What Is a HIPAA Violation in the Workplace? All You Need to Know

HIPAA in the workplace is a severe matter — if your company is not in compliance with HIPAA regulations, you could be looking at fines and other penalties. But what is a HIPAA violation in the workplace exactly, and how can you ensure your business is compliant?

In this blog post, we’ll break down everything you need to know about these violations. So keep reading to learn about the guidelines, how to avoid a HIPAA violation, and more.

What is HIPAA?

The Health Insurance Portability and Accountability Act, or HIPAA, was enacted in 1996 to protect the privacy of patients’ protected health information (PHI). The Act established national standards for handling PHI, including the storage, disclosure, and disposal guidelines.

HIPAA gives patients the right to access their medical records and request corrections to any inaccuracies. In recent years, it has been updated to include provisions for electronic health records and other digital forms of data.

The Importance of HIPAA in the Workplace

HIPAA is important for the workplace because it helps ensure the employees’ medical information stays confidential. This is especially important in workplaces where employees may have chronic conditions or take medication that could affect their work performance.

In addition, compliance with HIPAA helps prevent discrimination against employees with pre-existing medical conditions. By requiring employers to keep medical information confidential, HIPAA protects employees from being denied employment or promotions based on their health status.

In recent years, the rise of electronic health records has made HIPAA even more critical, as sensitive patient data is now easily accessible online. At the same time, covered entities must have strong security measures to protect this information.

In summary, HIPAA laws in the workplace help protect employees’ PHI and prevent discrimination in the workplace.

HIPAA Covered Entities

HIPAA covers all forms of protected health information, including its transfer via electronic, written, and oral communications. Any covered entity that fails to comply with its regulations can be subject to civil and criminal penalties.

HIPAA applies to covered entities, defined as health plans, healthcare clearinghouses, or healthcare providers.

Examples of covered entities include:

  • An insurance company or HMO
  • A government program that pays for healthcare, such as Medicare or Medicaid
  • A workplace wellness program
  • A healthcare provider, i.e., healthcare professionals and facilities where care is provided

A covered entity must also have a business associate who performs certain functions on its behalf. Examples of business associates include billing companies, transcription services, and third-party administrators.

HIPAA Violation in the Workplace

A HIPAA violation can occur when a covered entity or business associate fails to comply with its rules.

Examples of HIPAA Violations at Work

  • An employee sharing patient information with unauthorized individuals
  • A breach of patient data
  • Improper disposal of patient records
  • Accessing patient information without authorization
  • Using insecure methods to transmit patient data, such as email
  • Sharing patient information on social media
  • Failing to provide patients with their HIPAA rights
  • Failing to implement proper security measures to protect patient data
  • Failing to report a breach of patient data
  • Retaliating against an employee who reports a violation

HIPAA violations in the workplace can have serious consequences, including fines, imprisonment, and damage to an organization’s reputation. Employers can avoid them by understanding and complying with the law and taking active steps to protect employees’ privacy.

Employee HIPAA Law Violation

A few potential consequences could arise if an employee violates HIPAA.

First, they could face disciplinary action from their employer. This could include anything from a warning to being fired, depending on the severity of the violation.

Second, they could be subject to civil or criminal HIPAA violation penalties. These penalties can range from a fine to jail time.

Third, the patients or others whose PHI was improperly disclosed might sue the employee. This is known as a “private right of action” and can result in damages awarded to the plaintiff.

Finally, employee HIPAA violations could damage the reputations of both the employee and employer. Even if no legal action is taken, the mere accusation could be enough to cost someone their job. In some cases, the worker might not be able to find new employment after a HIPAA violation.

Employer HIPAA Violations

HIPAA requires that all covered entities provide employees with training on their obligations under the Act. This training must be provided regularly and tailored to each worker’s job duties. Failure to provide this training can result in significant fines for the employer.

Another example of a HIPAA violation by an employer is failing to establish appropriate physical safeguards for protected health information. This includes ensuring that PHI is properly stored and that only authorized individuals can access it. Business leaders who fail to take these precautions can be subject to significant HIPAA violation penalties for employers.

Finally, employers may violate HIPAA by disclosing protected health information without authorization. For example, they might send an employee’s medical records to an insurance company without the employee’s consent. Doing so could result in a fine of up to $50,000 per violation.

How to Avoid a Workplace HIPAA Violation

The best way to avoid a HIPAA violation is to ensure that all employees with access to PHI are adequately trained on HIPAA compliance. Covered entities should also have policies and procedures in place.

The Consequences of Violating HIPAA

The consequences of violating HIPAA are significant, and anyone who handles patients’ medical information should take care to comply with the law. Breaching HIPAA regulations can result in fines from $100 to $50,000 and imprisonment of up to 10 years. In some cases, violators may also be subject to civil liability.

Patients who have had their health information mishandled may also file lawsuits, seeking damages. As a result, covered entities need to take steps to ensure that they comply with HIPAA.

HIPAA Guidelines for Employers

The HIPAA Privacy Rule sets strict guidelines for using and disclosing protected health information (PHI). Under the Privacy Rule, covered entities must take reasonable steps to safeguard PHI from unauthorized access, use, or disclosure.

