient information is prohibited by the HIPAA rules. This includes:
- Disclosure of information to the patient’s employer
- Careless handling of PHI
- Disclosure of PHI after patient authorization expires
10 Failure to Enter into a HIPAA-Compliant Business Associate Agreement
The vendors with whom you will enter into an agreement should be HIPAA-compliant. You should be able to enter into a HIPAA-compliant agreement with the vendors before giving them access to PHI.
What Penalties Are Imposed on HIPAA Violations?
There are civil penalties and criminal penalties. Civil penalties are for violations that are made without malicious intent. It can be applied when the violation is a result of forgetfulness or the offender is not aware of what he did wrong.
Criminal penalties can be harsher than civil penalties as the offender is aware and there is malicious intent.
The following are some examples of criminal penalties:
- The offender may be fined up to $50,000 and put in jail for one year if he discloses information without authorization from the patient.
- The criminal penalty would be a fine of up to $100,000 and jail time of up to 5 years if the offender is proven to have committed violations under false pretences.
- If the crime is proven to have been committed for the personal gain of the offender, the penalty would be a fine of up to $250,000 and a jail term of up to 10 years.
How Can Entities Comply With the Standards Of HIPAA?
In every internal audit done by an entity, there should be a standard of compliance. In line with this, the HHS office issued a document containing the elements of an effective compliance program that can guide the entities.
7 elements compose effective compliance, and they are:
- Establishing effective lines of communication
- Responding quickly to detected offences and performing corrective actions
- Performing internal auditing and monitoring
- Establishing written policies, procedures, and codes of conduct
- Providing staff with effective and adequate training
- Appointing qualified individuals as compliance officers and a compliance committee
- Enforcing established standards through well-promoted disciplinary guidelines
HIPAA is a law that sets standards for the privacy of patient information. It aims to protect patients’ privacy while also ensuring that they receive the best healthcare possible.
Entities must make sure that they are always HIPAA compliant. All of their operations and conduct must adhere to HIPAA policies. Failure to comply with the standards established would result in a penalty, which is dependent on the offender’s knowledge of the offence committed.
Companies and associations that deal with healthcare must make sure that their staff undergo proper training so that they are all aware of the compliance requirements and their importance to the entity.
The HIPAA law is there to guide both the entity and its patients. Complying with this would mean that the entity could give its patients the best service.