The Most Common HIPAA Violations and How to Avoid Them

Most healthcare organizations aren’t brought down by a dramatic cyberattack or a rogue employee. They’re brought down by small, preventable mistakes that compounds over time. HIPAA violations rarely look the way people expect them to.

At Abacus Healthcare, we work with healthcare organizations every day and see the same patterns emerge. Here are the most common HIPAA violations we encounter, and what you can do to avoid them.

Lack of a Current Risk Assessment

The HIPAA Security Rule requires an accurate, thorough, and ongoing assessment of risks to electronic protected health information (ePHI). Despite this, outdated or missing risk assessments are among the most frequently cited violations in OCR audits. A risk assessment isn’t a one-time checkbox; it needs to be revisited whenever your environment changes in any meaningful way.

Insufficient Access Controls

Not everyone in your organization needs access to all patient data. HIPAA’s minimum necessary standard requires that ePHI access be limited to what’s needed for a person to do their job. We frequently see organizations where staff retain admin-level access to clinical systems simply because no one revisited their permissions after initial setup. There is also the ongoing issue of ensuring onboarding and offboarding are handled properly and documented thoroughly for the IT team. Clear communication between HR and IT is essential so access is granted appropriately when employees join and revoked promptly and completely when they leave or change roles.

Missing or Outdated Business Associate Agreements

If you share ePHI with any third-party vendor, you are required to have a signed Business Associate Agreement (BAA) in place. This is a foundational requirement that’s routinely overlooked. Equally common: agreements that were signed years ago and no longer reflect current data-handling practices or vendors updating their policies without sending an updated BAA.

Unsecured Transmission of ePHI

Emailing patient information through an unsecured channel, sending records via standard text message, or accessing clinical systems over an unencrypted network are violations that occur regularly, often without malicious intent. When staff are not provided with secure, compliant tools or clear guidance, convenience tends to outweigh compliance.

Failure to Document Policies and Procedures

Many organizations rely on informal practices that may function reasonably well in day-to-day operations; however, informal processes do not meet HIPAA requirements. The HIPAA Security and Privacy Rules require that policies and procedures be formally documented, maintained, and consistently followed.

During an audit or investigation, documentation is often the deciding factor between a minor corrective action plan and significant financial penalties. If a policy isn’t written, approved, and accessible, it is effectively treated as non-existent by the Office for Civil Rights (OCR).

Additionally, outdated or inconsistently maintained documentation can create the same level of risk as having no documentation at all. Organizations should regularly review and update policies, ensure staff are trained on them, and maintain clear records of those trainings. Strong documentation not only supports compliance but also demonstrates a proactive commitment to safeguarding ePHI.

Insufficient Workforce Training

HIPAA requires ongoing workforce training on privacy and security policies, not just one-time onboarding. Staff need regular education, particularly as threats evolve. Organizations that invest in recurring, relevant training programs see it reflected in their overall risk posture.

Compliance is an ongoing operational discipline. If you’re not sure where your organization stands, a HIPAA risk assessment is the right place to start.

Contact Abacus Healthcare to schedule a compliance consultation.