scenarios that could lead to a violation of HIPAA law

What is HIPAA Violation in the Workplace?

The HIPAA law and its corresponding rules and policies were created to define the minimum standards of compliance that all covered entities must abide by. However, violations can happen and while they are common, they can come with costly fines. It is important to put priority on training and understanding the rules and policies under HIPAA to ensure you do not commit these violations. So, what is a HIPAA violation in the workplace?

This guide will explain the common violations organizations face and what to do in the event you are guilty of committing them.

What is a HIPAA Violation in the Workplace?

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was established to protect the health and personal information of patients. Not all information related to a patient is protected by HIPAA law. Instead, it defines protected health information as"individually identifiable information," whether it applies to a patient's past, present, or future medical records. It covers the creation, collection, and transmission of such information.

What is a HIPAA violation in the workplace? It is when a person's protected health information is compromised. The covered entities must ensure that only authorized healthcare workers and their staff have access to this information. It is considered a violation when the information is accessed by someone who does not have proper authorization, regardless if it's willful or inadvertent.

There are two possible reasons why such a violation could occur in the workplace. The lack of awareness of the healthcare professionals responsible for the violation could lead to the breach. And even when employees know, they could lack the proper training in the proper handling and sharing of information that led to the violation of a patient's privacy rights.

HIPAA Violation in the Workplace

Below are some of the common scenarios that could lead to a violation of HIPAA law in the workplace.

  • The healthcare staff releases the patient health records to the wrong patient. This violation might be unintentional, but it is the most common form of HIPAA violation in the workplace. There should be additional measures in place to avoid a careless mistake such as this.

  • The release of a patient's medical health records to unauthorized individuals is another HIPAA violation. If the patient is unable to claim the records her/himself, only those individuals who are explicitly named in the authorization form are given the right to receive the patient records.

  • The release of medical health records that had not been authorized for release. Even if the patient insists, they should not have access to the document until its approval.

  • The sharing of confidential patient health information to unauthorized persons, especially verbally. This scenario is common in a healthcare environment when colleagues casually talk about patient health information, even in the presence of those who are not authorized to have access to such information.

  • The failure to follow the minimum data security protocols in the workplace. The lack of sufficient security protocols could make protected health information at risk of a breach. For example, a healthcare employee sends confidential information through unencrypted emails or fax lines.

  • An employee who is tasked with destroying confidential documents containing patient records fails to follow the disposal measures compliant with the HIPAA Security Rule. This practice could put your patient information at risk of being accessed by unauthorized individuals.

Cost for Violating HIPAA Laws

A hefty fine awaits any violators of the HIPAA law. This fine could be equivalent to thousands of dollars and might even include jail time, depending on the severity of the violation. The cost of the fine will be based on the number of affected individuals and the nature of the violation.

Several other factors are taken into consideration when the Office of Civil Rights assesses your violation, such as the following:

  • Was the breach inadvertent or committed with malicious intent?

  • What actions were taken to address the violation?

  • What is the manner of the violation?

  • Was any harm caused as a result of the violation?

The cost of the fine starts at $100 and could cost up to $50,000 per violation. The covered entity could have more than one violation. The maximum fine can reach $250,000 and up to 10 years in jail.

Whether the violation was intentional or not, it could have a serious financial impact on your organization. You are responsible for educating and training your staff to ensure that they abide by HIPAA policies at all times.

Cost for Violating HIPAA Laws

What to Do After Committing a HIPAA Violation

In case you violate any of the rules and policies mandated by the HIPAA law, you must report it immediately upon discovery. The HIPAA Enforcement Rule indicates that covered entities could face financial settlement as a resolution for the violation. However, you can avoid this if you conduct an internal audit and make the necessary corrections to prevent the recurrence of such violations.

By making corrections internally, you could potentially lessen the harm that is inflicted on the affected parties resulting from the violation. Healthcare organizations that are governed by this rule must conduct an internal risk assessment to identify areas where improvements could be made and prevent the same violation in the workplace.

Prevention Tips

A HIPAA violations are hard to discover because of the difficulty of identifying the exact point where the information was compromised and who initiated it. This situation explains why many healthcare organizations are unaware that they have committed a violation.

Prevention is, therefore, your best line of defense against HIPAA violations in the workplace. You must conduct a periodic risk assessment to ensure that patient information is physically and digitally safe as part of your record-keeping practices.

Employees also play a vital role here. They must be trained regularly to equip them with the knowledge and the know-how on the HIPAA rules and policies. Most of the violations occur at an employee level, so you have to address the cause of the problem before it even occurs. Incompetence and ignorance of the HIPAA rules is not an excuse to risk your organization being penalized for violations when you could easily prevent them.