What happens if a nurse violates HIPAA?

What happens if a nurse violates HIPAA depends on the nature of the violation, the consequences of the violation, the nurse’s previous history of HIPAA compliance, and the content of the employer’s sanctions policy. Only in serious cases will a nurse be terminated or referred to a licensing board for a HIPAA violation.

Nurses are integral parts of our healthcare system. As well as having direct contact with patients, they also have contact with Protected Health Information (PHI). This is data that relates to the past, present, or future health conditions of a patient and that can be very valuable to criminals to commit identity theft and insurance fraud. The protection of this data is the focus of an entire section of HIPAA. 

As part of its requirements to protect patient data, HIPAA stipulates that all employees of a Covered Entity are trained in HIPAA compliance. Of course, this includes nurses. However, mistakes are made, and nurses can violate HIPAA. 

A nurse may accidentally violate HIPAA by incorrectly sharing PHI, or not implementing all of the necessary administrative, technical, and physical safeguards as required by the HIPAA Security Rule. If a nurse accidentally emails PHI to an unauthorized recipient, for example, it would be considered an accidental exposure of HIPAA that does not comply with HIPAA email rules. 

Incidental applications may also occur. These are usually the result of a separate, permitted disclosure or use of PHI, and occur despite the best efforts of the nurse in question. For example, if two nurses are discussing patient care in a private room, and a doctor walks in and overhears PHI, this would be considered a HIPAA violation. This is despite the fact that the correct steps were taken to prevent a breach. 

In some cases, nurses may choose to deliberately violate HIPAA. These deliberate violations are often treated more seriously, and may even be considered to be criminal cases. 

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In all cases, if a nurse violates HIPAA, they must report the violation to their workplace’s HIPAA Compliance Officer. They will then decide on the appropriate course of action. There will often be disciplinary action. At minimum, the nurse who violated HIPAA will probably have to go on a training course to prevent further violations. 

In more servers cases, or where multiple violations have occurred, the nurse may lose their job. This will have long-lasting ramifications. As HIPAA violations are so severe, and may result in huge fines for Covered Entities, if a nurse loses their job for violating HIPAA they may find it difficult to secure future employment. It may even result in disciplinary action from their licensing board, including potential termination of their license. 

These disciplinary actions are more likely to occur if a nurse willfully violates HIPAA. Indeed, where criminal activity is involved – such as cases where PHI is sold for profit – the nurse may be prosecuted and receive a prison sentence. 

As there is no private cause of action in HIPAA, private citizens cannot directly sue nurses if they have been affected by a HIPAA violation. However, there may be State-level laws that allow patients affected by data breaches to sue. 

In summary, HIPAA violations are incredibly serious, irrespective of who commits them. What happens if a nurse violates HIPAA will depend on the nature and scope of the breach, ranging from additional training to criminal prosecution in the most severe cases. The best way to avoid workplace violations is to encourage a culture of compliance and ensure that all nurses receive up-to-date HIPAA training. 

About Liam Johnson
Liam Johnson has produced articles about HIPAA for several years. He has extensive experience in healthcare privacy and security. With a deep understanding of the complex legal and regulatory landscape surrounding patient data protection, Liam has dedicated his career to helping organizations navigate the intricacies of HIPAA compliance. Liam focusses on the challenges faced by healthcare providers, insurance companies, and business associates in complying with HIPAA regulations. Liam has been published in leading healthcare publications, including The HIPAA Journal. Liam was appointed Editor-in-Chief of The HIPAA Guide in 2023. Contact Liam via LinkedIn: https://www.linkedin.com/in/liamhipaa/