What is Considered a HIPAA Violation?
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that sets standards for the protection of electronic Protected Health Information (ePHI). HIPAA defines ePHI as "individually identifiable health information" that is transacted electronically, and violations of its rules and regulations can have serious consequences.
What is a HIPAA Violation?
A HIPAA violation is any breach or failure to comply with the law’s rules and regulations related to the use and disclosure of ePHI. Breaches are considered significant and must be reported to the U.S. Department of Health and Human Services (HHS) and affected individuals if they meet certain threshold numbers. Breaches involving fewer than 500 individuals are required to be reported to the HHS on an annual basis.
Here are some examples of common HIPAA violations:
Unauthorized Disclosure
- Discussing a patient’s confidential health information in a public setting
- Posting information about a patient on a social media platform
- Leaving paper or electronic health records (EHRs) in a public area
- Sharing confidential patient information with unauthorized individuals
Data Breach
- Losing a portable data storage device (laptop, flash drive, etc.) containing ePHI
- Using public Wi-Fi or public Internet access to transmit or receive ePHI
- Opening an email with a suspicious attachment or phishing link containing ePHI
- Disposal of confidential documents, e.g., paper files with patient information, without using a secure method
Unsecured Electronic Devices
- Leaving computers or mobile devices with unencrypted ePHI unsecured
- Not setting up a lock or logoff function on an ePHI-containing device
- Failing to use full-disk encryption on laptops, smartphones, or tablets
Administrative Issues
- Failing to properly update or configure security systems, e.g., antivirus software
- Inadequate staff training or ongoing education on HIPAA
- Not establishing incident response plans for breach and security incident responses
- Lack of technical support and resources to monitor and test systems and policies
Table 1: Common HIPAA Violations and Examples
| Violation Category | Example |
|---|---|
| Unauthorized Disclosure | Discussing a patient’s confidential health information in a public setting |
| Data Breach | Losing a portable data storage device (laptop, flash drive, etc.) containing ePHI |
| Unsecured Electronic Devices | Leaving computers or mobile devices with unencrypted ePHI unsecured |
| Administrative Issues | Failing to properly update or configure security systems, e.g., antivirus software |
The Consequences of a HIPAA Violation
Penalties for HIPAA violations can be severe, depending on the circumstances. HHS has established two tiered systems for evaluating fines:
Tier 1: Willful Neglect
- Unconsciousable Intent: Lack of intent but the violation occurred despite procedures were in place
- $100-$50,000 per year and up to $1.5 million for similar failures
- Reckless Disregard: Conduct shows deliberate indifference or disregard
- $10,000-$250,000 and up to $1.5 million for similar failures
Tier 2: Knowing Disregard
- Actual knowledge: Knowledge or willingness to turn a blind eye
- $25,000-$1,500,000 per occurrence
- Extenuating circumstances: Exceptions may be granted based on factors like mitigating damages
- Customizable fines up to the specified limits
In conclusion
HIPAA violations are serious offenses that can lead to severe consequences for both individuals and organizations. By understanding the different types of violations, their potential penalties, and taking steps to prevent breaches, the healthcare industry can minimize risk and maintain trust in maintaining patient confidentiality.
Stay vigilant: Remember to report incidents and notify affected individuals whenever a HIPAA breach or violation occurs. Proper compliance with HIPAA rules and regulations will help safeguard electronic Protected Health Information (ePHI) and minimize the risk of adverse penalties.