In addition, under HIPAA, employees who work for covered entities are considered “covered individuals” and are subject to the same privacy and security rules as other covered individuals.

To ensure employer HIPAA compliance, covered entities should develop policies and procedures governing employee use and disclosure of PHI. These policies should be designed to protect the confidentiality of this information while still allowing workers to perform their job duties.

Covered entities should also provide regular training on HIPAA privacy rules for employees. By taking these steps, covered entities can help protect the confidentiality of PHI and avoid potential fines and penalties.

It’s important to emphasize that HIPAA doesn’t prohibit an employer from the following:

  • Requesting a doctor’s note for an absence or sick leave
  • Requesting information related to healthcare coverage or wellness programs
  • Asking for evidence of COVID-19 vaccine or test results

HIPAA Do’s and Don’ts for Employees

The HIPAA Privacy Rule sets strict standards for how PHI can be used and disclosed. However, with a little knowledge and effort, workers can easily comply with the HIPAA Privacy Rule. Here are some key HIPAA guidelines for employees to keep in mind:

  • Do: Keep PHI secure at all times. Organizations must take steps to protect physical records from being lost or stolen and ensure the electronic PHI is securely transmitted and stored.
  • Don’t: Share PHI without authorization. Unless an individual has given explicit permission, PHI should not be shared with anyone outside the organization.
  • Do: Respect patient privacy. Patients have a right to know who has access to their PHI, and they should be able to request that their information be kept confidential.
  • Don’t: Use or disclose more PHI than is necessary. When using or disclosing PHI, only include the information that is necessary for the task at hand.

By following these simple guidelines, workers can help ensure the security of PHI and avoid potential HIPAA violation penalties for employees.

What Should You Do if You Suspect a HIPAA Violation Has Occurred?

If you think a HIPAA violation occurred in the workplace, there are several steps you can take. 

First, try to resolve the issue directly with the individual or organization involved. If this is not possible, or if the problem persists, you can file a complaint with the Office for Civil Rights (OCR). OCR is responsible for enforcing HIPAA rules and will investigate any complaints they receive.

Next, you should document the details of the incident, including when and where it occurred and who was involved. This information will be essential for the investigation.

Finally, it would help if you refrained from discussing the incident with colleagues or anyone outside the investigation. Doing so could jeopardize the outcome or result in disciplinary action.

Following these steps can help ensure that a HIPAA violation at work is handled swiftly and appropriately.

Who Can Employees File Possible HIPAA Violations To?

If you believe your employer has violated your rights under the Health Insurance Portability and Accountability Act, you can report this in several ways. Depending on the nature of the violation, you may be able to file a complaint with your state’s insurance commissioner, your health plan, or the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR).

Contact the National Association of Insurance Commissioners (NAIC) to file a complaint with your state’s insurance commissioner. The organization can help you locate your state’s insurance department website so that you can submit a complaint electronically or via mail.

Can You Sue Your Employer for HIPAA Violation?

HIPAA does not generally protect an individual’s right to sue their employer for violating its provisions. However, there are a few exceptions to this rule, including an employer disclosing an individual’s health information in violation of their right to confidentiality. Another example is when an employer retaliates against an employee for exercising their rights under HIPAA.

If an employer discloses PHI in a way that violates the Act, the individual may file a civil suit against the employer. The accuser can seek financial damages, including reimbursement of the medical treatment and therapy costs related to the breach and punitive damages.

In addition, if an employee is responsible for the disclosure, they may be subject to criminal penalties.

The Exceptions to the HIPAA Rules

There are some exceptions to the HIPAA rules. However, they are typically only granted in cases where patient privacy is not at risk.

For instance, HIPAA permits covered entities to share protected health information (PHI) without patient authorization in certain situations, such as when law or Public Health Authority guidelines are in effect.

Another common exception includes sharing information with family members or friends involved in the individual’s care.

In addition, PHI may be shared amongst covered entities for treatment purposes without patient authorization. You can contact your local Office for Civil Rights representative for more information on these and other exceptions to HIPAA rules.

Resources for Learning More About HIPAA and Protecting Patient Privacy

Here are some resources for learning more about HIPAA at work and safeguarding your personal healthcare information:

The U.S. Department of Health and Human Services’ Office for Civil Rights enforces HIPAA regulations and provides resources for patients and providers. Their website includes FAQs, educational materials, and contact information for filing a complaint.

The Centers for Medicare & Medicaid Services also offer resources on their website, including an overview of HIPAA rules and tips for patients on guarding their personal information.

Numerous private companies provide compliance consulting services and educational resources on HIPAA, such as Compliancy Group, Protenus, and Secure My Health Record.

Patients should be aware that they can learn about HIPAA  and safeguard their PHI through many methods. By educating themselves, they can help ensure that their HIPAA employee rights are protected, and their privacy is respected.

What Is a HIPAA Violation in the Workplace?  — Final Thoughts

As you can see, there are several ways a HIPAA violation can occur in the workplace. Therefore, it is important to be aware of the potential risks and take steps to prevent them from happening.

If you believe your workplace may have committed a HIPAA violation, it is essential to report it to the proper authorities. Doing so can help to ensure that the problem is addressed and corrected. Moreover, it can help prevent future violations from occurring.

What is a HIPAA Violation in the Workplace? — FAQ