PHI violations can range from providing more information than the minimum necessary to achieve the purpose of an allowable disclosure to the hacking of an unencrypted database that exposes the PHI of thousands of patients. Violations of HIPAA involving the unauthorized disclosure of PHI beyond the permitted uses and disclosures are the most common type of HIPAA violation. Since the publication of the Final Omnibus Rule in 2013, Business Associates have had the same requirements as Covered Entities to comply with the Privacy, Security, and Breach Notification Rules as found in 45 CFR Parts 160, 162, and 164. Most health care providers qualify as a Covered Entity, but it is important to be aware that some are exempted.īusiness Associates are businesses with whom a Covered Entity shares PHI to help carry out its health care activities and functions.
Covered Entities are defined as health plans, health care clearing houses, and health care providers who electronically transmit PHI in connection with transactions for which HHS has adopted standards. The Standards apply to Covered Entities and Business Associates. Examples of other types of HIPAA violations are provided below along with the penalties that may be applied when a violation of HIPAA occurs. For example, one of the most common types of complaint relates to the failure to provide patients with copies of their PHI on request. The failure to comply with these Standards is considered a violation of HIPAA – even if no harm has resulted. Since its passage, Standards have been introduced to improve patients´ rights and safeguard Protected Health Information (PHI). The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was introduced to simplify the administration of healthcare, eliminate wastage, prevent healthcare fraud, and ensure employees could maintain healthcare coverage between jobs. Nonetheless, it may be important for some to review their interpretation of what constitutes a violation. While these statistics imply more than two-thirds of people do not understand what is a HIPAA violation, it is important to put the statistics into context as they only relate to complaints received by the HHS and do reflect nationwide levels of compliance.
Additionally, in nearly 14,000 cases in which reviews were carried out, no violation of HIPAA was found. However, in more than 200,000 cases, complaints received by HHS have not been reviewed by OCR for reasons such as the entity alleged to have violated HIPAA was not a HIPAA Covered Entity, or the alleged activity did not violate HIPAA rules. On its behalf, the Office for Civil Rights (OCR) has conducted tens of thousands of compliance reviews or intervened with technical assistance before a review was necessary.
The web page is regularly updated with statistics relating to complaints about HIPAA violations, compliance reviews, and enforcement action.Īccording to the most recent update, the HHS has received almost 300,000 complaints since the compliance date of the Privacy Rule (April 2003).
The evidence that there may be a misunderstanding about what a HIPAA violation is comes from the Department of Health and Human Services (HHS) Enforcement Highlights web page. To best answer the question what is a HIPAA violation, it is necessary to explain what HIPAA is, who it applies to, and what constitutes a violation for although most people believe they know what a HIPAA violation is, evidence suggests otherwise.
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