A dentist breaking HIPAA (Health Insurance Portability and Accountability Act) rules can have serious consequences. The results are profound: fines, legal dilemmas, and reputational damages. After all, these rules require protected health information to be strictly kept private.
This article explores what happens if a dentist violates HIPAA and whether it could lead to severe repercussions such as significant financial losses and fines leading to license revocation. You will also learn some best practices for avoiding HIPAA violations.
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Do Dentists Need to Comply With HIPAA?
Dentists, although not explicitly listed, are considered healthcare providers under HIPAA. Therefore, they are part of the “covered entities” that must abide by the HIPAA standards and guidelines.
More specifically, any dental health professional handling and transmitting electronically protected health information (ePHI) must comply with HIPAA. On the other hand, dentists who only cater to cash-paying patients do not need to abide by HIPAA guidelines. This exception generally applies to dentists who do not send or store PHI electronically.
Read: HIPAA rules for dentists
What Happens if a Dentist Violates HIPAA?
A dentist violating HIPAA can face civil and criminal penalties. If proven guilty, the Department of Health and Human Services Office for Civil Rights (OCR) could order the dentist to pay up to $100,000 in civil penalties per violation. The amount will vary based on the violation’s severity.
In some instances, the OCR may waive some or all of the monetary sanctions, especially if they seem excessive compared to the violation. The OCR may also waive penalties if the breach appears to be unintentional.
Depending on the HIPAA violation tier, the Office for Civil Rights may impose criminal penalties on a dentist or group of dentists violating HIPAA. Imposing criminal penalties equates to hefty fines or years of imprisonment. It depends on whether the offense has occurred out of malicious intent.
Examples of HIPAA violations by dentists
The Office for Civil Rights and State Attorneys General can impose monetary civil penalties on dentists for violating HIPAA, resulting in significant fines.
Below are some real-world cases of dentists who violated HIPAA and their corresponding legal and monetary repercussions:
- In 2015, Joseph Beck of Comfort Dentists, Kokomo, Ind., received a $12,000 fine for unauthorized disclosure of patient records left near a dumpster.
- In 2019, Elite Dental Associates in Dallas, Texas, settled for $10,000, addressing improper patient ePHI disclosure on a review site.
- In 2022, three dental practices settled for $142,500, addressing patient rights non-compliance, exposure of PHI on social media, and unauthorized PHI use for marketing.
HIPAA violations by dental workforce members can also lead to more severe consequences. For instance, a 2018 case involving a dental receptionist exploiting system access rights and stealing health data from 653 patients led to a 2 to 6-year sentence.
Common Reasons Why Dentists Violate HIPAA
Here are the primary reasons dentists or dental firms breach the regulations set by HIPAA:
Inadequate document access controls
Adequate internal user security demands distinct access levels for different staff roles. Patient data should be accessible to the relevant personnel while preventing unnecessary access by users, vendors, and entities. Secure individual login credentials and discourage password sharing.
Loss or theft of electronic devices
Devices containing protected health information and other sensitive patient details require additional physical safeguards, particularly for devices that handle, store, or transmit ePHI. It’s best to set devices to auto-lock after a brief period and enable remote data wiping to prevent breaches in case of theft or loss.
Insufficient medical records security
Central to HIPAA compliance is safeguarding patient records. Always remember to secure forms and documents with ePHI using advanced security technologies like AES encryption and role-based user access controls.
Inadequate employee training
Employee understanding of the HIPAA rules is critical for maintaining compliance. Ensure comprehensive training beyond basics, focusing on protocols for dental HIPAA compliance. Conduct regular refresher courses to keep staff informed.
Improper disposal of records and devices
Dispose of records and electronic devices securely. With ePHI, destroying the media or storage device containing sensitive data can help prevent unauthorized disclosure or access. Degaussing is another secure way to remove the files stored on hard drives, USB drives, and SD cards.
Absence of risk management protocol
A lack of a comprehensive risk management plan signifies a serious HIPAA violation. Thus, to ensure compliance, dentists must come up with a risk management plan tailored to the needs or requirements of their dental practice.
Preventing HIPAA Violations: 7 Best Practices for Dental Offices
Following these best practices can help dentists avoid HIPAA violations:
1. Prioritize HIPAA training
Regular employee training is essential to help staff stay updated on HIPAA compliance and better understand its regulations. The Security and Privacy Rule has set specific training guidelines that dentists and dental firms can follow to avoid penalties and fines.
2. Transition to electronic formats
Switching to electronic records can help minimize operational risks such as accidental exposure, improper disposal, and data loss due to disasters. Plus, it’s easier to track, control, and monitor user access and prevent malicious attacks by implementing robust security protocols.
3. Discerning business partnerships
Establish business associate agreements (BAAs) with third-party entities to ensure HIPAA-compliant management and handling of protected health information. This shared accountability further helps safeguard patient privacy.
4. Decode the auditing process
The OCR audit process involves detailed audits examining a dentist’s adherence to the HIPAA Privacy, Security, and Breach Notification rules, followed by comprehensive onsite visits. Detailed reports from these visits reveal compliance methods, findings, and recommendations.
5. Comprehensive documentation
Detailed documentation of security risk assessments, policies, training records, breach notifications, and complaints helps dentists achieve compliance. It’s also an effective way to monitor and assess areas of improvement.
6. Execute thorough risk analysis
Perform an exhaustive risk analysis on electronic assets used for PHI management. Evaluate vulnerabilities, threats, and associated risks in terms of likelihood and severity, enhancing security measures.
7. Devising incident response plans
Develop an Incident Response Plan (IRP) to manage breaches effectively. Customize the IRP according to organizational specifics and keep it up-to-date. A well-prepared response plan can help ensure a timely and well-coordinated approach.
Embracing these measures gives patients the confidence to allow dentists access to their sensitive health information. It also enables professional dental health providers to display their commitment to maintaining patient data integrity while focusing on providing the best quality dental care.
