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HIPAA Violations: Top 5 Ways to Avoid Fines (and Maybe Get Promoted)

HIPAA Violations: Top 5 Ways to Avoid Fines (and Maybe Get Promoted)



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

Healthcare professionals around a table

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.

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