The US healthcare system is quite heavily regulated, and for good reason. It deals with extremely sensitive data that causes a lot of problems if it falls into the wrong hands. For instance, Social Security numbers, account numbers, facial photos, medical record numbers, and addresses are heavily interlinked with healthcare in the US, and these are known as PHI (protected health information). Any organization dealing with PHI needs to ensure HIPAA compliance, as it helps them to ensure the safety of PHI. If organizations fail to do so, they face severe HIPAA violation consequences. This article will focus on some of the common HIPAA violations, consequences of HIPAA violations, and why HIPAA compliance is necessary.
HIPAA compliance is mandatory
HIPAA was introduced back in 1996. However, it is currently being used to ensure that certain patient data stays protected at all times, known as protected health information (PHI). This is crucial because the data in the wrong hands could be used for a lot of nefarious purposes – it gets sold in the black market, it is used to commit medical identity theft, it can disclose medical conditions of the patients that they might find uncomfortable, and so on.
It is quite crucial that healthcare providers, as well as those dealing with PHI, ensure that they are safeguarding PHI at all times. Not only will they face unwanted attention, administrative costs, and a mention in the HIPAA wall of shame, but they will face severe HIPAA violation consequences as well. In order to enforce that the HIPAA rules are being followed, the OCR (Office for Civil Rights) can issue penalties. Moreover, individuals who are violating HIPAA can be terminated as soon as their employer detects the violation. Thus, not only is the organization at risk, but employees who violate the rules and regulations are in danger as well. Organizations can simplify compliance by using solutions like HIPAAReady, which can help them with mitigating violations, but more on that later.
Some common HIPAA violations
There are several ways an organization or its employees can violate HIPAA. Some of the simple but more common ones are:
- Not keeping proper documentation of HIPAA compliance efforts
- Accessing PHI from an unauthorized device and without permission
- Not executing BAAs (Business Associate Agreements)
- Not monitoring PHI access properly
- Not conducting risk analyses
Other than that, here is some more detailed information regarding five common HIPAA violations and how to prevent them as well as five common blunders that might result in HIPAA violations.
HIPAA violation consequences
HIPAA violations have been classified into four tiers.
- Tier 1: The organization was unaware of the violation and it would have been impossible to avoid it even if detected or if it did follow the HIPAA rules to the T. Tier 1 fines start from $100 and go up to $50,000 per violation, with a maximum of $1.5 million per year.
- Tier 2: The organization, or the individual, should have known about the violation but it was an unavoidable violation nonetheless. It can be seen as a violation occurring due to lack of due diligence and reaches quite close to “willful neglect”. The minimum fine is $1,000 and goes up to $50,000 per violation, with a maximum of $1.5 million per year.
- Tier 3: The organization violated HIPAA rule(s) and it was a result of “willful neglect”, but it also attempted to rectify the violation in question. This is where the fines get quite serious. Fines start from $10,000 to $50,000 per violation, maxing out to $1.5 million per year.
- Tier 4: HIPAA violation(s) occurred due to “willful neglect” and where the organization made no effort to rectify the violation. There is no range here – it is $50,000 per violation and it maxes out to $1.5 million a year.
HIPAA violation consequences result in criminal penalties
Other than fines, there are also criminal penalties as consequences as well as potential jail sentences for individuals violating the rules. These are classified into three tiers.
- Tier 1: The person, unwittingly, or with reasonable cause, violated the rule(s). This can result in a jail sentence up to a year and no financial penalties.
- Tier 2: The person used false pretenses to gain access to the PHI, resulting in a sentence of up to 5 years in jail as well as a fine up to $100,000 per violation.
- Tier 3: The person accessed the PHI with malicious intent or for personal gain, resulting in jail time of up to 10 years as well as a fine of up to $250,000 per violation.
Prevent HIPAA violations
As can be seen, there are numerous ways you can inadvertently commit HIPAA violations. On top of that, HIPAA violation consequences can be quite severe – costing you up to $1.5 million per year as well as criminal penalties. You’ll have unwanted media attention, administrative costs, and legal issues to deal with. In short, HIPAA violations are something you simply do not want to face.
However, you can simplify HIPAA compliance management. There are many innovative ways to do that, but using a robust HIPAA compliance software is the better option. HIPAAReady is such an application that, with its set of simple yet powerful features, can remove the administrative burden for you.
Ensure effective training management & scheduling to inform your employees of the latest HIPAA changes as well as provide retraining regarding common sensitive topics like HIPAA violations, their consequences, and how to avoid them. Organizations can lose a lot of time during audits when they do not keep all their HIPAA documentation organized – remove that worry with HIPAAReady, as you can keep all the documentation in a centralized location and be prepared for audits. Conduct internal audits yourself to identify vulnerabilities and address those security issues, mitigating risks of violations. Since your employees are the ones who deal with PHI regularly, keep them all updated and on the same page with HIPAAReady, eliminating any chances of misinformation and clearly communicating the dos and don’ts. Try HIPAAReady now for free and experience how it can mitigate violations for you and simplify compliance management.