HIPAA Enforcement: What Every Healthcare Practice Needs to Know

HIPAA enforcement isn’t just about avoiding fines—it’s about protecting patient trust and sustaining your business. For small and midsize healthcare organizations, understanding how the enforcement process works—and how recent audit trends affect you—is essential for staying secure and compliant.

In this post, we’ll demystify the HIPAA enforcement process, highlight the recent rise in random audits, and explain how you can safeguard your practice before OCR comes knocking.

The OCR’s HIPAA Enforcement: How It Starts

The Office for Civil Rights (OCR) enforces the HIPAA Privacy, Security, and Breach Notification Rules through a range of activities, including:

• Investigating complaints filed by patients, employees, or the public

• Reviewing breach reports submitted by covered entities or business associates

• Initiating compliance reviews triggered by patterns or red flags

Each of these can lead to an official enforcement action—especially if there’s evidence of widespread or negligent noncompliance.

Random HIPAA Audits Are Back—and They’re Targeting SRAs

In 2024, HHS revived its random HIPAA audit program, with a sharp focus on the HIPAA Security Rule and whether healthcare organizations are properly conducting Security Risk Assessments (SRAs).

These audits are not triggered by complaints or breaches—they are randomly assigned and have already impacted small practices, clinics, and business associates across the country.

If selected, your organization will be asked to provide documentation of your last SRA, security measures, and evidence of ongoing compliance. Practices without up-to-date assessments or documented mitigation efforts face a higher risk of fines or required corrective action plans.

What Happens During a HIPAA Investigation?

Here’s what you can expect if OCR opens an enforcement case:

1. Initial Intake

OCR evaluates whether the issue falls under HIPAA and decides whether to move forward.

2. Formal Investigation

You’ll be asked for detailed information on your compliance posture, including policies, training records, and security controls.

3. Resolution Outcomes

• No Violation: Case closed, no further action.

• Voluntary Compliance: You correct the issues informally.

• Corrective Action Plan (CAP): You enter into a monitored plan with strict deadlines.

• Civil Money Penalties (CMPs): If violations are severe or unaddressed, you may face steep fines—up to $68,928 per violation.

Why Small Healthcare Practices Are at Risk

OCR’s enforcement actions don’t just target large hospital systems. In fact, small and midsize practices are increasingly being investigated because:

• They often lack dedicated compliance staff

• They delay or skip SRAs

• They fail to keep training or documentation up to date

One solo practitioner was fined over $100,000 for not completing a proper risk analysis. Another was penalized after disposing of patient records in a public dumpster.

No practice is too small to be audited.

How to Protect Your Business from HIPAA Fines

Proactive compliance is the best defense. Here’s how to prepare:

• Conduct annual Security Risk Assessments (SRAs)

• Implement administrative, physical, and technical safeguards

• Train employees on HIPAA policies and phishing risks

• Keep compliance documentation up to date

• Develop a breach response and incident management plan

These steps ensure you respond confidently if you’re selected for an audit or investigation.

Partner with HIPAA Secure Now: Your SMB Compliance Ally

Navigating HIPAA enforcement and random audits is complex—but you don’t have to go it alone.

HIPAA Secure Now offers clear, simple compliance solutions for small to midsize healthcare businesses, including:

• Security Risk Assessments (with documentation ready for audits)

• Comprehensive HIPAA training for your workforce

• Automated policy management

• Breach response support

• Ongoing compliance monitoring

We’ve helped thousands of providers stay compliant, pass audits, and protect their reputations.

Don’t let an audit be your wake-up call.

Contact HIPAA Secure Now today to safeguard your practice from costly HIPAA enforcement actions.