The Health Insurance Portability and Accountability Act (HIPAA) establishes requirements for the healthcare industry to encourage the use of electronic media for patient data. It also requires that healthcare providers, health plans, and healthcare clearinghouses protect this data. Those who fail to do so may be subject to HIPAA violation penalties.
The Department of Health and Human Services enforces HIPAA rules. Unintentional violations can result in civil penalties, while violations committed with malicious intent may result in criminal charges. The most common violations occur because of human error, misconfigured computer systems, and improperly shared data.
HIPAA rules only permit covered entities to use personal health information (PHI) for treatment, health care operations, and payment. One of the most common HIPAA violation penalties occurs when employees access or share PHI for a non-permissible reason, such as snooping through the healthcare records of a friend.
Employees who commit this violation are usually fired from their jobs and could face criminal charges if the intent behind the access was malicious. Their employer may also face substantial fines.
The HIPAA Privacy Rule entitles patients to access their medical records on demand. Covered entities who do not allow patients to obtain copies of their health records or take longer than 30 days to respond to requests may face fines that range from $3,500 to more than $4 million.
Most healthcare providers work with many vendors. If those vendors have access to PHI and fail to follow the HIPAA regulations, the providers who gave them access may face HIPAA violation penalties
HIPAA regulations require healthcare companies and the vendors who work with them to complete an organization-wide risk analysis to identify any security issues that put patients’ PHI at risk. Penalties for not completing this risk assessment range from $100,000 to $6 million in fines. Security violations that occur because of failing to perform the risk analysis or address known security issues can result in additional penalties.
HIPAA rules do not require organizations to encrypt data, but organizations that do not use encryption must use an equivalent security measure instead. Violations of this rule often occur when employees accidentally download unencrypted data onto mobile devices or leave data, such as patient charts, where unauthorized people can access it. Fines for these violations can be millions of dollars.
HIPAA violations often occur because employees are careless or do not understand the rules. Comprehensive employee training on the rules and best practices for accessing, sharing, and protecting PHI can avoid many penalties. Organizations must also implement strong cybersecurity measures and regularly check for and correct security flaws.
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