Top HIPAA Violation Examples and Fines, with Practical Risk Mitigation Guidance

HIPAA enforcement focuses on how well you protect Electronic Protected Health Information (ePHI) and respond when things go wrong. Fines and settlements hinge on factors like the level of negligence, scope and duration of exposure, harm to patients, and how quickly you correct issues. The examples below pair real‑world risks with practical Security Safeguards you can implement now.

Across scenarios, consistent themes drive outcomes: perform an enterprise‑wide Risk Analysis, deploy controls proportionate to your risks, keep reliable Access Logs, train your workforce, oversee vendors, and follow the Breach Notification Rule when incidents occur.

Unauthorized Access by Employees

What it looks like

Workforce members view a celebrity’s chart “out of curiosity,” look up a neighbor’s records, or use another employee’s login. These events expose PHI without a treatment, payment, or operations purpose and are often uncovered by Access Logs or patient complaints.

Potential fines and penalties

Regulators weigh whether you had reasonable and appropriate access controls, unique user IDs, audit logging, and sanctions. Missing or weak controls, repeated snooping, or failure to act on audit findings can trigger significant civil penalties and corrective action plans.

Risk mitigation in practice

• Enforce least‑privilege, role‑based access; remove shared accounts and generic logins.
• Monitor and review Access Logs routinely; enable alerts for VIP lookups and anomalous access.
• Require strong authentication and session timeouts; secure remote access.
• Apply and document sanctions consistently; retrain after each incident.
• Use break‑glass workflows with justification and enhanced monitoring.

Data Breach Due to Phishing

What it looks like

Attackers trick a user into revealing credentials or installing malware, leading to mailbox or portal compromise and exfiltration of ePHI. Threats also arrive through vendors or compromised business associates.

Potential fines and penalties

Fines increase when basic controls—such as multi‑factor authentication, email filtering, and response plans—are missing. Delays or gaps in required notices under the Breach Notification Rule can add penalties and oversight obligations.

Risk mitigation in practice

• Enable multi‑factor authentication on email, VPNs, and any ePHI‑capable system.
• Deploy phishing defenses: advanced email filtering, attachment sandboxing, and domain protection.
• Run continuous Employee Training Programs with realistic simulations and feedback.
• Segment mailboxes with ePHI, restrict auto‑forwarding, and limit OAuth app permissions.
• Prepare a tested incident response and breach notification playbook aligned to the Breach Notification Rule.

Unencrypted Device Theft

What it looks like

A laptop, tablet, smartphone, or portable drive containing ePHI is lost or stolen from a car, office, or home. Without encryption, the data is readily accessible to unauthorized parties.

Potential fines and penalties

Penalties are common when devices lack full‑disk encryption or inventory controls. If encryption is properly implemented and keys are safeguarded, an incident may not constitute a reportable breach—reducing regulatory exposure.

Risk mitigation in practice

• Mandate full‑disk encryption on all endpoints; manage keys centrally.
• Use mobile device management for remote lock/wipe, geofencing, and compliance checks.
• Minimize local storage of ePHI; prefer secure, access‑controlled servers or portals.
• Maintain a current asset inventory and rapid loss reporting process.
• Physically secure devices; prohibit storing ePHI on unapproved media.

Improper Disposal of PHI

What it looks like

Paper records placed in regular trash, labels on medication bottles readable in dumpsters, or copier and hard drive media discarded or resold without secure wiping—leaving PHI exposed.

Potential fines and penalties

Regulators penalize organizations that lack disposal policies, shredding or media sanitization procedures, or oversight of destruction vendors. Failures in Vendor Compliance, such as missing business associate agreements or poor supervision, increase liability.

Risk mitigation in practice

• Adopt secure disposal: cross‑cut shredding for paper; degauss or cryptographically wipe digital media.
• Use locked shred bins and track chain‑of‑custody to final destruction.
• Execute and enforce business associate agreements with disposal vendors; verify certificates of destruction.
• Remove PHI from copiers, printers, and scanners before return or resale.
• Train staff on disposal workflows and spot checks of high‑risk areas.

