B&L PC Solutions realizes that protecting the patient's data cannot be purely a legal mandate but a standard given by trust in health care. The Health Insurance Portability and Accountability Act (HIPAA) establishes sensitive information patient protection standards. But then there are violations with dire consequences. This in-depth guide discusses HIPAA violations examples, what penalties one would incur, and how to avoid them.
A Brief Overview of HIPAA:
Passed in 1996, HIPAA is a federal statute intended to safeguard patients’ sensitive health information from release without the patient's knowledge or permission. The provider is responsible for maintaining the patient's safety and not revealing it without permission.
It became a federal law and comprises several rules:
- Privacy Rule: Sets national standards concerning the protection of individually identifiable health information.
- Security Rule: Aims at establishing electronic protected health information (ePHI) security standards.
- Enforcement Rules: In case of violation, investigations, penalties, and procedures are described.
HIPAA-associated organizations are healthcare professionals, healthcare service providers, clearinghouses, and their professional partners.
What is a HIPAA Violation?
A violation of the HIPAA means that the coverage unit or the Business Association will not maintain any requirements set in the HIPAA standards. Some crimes can be classified based on the nature of culpability:
| Tier | Description | Penalty Range (Per Violation) | Annual Cap |
|---|---|---|---|
| 1 | Unaware of the violation | $137 – $68,928 | $2,067,813 |
| 2 | Reasonable cause, not willful neglect | $1,379 – $68,928 | $2,067,813 |
| 3 | Willful neglect, corrected within 30 days | $13,785 – $68,928 | $2,067,813 |
| 4 | Willful neglect, not corrected | $68,928 – $2,067,813 | $2,067,813 |
Common HIPAA Violation Examples
- Unauthorized Access to PHI: Accessing records without legitimate cause (e.g., snooping on celebrity files).
- Loss or Theft of Unencrypted Devices: Misplaced laptops or USBs with unencrypted PHI.
- Improper Disposal of PHI: Discarding documents without secure shredding or deletion.
- Sharing PHI on Social Media: Posting patient info or photos without consent.
- Sending PHI to the Wrong Recipient: Faxing or emailing sensitive data to unintended recipients.
- Lack of Access Controls: Unauthorized staff gaining access due to inadequate role-based restrictions.
- Inadequate Employee Training: Staff violating HIPAA due to lack of knowledge.
- Failing to Provide Access to Patient Records: Not delivering records within 30 days.
- Speaking in Public Places About PHI: Discussing PHI in common areas or elevators.
- Use of Personal Devices Without Security: Accessing or storing PHI on unsecured personal devices.
Real-World HIPAA Violation Examples
1. Anthem Inc. – Largest HIPAA Settlement
What Happened: Hackers accessed nearly 80 million records via phishing.
Violation: Inadequate cybersecurity.
Consequence: $16 million fine.
Lesson: Conduct enterprise-wide risk assessments.
Source
2. New York-Presbyterian Hospital/Columbia University
What Happened: 6,800 records exposed due to server misconfig.
Violation: Poor safeguards.
Consequence: $4.8 million fine.
Lesson: Technical errors can be costly.
Source
3. UCLA Health System
What Happened: Celebrity records accessed.
Violation: Unauthorized access.
Consequence: $865,000 fine.
Lesson: Curiosity is not an excuse.
Source
4. Cottage Health
What Happened: Two breaches exposing over 50,000 records.
Violation: Poor safeguards.
Consequence: $3 million settlement.
Lesson: Repeated mistakes cost more.
Source
5. Walgreens
What Happened: Pharmacist disclosed patient info to ex-boyfriend.
Violation: Improper disclosure.
Consequence: Lawsuit & damages.
Lesson: Monitor and train staff.
Source
6. Jackson Health System
What Happened: Employee leaked info to media.
Violation: Unauthorized disclosure.
Consequence: $2.15 million settlement.
Lesson: Monitor access logs.
Source
7. MD Anderson Cancer Center
What Happened: Lost unencrypted devices with 33,000 records.
Violation: Lack of encryption.
Consequence: $4.3 million fine.
Lesson: Encryption is mandatory.
Source
8. Pagosa Springs Medical Center
What Happened: Ex-employee accessed PHI post-employment.
Violation: Failed access termination.
Consequence: $111,400 settlement.
Lesson: Offboarding matters.
Source
How to Avoid Violating HIPAA
- Regular Employee Training: Keep teams updated on HIPAA rules.
- Implement Access Controls: Restrict PHI access to authorized personnel.
- Encrypt Electronic Devices: Ensure all devices with PHI are encrypted.
- Secure Communication Channels: Use encrypted channels for PHI exchange.
- Develop Clear Policies: Define how to handle, store, and dispose of PHI.
- Conduct Audits Regularly: Identify and mitigate risks before breaches happen.
- Immediate Breach Response: Respond swiftly to any data breach.
Conclusion
HIPAA compliance is necessary to protect the patient and gain confidence in the health care system. Specific violations based on real-world problems and learning can help organizations implement appropriate security procedures. B&L PC Solutions is dedicated to helping health care professionals navigate HIPAA rules and providing strong data protection.
Frequently Asked Questions (FAQs)
- What is the most frequent HIPAA offense?
Improper use of Protected Health Information (PHI) without legitimate reason. - Can anyone be held responsible for the HIPAA breach?
Yes, depending on the severity, criminal and civil penalties may apply. - Where should I report HIPAA violations?
Submit a Civil Rights Complaint to the Office for Civil Rights (OCR) at the US Department of Health and Human Services. - What if a HIPAA violation is accidental?
Even accidental breaches are punishable, but corrective action can reduce penalties. - How many times should HIPAA training be conducted?
Initially upon hiring and then regularly for ongoing compliance.
Secure your compliance with B&L PC Solutions' HIPAA Compliance Services on Long Island. Don’t wait for a violation to harm your reputation. Partner with B&L PC Solutions for tailored HIPAA strategies. Our experts are here to guide you every step of the way.
