HIPAA Compliance: Why You Shouldn't Risk Getting it Wrong

Over 176 million patients in the US have been impacted by breaches of protected health information (PHI), most of which have stemmed from employee negligence and failure to comply with HIPAA rules and regulations, according to the National Library of Medicine. HIPAA compliance is just a fact of life for those working in the healthcare field— especially care teams who engage in data-sharing and frequent communication with patients.

Today, we’re talking all things HIPAA: What it is, examples of non-compliance, and why you shouldn’t risk getting it wrong.

What is HIPAA?

The Health Insurance Portability and Accountability Act, more commonly referred to as “HIPAA,” was enacted in 1996 as a means to secure health data (written, electronic, or verbal) and safeguard patient privacy. HIPAA regulations apply to providers, insurers, and other organizations that handle patient data.

HIPAA Violations and Penalties

HIPAA compliance is non-negotiable for nearly anyone who handles PHI, and violations may result in civil—or even criminal—penalties that can be (to put it lightly) bothersome to deal with.

8 Examples of HIPAA Violations

Below are some examples of common violations that are important to be aware of:

1. Failure to provide the patient with access to their PHI
2. Unauthorized access to or disclosure of PHI
3. Failure to properly implement PHI safeguards
4. Failure to carry out an organization-wide risk analysis
5. Failure to safeguard electronic PHI (ePHI) on portable devices via encryption or equivalent measure
6. Improper disposal of PHI
7. Missing the 60-day deadline for breach notifications
8. Misplacement of medical records (even in cases where they’re eventually found)

HIPAA Non-Compliance Penalties: Civil and Criminal

Civil

If a violation is discovered, the Office for Civil Rights (OCR)—a government agency responsible for enforcing HIPAA compliance—will attempt to resolve the matter through a corrective action plan or they may opt for monetary penalties.

Criminal

If the violation appears to be a criminal matter, the OCR may refer it to the Department of Justice (DOJ) for further investigation. Offenders who are found to have knowingly and improperly obtained or disclosed PHI may be subject to fines of up to $50,000 and one year in prison. Violations committed under false pretenses could rack up $100,000 in fines and up to five years of prison time. Violations involving the intent to sell or use PHI for unauthorized commercial or personal gain could result in fines of up to $250,000 and 10 years of prison time.

HIPAA Compliance Checklist

Needless to say, the consequences of HIPAA non-compliance are anxiety-inducing, but with the right planning, your organization will be primed for success. The following checklist can be used as a starting point to make sure you’re on the right track.

1. Conduct a thorough risk analysis of your organization and come up with an action plan and security policies accordingly.
2. Collaborate with interdisciplinary teams across the organization to align on HIPAA rules and regulations and how you’ll carry out your game plan.
3. Train employees on HIPAA requirements and assess the level of patient data that each team member requires access to.
4. Don’t forget about billing. HIPAA should be factored into the billing process as it involves the transmission of ePHI through submitted claims. Any healthcare organization with an in-house billing team should implement a secure communication system.
5. Inform patients of their privacy rights and how their information will be used.
6. Invest in HIPAA-compliant technology to simplify the process and streamline your workflow.

(Note: This checklist is for informational purposes only and should not be taken as legal advice. Please consult a qualified legal professional as needed.)

The Right Tools Are Crucial

In the digital age, having access to comprehensive, HIPAA-compliant tools and technologies that safeguard sensitive data isn’t merely a suggestion—it’s an absolute must. The best tools for the job will be equipped with enterprise-grade security and built-in HIPAA-compliant messaging that lets care teams and their patients communicate securely and seamlessly.

Don’t Cut Corners When it Comes to Compliance!

It’s important to keep in mind that, while HIPAA-compliant technology is a necessity for those who handle patient data, it’s ultimately the responsibility of each organization to conduct a thorough risk analysis, train employees, and get the ball rolling on interdisciplinary collaboration. A top-of-the-line Chronic Care Management platform ensures that patient data is encrypted and that only authorized parties have access to it.

Complying with HIPAA rules and regulations may initially feel overwhelming, but investing in the right tools and protocols will safeguard your organization from serious penalties and hefty fines.

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