A HIPAA violation is a failure by a HIPAA Covered Entity or Business Associate to comply with requirements in the HIPAA Privacy Rule, HIPAA Security Rule, or HIPAA Breach Notification Rule, including failures involving protected health information safeguards, permitted uses and disclosures, or required notifications.
Organizations and Individuals Covered
HIPAA obligations apply to HIPAA Covered Entities and their workforce members. HIPAA obligations also apply to Business Associates and their workforce members when they create, receive, maintain, or transmit protected health information on behalf of a HIPAA Covered Entity.
A Business Associate can violate HIPAA through its own actions or through failures to manage subcontractors that handle protected health information under the Business Associate’s direction.
Types of HIPAA Violations
Privacy violations involve improper uses or disclosures of protected health information, failures to follow the HIPAA Minimum Necessary Rule, and failures to provide required protections for patient rights workflows. Privacy violations can occur through misdirected communications, unauthorized access, improper sharing, or disclosing more information than the job function requires.
Security violations involve failures to implement or follow administrative, physical, and technical safeguards required by the HIPAA Security Rule to protect electronic protected health information. Security violations can include weak access controls, failure to manage user accounts, inadequate device security, improper remote access practices, and failure to address identified risks.
Breach notification violations involve failures to identify, document, assess, and notify as required after discovery of a breach of unsecured protected health information. Notification failures can include late reporting to required parties, incomplete information, or failure to follow established incident response procedures.
Common Operational Examples
A workforce member accesses a patient record without a job-related purpose. A message containing protected health information is sent to the wrong recipient. Paper records are left in an unsecured location where unauthorized individuals can view them.
A user account is shared among multiple staff members. A laptop or mobile device containing electronic protected health information is lost without required safeguards. A phishing email leads to credential compromise and unauthorized access to systems containing electronic protected health information.
Consequences and Enforcement Outcomes
HIPAA violations can lead to corrective action plans, monitoring, civil monetary penalties, and reputational harm. Organizations may also impose workforce sanctions under internal policies, including retraining, access restrictions, or disciplinary measures.
A violation can also trigger contractual consequences, including required notifications to clients, audits, or termination rights in Business Associate Agreements.
Incident Reporting and Organizational Response
Organizations should require workforce members to report suspected unauthorized access, use, or disclosure of protected health information and suspected security incidents through a designated internal channel. Compliance, privacy, and security personnel should document the event, contain risk, evaluate whether a breach determination process applies, and implement mitigation and corrective actions.
Business Associates should follow contractual reporting requirements and internal escalation procedures that support timely notification to the HIPAA Covered Entity.
Prevention Controls
HIPAA policies and procedures should define permitted uses and disclosures, access rules, safeguard expectations, and reporting pathways. Role-based access controls, unique user identification, and logging support detection and accountability. HIPAA awareness training should be provided to all staff in contact with protected health information and refreshed on an annual cycle as an industry best practice.