Lack of Employee Training

What it looks like

Staff send ePHI to the wrong recipient, fall for phish, share passwords, or store PHI on personal devices because policies were unclear or training was rushed and infrequent.

Potential fines and penalties

Inadequate or undocumented Employee Training Programs are often cited as willful neglect, especially when repeated incidents show a pattern. Organizations can face penalties and multi‑year corrective action plans requiring program rebuilds.

Risk mitigation in practice

• Provide role‑based onboarding and regular refreshers tailored to job duties.
• Cover core topics: minimum necessary, secure messaging, incident reporting, and the Breach Notification Rule.
• Include hands‑on exercises, simulations, and micro‑learning; measure comprehension.
• Document attendance, scores, and remediation; tie completion to access privileges.
• Reinforce with just‑in‑time tips inside systems where users handle ePHI.

Failure to Conduct Risk Assessments

What it looks like

No enterprise‑wide Risk Analysis, outdated assessments, or incomplete scope that omits cloud apps, medical devices, or vendors. Without a current picture of threats and vulnerabilities, gaps persist.

Potential fines and penalties

OCR frequently cites incomplete or absent assessments as a root cause. Systemic failures to analyze and manage risk lead to larger settlements, external monitoring, and mandated remediation plans.

Risk mitigation in practice

• Perform an annual, enterprise‑wide Risk Analysis covering systems, data flows, and vendors.
• Maintain a risk register with likelihood and impact ratings; set owners and deadlines.
• Implement a living risk management plan; track remediation to closure.
• Evaluate Vendor Compliance through due diligence, contracts, and ongoing monitoring.
• Validate controls with technical testing: vulnerability scans, configuration reviews, and targeted exercises.

Insider Threats

What it looks like

Disgruntled or financially motivated insiders sell data, bulk‑download records, or misuse privileged access. Insider risk can also arise at business associates and subcontractors.

Potential fines and penalties

Organizations are penalized when they lack mechanisms to detect and deter insider misuse—such as absent Access Logs, weak segregation of duties, or no user behavior monitoring. Individuals may also face criminal consequences.

Risk mitigation in practice

• Apply the minimum necessary standard; implement privileged access management and approvals.
• Monitor Access Logs with user behavior analytics and alerts for mass exports or odd hours.
• Use data loss prevention to restrict printing, USB use, and bulk transfers.
• Segment sensitive systems; enforce dual control for high‑risk actions.
• Harden offboarding: immediate account revocation, device return, and ePHI attestations.

In summary

Most penalties stem from predictable gaps: missing Risk Analysis, weak Security Safeguards, poor Access Logs, limited training, and loose Vendor Compliance. Shore up these basics, encrypt everywhere, monitor continuously, and be ready to act swiftly under the Breach Notification Rule to reduce both breach impact and fines.

FAQs.

What are common causes of HIPAA violations?

Frequent causes include employee snooping, phishing‑driven account compromise, unencrypted device loss, improper disposal of PHI, inadequate Employee Training Programs, skipped or superficial Risk Analysis, and insider misuse. Vendor errors—like improper data handling by a business associate—also contribute when oversight is weak.

How are HIPAA violation fines determined?

Regulators consider the nature and extent of the violation, number of individuals affected, duration, level of negligence, whether you corrected issues promptly, your prior history, and cooperation. Controls in place at the time—encryption, audit trails, Security Safeguards, and response to the Breach Notification Rule—heavily influence penalty tiers and any corrective action plan.

What steps can organizations take to mitigate HIPAA risks?

Start with an organization‑wide Risk Analysis and a prioritized remediation plan. Implement layered Security Safeguards (encryption, access control, logging, monitoring), strengthen Employee Training Programs, and test incident response and breach notification. Enforce Vendor Compliance with due diligence and contracts, and continuously review Access Logs to detect issues early.

How important is employee training for HIPAA compliance?

It is critical. Even strong technical controls fail if people bypass them. Effective, role‑based training builds a culture of privacy and security, reduces common errors like misaddressed emails or phishing clicks, and demonstrates due diligence—often lowering regulatory exposure when incidents occur.