The HIPAA law to protect patient health information is quite well known by personnel in most physician offices. There still remain, however, some questions regarding HIPAA's rules and regulations. Providers who are not up to date with changes in the law risk potential violation that could not only damage a practice's reputation but cause criminal and civil fines.
The Health Insurance Portability and Accountability Act, commonly referred to as HIPAA, was established in 1996 to set national standards for the confidentiality, security, and transmissibility of personal health information.
Healthcare providers are required, under the HIPAA Privacy Rule, to protect and keep confidential any personal health information. It also sets limits and conditions on its use and disclosure without patient authorization. The Rule also gives patients rights to their health information, including rights to obtain a copy of their medical records, and request corrections.
HIPAA does have exceptions to the rule, however, such as if it hindered the ability to provide quality healthcare services. One example is discussion between two physicians who are both treating a patient. In addition, peer reviewed activities, disclosures needed by health plans to resolve billing questions, and other similar situations are exempted.
The Department of Health and Human Services defines covered entities as healthcare providers, health plans, and healthcare clearinghouses, which include hospitals, physicians, chiropractors, dentists, optometrists, schools, nonprofit organizations that provide some healthcare services, and even government agencies. However, those affected by HIPAA does not end there.
HIPAA violations can result in substantial fines to a practice ranging from $100 to $1.5 million. Healthcare providers can also be at risk for sanctions or loss of license.
We list below some of the more common reasons for HIPAA violation citations:
1. Employees disclosing information – Employees' gossiping about patients to friends or coworkers is also a HIPAA violation that can cost a practice a significant fine. Employees must be mindful of their environment, restrict conversations regarding patients to private places, and avoid sharing any patient information with friends and family.
2. Medical records mishandling – Another very common HIPAA violation is the mishandling of patient records. If a practice uses written patient charts or records, a physician or nurse may accidentally leave a chart in the patient's exam room available for another patient to see. Printed medical records must be kept locked away and safe out of the public's view.
3. Lost or Stolen Devices – Theft of PHI (protected health information) through lost or stolen laptops, desktops, smartphones, and other devices that contain patient information can result in HIPAA fines. Mobile devices are the most vulnerable to theft because of their size; therefore, the necessary safeguards should be put into place such as password protected authorization and encryption to access patient-specific information.
4. Texting patient information – Texting patient information such as vital signs or test results is often an easy way that providers can relay information quickly. While it may seem harmless, it is potentially placing patient data in the hands of cyber criminals who could easily access this information. There are new encryption programs that allow confidential information to be safely texted, but both parties must have it installed on their wireless device, which is typically not the case.
5. Social Media - Posting patient photos on social media is a HIPAA violation. While it may seem harmless if a name is not mentioned, someone may recognize the patient and know the doctor's specialty, which is a breach of the patient's privacy. Make sure all employees are aware that the use of social media to share patient information is considered a violation of HIPAA law.
6. Employees illegally accessing patient files - Employees accessing patient information when they are not authorized is another very common HIPAA violation. Whether it is out of curiosity, spite, or as a favor for a relative or friend, this is illegal and can cost a practice substantially. Also, individuals that use or sell PHI for personal gain can be subject to fines and even prison time.
7. Social breaches - An accidental breach of patient information in a social situation is quite common, especially in smaller more rural areas. Most patients are not aware of HIPAA laws and may make an innocent inquiry to the healthcare provider or clinician at a social setting about their friend who is a patient. While these types of inquiries will happen, it is best to have an appropriate response planned well in advance to reduce the potential of accidentally releasing private patient information.
8. Authorization Requirements - A written consent is required for the use or disclosure of any individual's personal health information that is not used for treatment, payment, healthcare operations, or permitted by the Privacy Rule. If an employee is not sure, it is always best to get prior authorization before releasing any information.
9. Accessing patient information on home computers – Most clinicians use their home computers or laptops after hours from time to time to access patient information to record notes or follow-ups. This could potentially result in a HIPAA violation if the screen is accidentally left on and a family member uses the computer. Make sure your computer and laptop are password protected and keep all mobile devices out of sight to reduce the risk of patient information being accessed or stolen.
10. Lack of training - One of the most common reasons for a HIPAA violation is an employee who is not familiar with HIPAA regulations. Often only managers, administration, and medical staff receive training although HIPAA law requires all employees, volunteers, interns and anyone with access to patient information to be trained. Compliance training is one of the most proactive and easiest ways to avoid a violation.
The privacy and security of patient health information should be a priority for all healthcare clinicians and medical professionals. Make sure your materials are current, update your manuals, and conduct annual HIPAA training to prevent potential violations. Most violations can be easily be prevented by implementing HIPAA regulations into practice policies and procedures and ensuring that all individuals with access to patient information receive the proper training.