5 HIPAA Violation Examples That You Can Avoid

Maintaining HIPAA compliance is an essential way to protect patient privacy and avoid legal repercussions at your facility. The underpinnings of these federal rules are complex, so referencing HIPAA violation examples in the workplace can be a helpful way to identify and prevent the misuse of patient information.

Many healthcare staff may not fully understand what constitutes a violation, so some situations can be unintentional. To help you improve compliance at your facility, we’ll describe five examples of HIPAA violations along with actionable tips for how to avoid them.

What Are HIPAA Violations?

The Health Information Portability and Accountability Act (HIPAA) is a federal law that upholds the privacy and security of patients by outlining standards for handling protected health information (PHI). If a facility fails to meet these standards, this can result in a violation.

HIPAA violation penalties (for employees, managers, or anyone else involved) can range in severity, depending on the situation and resolution process. But, in general, violations of HIPAA rules can result in lawsuits, heavy fines, or even prison time — so it’s essential for facilities to stay well-informed about these regulations. The DHS provides HIPAA violation lawsuit examples on its website, organized by issue and type of entity.

HIPAA Violation Examples in Healthcare

As a facility, adhering to HIPAA regulations is not only a way to avoid penalties, but is also crucial to improving overall quality of care. We’ll walk through five common HIPAA violation examples and share tips to help you prevent them from happening at your facility.

1. Lack of HIPAA Compliance Training

Federal law mandates HIPAA compliance training for all staff members who have access to PHI. Failing to implement, and document, training can result in a violation. Beyond this, training is important for preventing other incidents that could occur from a lack of staff knowledge.

Example Scenario

A clinic is being investigated due to potential mishandling of PHI by a receptionist. To facilitate the investigation, the clinic is asked to provide documentation of HIPAA training delivered during the receptionist’s tenure. While the facility provided regular training to their healthcare providers, they excluded all the receptionists.

Prevention Tips

• Implement training in a timely manner after hiring new employees.
• Thoroughly document all modes of training that are delivered.
• Provide training for all covered entities and business associates.
• Ensure training is HIPAA-certified, covering all essential topics.

2. Inappropriate Sharing of PHI

One of the most common examples of HIPAA violations by nurses, doctors, and other health professionals is inappropriate sharing of PHI. Patient information should only be discussed among authorized personnel when necessary for treatment. But sometimes, employees may inappropriately share patient-related stories to families or friends, or even on social media.

Providing more information than necessary for treatment among staff can also be considered inappropriate sharing of PHI. This encompasses one of many examples of unintentional HIPAA violations.

Example Scenario

A nurse sitting at the workstation loudly complains that the patient in room 204 has a medical condition requiring very extensive care. One of the other nurses points out that her complaints contain PHI that she should not be sharing openly to other staff on the floor.

Prevention Tips

• Promote a positive work culture by dissuading patient-related gossip.
• Implement periodic/annual HIPAA training to provide refreshers on policies.
• Prohibit use of insecure channels (i.e., mobile phones) to relay patient information.
• Have clear and accessible guidelines on what is considered PHI.

3. Unauthorized Access to PHI

Aside from healthcare staff requiring PHI for treatment purposes, access to PHI files must first be authorized by the patient. This means that staff members outside a patient’s care should not be looking through their files. Additionally, family members of a patient will need the patient’s consent to obtain any PHI.

Example Scenario

A nursing assistant has down time on her shift and decides to look through the facility’s EHR. She notices that one of her old teachers is a registered patient, and decides to quickly peek at his records out of curiosity.

Prevention Tips

• Outline access control guidelines and termination policies for inappropriate PHI use.
• Assign unique user IDs for employees to track electronic PHI access.
• Physically secure any hard-copy files containing PHI in locked cabinets.
• Implement protocols for HIPAA violation reporting in the event of unexpected misuse of PHI.

4. Improper Disposal of PHI

HIPAA requires facilities to remove all hard-copy or electronic forms of PHI that are expired or no longer needed for care. This means facilities must implement a robust data control policy throughout their organization. Leaving unnecessary PHI in your facility is one of many HIPAA violation examples that can also increase risk for unauthorized access.

Example Scenario

A doctor is cleaning up his workspace, disposing of paper piles laying on his desk. Some of these papers are hard-copy charts of patients he no longer sees. He doesn’t notice this, and tosses the piles in an open trash bin that’s easily accessed by other people.

Prevention Tips

• Enforce requirement that all hard-copy PHI be shredded into secured bins.
• Work with IT to ensure that electronic files are deleted beyond recovery.
• Conduct regular audits to ensure all expired PHI is properly disposed of.
• Include best practices for PHI disposal in staff training.

5. Unreasonably Denying Patient Access

Facilities are required to grant patients access to their own PHI upon request. Denying copies or imposing unreasonable barriers to access can result in a HIPAA penalty. However, there are some specific circumstances in which a patient could rightfully be denied access.

Example Scenario

A patient calls to request that their medical history be mailed to their residence. It was a particularly busy week at the clinic, so the doctor insists that the patient picks up the forms instead, even though they now live quite a distance away. This can impose an unreasonable barrier for the patient.

Prevention Tips

• Ensure that any requested PHI is provided within 30 days.
• Enforce policies on reasonable fees and formats of access.
• Educate staff about specific cases that rightfully warrant denial.
• Follow procedures for verifying patient identity upon receiving requests.

Stay Current With Your Healthcare Compliance

Now that you’ve read through common HIPAA violation examples — and how to avoid them — you may want other resources to stay on top of healthcare regulations. Sign up for IntelyCare’s free newsletter to get the latest regulatory compliance guides, and more, delivered straight to your inbox.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.