HIPAA Violations: Top 5 Ways to Avoid Fines (and Maybe Get Promoted)
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With HIPAA violation fines reaching up to $63,973 (per violation) and a maximum annual penalty of $1.9 million for all identical violations (per provision), the high stakes are increasingly clear for why healthcare professionals must always seek to remain HIPAA-compliant.
Since HIPAA regulations are unhelpfully complex and ever-evolving, keeping track of the latest changes and violations would be difficult without a dedicated compliance team.
The bottom line is consistent workforce training can educate your staff on how to remain HIPAA-compliant and, collectively, protect your organization against violations with due diligence (and not by chance).
You can decrease your organization's likelihood of being listed on the HIPAA "Wall of Shame" by staying vigilant to these top 5 frequent HIPAA violations. This quick advice can help you become an internal "compliance hero" (and perhaps build your case for a promotion) by repeatedly saving your organization from unnecessary fines, penalties, and costs.
The HIPAA "Wall of Shame" by HHS OCR
Check out the HSS OCR's Breach Portal —dubbed the HIPAA "Wall of Shame" online— to view the current list of significant breaches or HIPAA violations affecting 500 people or more. The fact that HHS maintains this list is a sobering reality. However, when we know better, we can do better to decrease our risk of expensive fines or even jail time.
Who can be held
liable for HIPAA Violations?
- Clinics, providers
- Business associates
(individuals, entities handling PHI)
- Health care clearinghouses
- Health care facilities
- Health plans
- Medicare prescription drug card
sponsors
Ensure that
the most recent HIPAA regulations are shaping
your organization's policies and procedures. Sometimes,
a significant breach might have resulted from
an organization knowingly violating HIPAA requirements (but hoping not to get caught). Other times, many HIPAA
violations and fines happen because people genuinely thought they were
compliant (but acted out inadequate policies and procedures).
Top 5 Most Frequent HIPAA Violations Causing Fines and Penalties
Here is a list of
the top 5 most common HIPAA violations (based on HHS
OCR Resolution Agreements & OIG Enforcement Actions) that plagues the
U.S. healthcare industry with fines & penalties.
#5. Disclosing PHI to an Unauthorized 3rd Party
Protected health information
(PHI) must be discussed only with authorized people who need to know (such
as the patient, the doctor/physician, and necessary billing information for
procedures, medications, or follow-up services). A direct HIPAA violation is when you have access to and discuss PHI with somebody without the right of access. You can mitigate the majority of these data
breaches or violations through consistent
LMS
workforce training
that identifies and safeguards access, use, and
transmission of PHI records.
#4. Managing PHI, or Improper Disposal of Records
An essential procedure to enforce is the proper disposal of PHI
records. Although it sounds too simple, who did remember the trash? Staff members should understand that all information that
contains PHI (such as social security numbers,
medical procedures, diagnoses, etc.) should be
shredded, destroyed, wiped from the hard drive, and so on. PHI could get
into the wrong hands and become a severe HIPAA
violation when any sensitive information is accessible (or left exposed in a trash can, in a computer's recent files
folder, etc.).
#3. Missing Technology, Lost or Stolen Devices
Treat any device as sensitive
if it has ever
accessed, stored, or transmitted PHI. Implement policies and procedures that
demarcate personal life from professional life
through inventory tracking for company items (ranging
from company laptops, smartphones, or USB devices). When smart technology becomes missing
or stolen, that convenient
device may become an entry point for exposing PHI— a direct HIPAA violation.
#2. Cybersecurity Threats, Hacking & IT Incidents
Malicious actors will continue
to target the healthcare industry. The risks of HIPAA
breaches are increasing with physical office
break-ins or digital technology hack-ins. Ensure that your network servers operate in secure
locations and properly manage electronic medical records (EMR). Although we'd
like to think it would never happen to us, targeted ransomware and
malware attacks are real threats. Medical practices must protect against cybersecurity
threats wherever possible.
#1. Insider Threats & The Lack of Employee Training
One of the most
crucial benefits of workforce training is to reduce the risk of insider threats.
Whether the actions are from a disgruntled or
negligent employee, the consequences can be mitigated when you raise
awareness with your healthcare staff. Assigning
a compliance officer and compliance committee can help to review risks to the team and encourage an atmosphere of compliance that
protects your organization.
The Costs of Non-Compliance are Astonishing
What are the costs of
non-compliance to healthcare clinics, providers, and facilities?
- Fines & Penalties: Organizations face monetary
fines and business penalties reaching up to $63,973 (per violation) and a maximum of $1.9 million (calendar-year cap for all identical provisions) when
labeled as non-compliant by regulatory enforcement authorities.
- Settlement Costs: Consider the legal or
non-legal settlements for any defense associated with data
protection, infractions, or other non-compliance issues.
- The Loss of Time: Calculating the cost of
time for staff and their available resources will depend on the incident's
severity.
- Explanations to Management: Can you tell them? The need
for tough conversations cannot be overstated when violations happen or during incidents of
downtime that causes economic loss.
- The Loss of Reputation: As a potential individual
responsible, your reputation is on the line as well as your
organization's reputation due to a HIPAA violation.
A wait-and-see attitude is the
riskiest gamble and not a strategy for handling compliance needs. Even procrastination can result
in a significant loss of public trust. From a business perspective of those ramifications, losing trust through non-compliance must be avoided at all
costs.
How to Avoid HIPAA Violations (and Maybe Get Promoted)
Compliance is more
than a one-n-done checklist. HIPAA
compliance is an ongoing process of reviewing policies and
implementing corrective action plans. You can decrease the risk of HIPAA
violations through our approach of identifying, mitigating, and protecting your
organization with an effective compliance program tailored to your needs.
Healthcare
Compliance Pros (HCP) offers an
all-in-one compliance platform to help you manage your complete
compliance program (HIPAA, OSHA, Corporate Compliance, and other essential areas)
with a guarantee of up to $1 million in Audit
Assurance Protection. You can start actively fostering an atmosphere of compliance by
leveraging our workforce training courses available
in the learning
management system (LMS).
Are you already an
HCP client? Ensure that you maximize your compliance features by logging into the HCP Portal. Contact your
dedicated team of compliance advisors when you need assistance.
Not an HCP client
yet? For more
information about building an "audit proof" compliance program, the fastest way
is to schedule
a free online consultation.
