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HIPAA Compliance Audit: What You Need to Know?

Author • Araks

HIPAA Compliance Audit: What You Need to Know?

Date: 2022/10/11


In the healthcare industry, maintaining compliance with various regulations is a constant challenge. HIPAA is just one of many regulations that healthcare organizations must adhere to. A HIPAA audit is an important way to make sure that your business is compliant with the law and avoids any risks of non-compliance. Whether you are a dental clinic, a hospital or any other healthcare institution you should stay HIPAA compliant. Let’s look at what you need to know about a HIPAA audit, what are the potential penalties of it and what you can do to stay compliant and avoid such unpleasant consequences.


In this article you will find:

What is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) is a must-know piece of legislation for any healthcare company. It sets standards for protecting patient data, especially in instances where that data could be sold or shared outside of the company. In other words, HIPAA helps to keep confidential information about patients private. The Department of Health and Human Services has strict guidelines to make sure all healthcare organizations are keeping up their end of the deal and following HIPAA best practices.

What is a HIPAA audit?

A HIPAA audit is a thorough review of your business to make sure that you’re compliant with legal rules and regulations. In many cases, it is conducted by an independent third party who has the knowledge and expertise to conduct a HIPAA compliance audit. It’s important to note that a HIPAA audit is not the same as an HIPAA compliance assessment. An audit is a thorough review of your business’s practices and policies to make sure that they are compliant with HIPAA. By contrast, an assessment is a much more cursory review, where the auditor will look for significant red flags. Auditors may also review your business’s organizational structure, and employees’ training to make sure that there isn’t a significant risk of a breach of protected health information (PHI).

Why is a HIPAA audit required?

The primary reason why a HIPAA audit is necessary is to make sure that your business has a legal right to operate. To put it simply, being HIPAA compliant means your policies and practices do not violate any of HIPAA’s provisions. There are also a few specific reasons why you might want to conduct an audit. For example, you might want to perform an audit as part of your organization’s compliance with the HITECH Act, which is an amendment to HIPAA that adds new provisions to protect patients’ privacy. Or you might want to conduct a HIPAA audit as part of a merger or acquisition to make sure that the business you’re acquiring is not at risk of a breach.

How to find out if you’re out of compliance?

If you have reason to suspect that you may be out of compliance, you can conduct an internal audit to see whether your suspicions are accurate or not. In some cases, you may be mandated by law to conduct an audit (as part of compliance with the HITECH Act, for example). There are a number of red flags that you can look for to make sure your business is compliant with HIPAA. For example, if you are in charge of hiring new employees, you may be required to use a written form when collecting information about potential new hires. You may also need to make sure that your employees are trained on how to handle sensitive information properly.

Potential penalties for non-compliance

The penalties for a violation can be significant, ranging from $100 per violation to a maximum of $50,000 per violation. You can be penalized even if the violation did not result in any harm (for example, if someone else gained access to your patient’s information without authorization). You can be penalized even if you were unaware of the violation. Businesses that are fined for a HIPAA violation are also subject to an audit for the next 10 years.

What are the consequences of non-compliance?

As you saw, the penalties for non-compliance are pretty huge, that’s why it is better to invest the money in staying compliant rather than paying the fines. Not to mention, that the cost is not just monetary, meaning you don’t just pay the fines and move on. It affects your company’s reputation as well, which is more difficult to gain back than the money lost. Especially in the healthcare field, the reputational damage can result in huge business losses because patients will no longer trust you. Thus, you will need to invest lots of time, effort and other resources to regain your company’s reputation and there is no guarantee that you would be able to.

How to stay compliant?

As we came this far we saw that non-compliance costs much more, but now the question is “How to stay compliant and avoid these huge costs?” Fortunately, it’s pretty simple to do. All you need to do is to have a complete compliance solution that will take care of everything: HIPAA ready-made training courses, written programs, checklists etc. Also, to guarantee yourself full safety, see whether they offer a yearly compliance inspection. In the best scenario, you can get your own compliance advisor and be sure that you are in safe hands. In this way you will make sure that all the issues will be identified and fixed before they arise. You will just run your business and they will take care of the rest, what can be better? :)

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