HIPAA is designed to protect patients’ sensitive health information, but HIPAA violations remain a major issue for healthcare providers, insurers, and business associates. Failing to comply can result in hefty fines, legal action, and reputational damage. In 2023 alone, the U.S. Department of Health and Human Services (HHS) issued $4.3 million in HIPAA violation fines, underscoring the importance of strict compliance.
Despite clear regulations, many violations occur due to lack of training, poor security measures, and improper PHI handling. This article explores the most common HIPAA violations and practical ways for covered entities to stay compliant and avoid costly mistakes.
1. Unauthorized Access to PHI
Unauthorized access to Protected Health Information (PHI) is one of the most common HIPAA breaches. This includes employees snooping on patient records without a valid reason or accessing information out of curiosity rather than necessity.
High-profile cases include hospital staff accessing celebrity medical records without authorization, leading to major fines and terminations. In 2022, a Texas hospital was fined $1.6 million after employees accessed patient records without legitimate purposes.
How to Avoid It
Covered entities should implement Role-Based Access Control (RBAC), ensuring employees only access the PHI necessary for their job. Regular audit logs and monitoring tools can detect unauthorized access in real time, allowing administrators to flag suspicious activity before it becomes a full-blown breach. Mandatory HIPAA training should reinforce the importance of patient privacy and the legal consequences of unauthorized access.
2. Failure to Implement Proper Security Measures
Weak security protocols leave PHI vulnerable to cyberattacks and unauthorized access. Many HIPAA violations occur because organizations fail to encrypt data, update software, or secure devices used to access patient records. A major example is the Anthem data breach, where hackers stole 78.8 million patient records due to poor encryption practices, resulting in a $16 million HIPAA fine.
How to Avoid It
Organizations should enforce end-to-end encryption for all PHI, both at rest and in transit, ensuring that even if data is intercepted, it remains unreadable. Multi-Factor Authentication (MFA) should be mandatory for logging into EHR systems, adding an extra layer of security. Regular penetration testing and risk assessments help identify vulnerabilities before attackers do, ensuring proactive security measures.
3. Lack of Employee Training
Many HIPAA violations occur simply because employees do not understand the law. Staff may accidentally disclose PHI, click on phishing emails, or fail to follow security policies due to a lack of training. The HHS Office for Civil Rights (OCR) consistently cites insufficient workforce training as a leading cause of HIPAA breaches. For instance, Children’s Hospital Colorado was fined $548,265 due to insufficient workforce training that resulted in a phishing incident.
How to Avoid It
Training should be mandatory for all employees and conducted annually, with updates when regulations change. Organizations should offer interactive training sessions with real-world scenarios, ensuring employees recognize threats like phishing attacks and social engineering. Regular testing and HIPAA compliance quizzes help assess employee knowledge and reinforce security best practices.
4. Improper PHI Disposal
The Violation
Failing to properly dispose of Protected Health Information (PHI) is a serious HIPAA violation that can lead to data breaches, legal penalties, and reputational damage. PHI is not limited to medical records—it also includes billing information, lab results, prescriptions, insurance details, and even appointment schedules. Improper disposal of these materials can expose patients to identity theft and fraud, as well as put covered entities at risk of compliance violations.
For example, in 2016, New York-Presbyterian Hospital agreed to a $2.2 million settlement for allowing patients to be filmed for a television show without obtaining prior authorization, which is a violation of HIPAA’s privacy rules.
How to Avoid It
All paper documents should be shredded before disposal. Digital PHI stored on USBs, hard drives, or cloud servers should be securely erased using data-wiping software before disposal or repurposing. Organizations must follow the NIST 800-88 Guidelines for Media Sanitization, ensuring that PHI cannot be recovered after deletion.
5. Insufficient Business Associate Agreements (BAAs)
The Health Insurance Portability and Accountability Act (HIPAA) mandates that covered entities establish Business Associate Agreements (BAAs) with third-party vendors that handle Protected Health Information (PHI). These agreements ensure that vendors adhere to HIPAA regulations and safeguard PHI appropriately. Neglecting to implement BAAs can result in substantial penalties.
For instance, North Memorial Health Care of Minnesota faced a $1.55 million fine for failing to execute a BAA with a major contractor, which had access to the PHI of approximately 9,000 patients.
How to Avoid It
Before sharing any PHI, organizations must ensure that vendors sign BAAs outlining how they will protect sensitive data. Vendors should be required to conduct regular HIPAA compliance audits, and covered entities must verify their security practices before granting access to PHI.
6. Failure to Conduct Risk Assessments
HIPAA requires regular security risk assessments to identify vulnerabilities in how PHI is stored and accessed. Many organizations skip or delay these assessments, leaving them exposed to data breaches and compliance penalties.
How to Avoid It
Risk assessments should be conducted annually, with additional reviews after security incidents or system changes. Organizations can use third-party cybersecurity firms to evaluate risks, ensuring all vulnerabilities are properly documented and addressed.
7. Unsecured Electronic Communications
Sending Protected Health Information (PHI) via unencrypted emails, texts, or personal messaging apps can lead to accidental exposure and constitutes a HIPAA violation. For instance, in North Carolina, a doctor requested a nurse to send a patient’s laboratory results via text message. Although only authorized individuals viewed the data, transmitting PHI over an unencrypted and insecure connection posed a risk of unauthorized access. This incident resulted in the nursing facility receiving an e-class deficiency from The Centers for Medicare & Medicaid Services (CMS), highlighting the importance of using secure communication channels for PHI.
How to Avoid It
Healthcare organizations should use HIPAA-compliant messaging platforms for PHI transmission. Encryption, email filters, and secure login portals ensure messages are protected, preventing unauthorized access.
Final Thoughts
HIPAA violations can lead to severe financial penalties, loss of trust, and legal repercussions. By enforcing strict security protocols, training employees, and conducting regular audits, covered entities can protect patient data and avoid costly compliance failures.
For organizations looking to streamline HIPAA compliance, ScaleOps provides automated security monitoring, real-time risk assessments, and compliance enforcement tools to ensure PHI is always protected.Start your free trial today to see how ScaleOps can help keep your organization HIPAA-compliant.