The Risks of Non-Compliant Email: How HIPAA Violations Hurt Healthcare Companies

February 3rd, 2025

In today’s increasingly digitized healthcare landscape, email is an essential tool for communication between providers, patients, and other key stakeholders. However, non-compliance with HIPAA standards for email can have devastating consequences.

From hefty fines to eroded patient trust, the risks of non-compliance with HIPAA regulations, for healthcare organizations of all sizes are considerable. Understanding what constitutes HIPAA-compliant email communication and how to best protect sensitive patient data are crucial to mitigating these risks.

With this in mind, this post details the risk of non-compliant email, the security measures required by HIPAA regulations, and essential strategies for securing protected health information (PHI) and ensuring compliance.

What Are The Risks of Non-Compliant Email?

Let’s begin by detailing the consequences of non-compliance with HIPAA regulations

Data Breaches: while not a direct consequence of non-compliance, by failing to implement the security measures mandated by HIPAA, you increase the risk of falling victim to a data breach by malicious actors. This can result in unauthorized access to sensitive patient data – leading to the additional consequences of non-compliance outlined below.

Operational Issues: a data breach will negatively impact an organization’s regular operations: exhausting manpower, resources, and attention until it’s contained – and the resulting fallout is managed. At worst, this can demand a lot of a company’s time and resources, for an extended period, affecting their ability to deliver their products and services.

Unfortunately, when it comes to patients’ healthcare, this can have devastating ripple effects, e.g., an individual not being able to acquire a required prescription or medical device in a timely fashion.

Financial Penalties: Non-compliance with HIPAA or other privacy laws can result in hefty fines, compensation from resulting lawsuits, and, in some cases, financial penalties from the state in which the healthcare organization is based.

Reputation Damage: Mishandling sensitive data can lead to a loss of credibility – erode patient trust and harm the organization’s hard-earned public image and industry standing. As we’ll see later in this post, the larger the healthcare organization, the bigger the story and the more significant the potential fallout.

What Does HIPAA-Compliant Email Require?

So, now we’ve covered the consequences of not adhering to HIPAA standards, how can organizations avoid them and achieve compliance. Let’s explore the critical components of HIPAA-compliant email.

  • Encryption
    The HIPAA Security Rule mandates encryption of email data both in transit, when being sent to recipients,  and at rest, where it is stored. This means that emails containing PHI must be scrambled into an unreadable format, ensuring they are only accessible to authorized recipients – even in the event they’re intercepted by cybercriminals. Advanced encryption protocols, such as Transport Layer Security (TLS), and measures, such as end-to-end and flexible encryption, ensure the secure exchange of sensitive patient data between servers.
  • Access Control
    Just because a healthcare organization has access to a patient’s sensitive data, that certainly doesn’t mean that any employee should be able to access said data – quite the opposite, in fact. Consequently, healthcare organizations must implement access control measures to ensure that only those authorized to handle PHI within your organization have access to it.A prominent example of this is role-based access control (RBAC), by which employees are granted access privileges according to their job role and the extent to which they need to deal with patient data. For example, an employee in a healthcare provider’s billing department will need access to PHI, to include it in email communications with patients.
  • User Authentication
    In addition to limiting access to the appropriate employees, it’s critical that personnel are who they claim, or present themselves, to be when logging into your company’s network – so you must also implement strong user authentication measures.

Common ways of authenticating users include unique usernames, strong passwords, and multi-factor authentication (MFA) – where users have to prove their identity in more than one way (e.g., a one-time password (OTP) or biometric scan).  This is a growing cybersecurity requirement that’s increasingly essential for preventing unauthorized access from cybercriminals who are looking to access PHI by impersonating the employees of healthcare companies.

  • Automatic Session Timeout
    Another simple, yet effective mitigation measure against unauthorized access is the inclusion of a built-in session timeout feature. This will cause an application to automatically log a user out after a set period of inactivity, reducing the risk of session jacking and other methods of unauthorized access.
  • Audit Logs
    Another key aspect of HIPAA compliance is for a healthcare organization to maintain detailed logs of email activity. This involves continually recording information that includes who accessed the data, at which time, and, how it has been modified in any way. As well as helping with compliance, audit logs make it easier to locate and contain breaches – in addition to highlighting how and where an organization must strengthen its cybersecurity posture.
  • Business Associate Agreements (BAA):
    If you use a third-party email provider to transmit PHI, you must have a BAA in place to avoid the risks of HIPAA non-compliance. A BAA details the respective responsibilities of both the healthcare company and the email provider in protecting patient data, which holds both parties accountable.

 

Real-World Consequences of Non-Compliant Email

 

Now that we’ve explored the consequences of email non-compliance, as well as what a healthcare organization must do to adhere to HIPAA regulations, let’s briefly look at a couple of recent real-life examples

Example of a Large-Scale Breach

In 2023, a leading U.S. hospital system exposed over 3 million patient records due to unencrypted emails containing PHI. Not only was the healthcare organization fined $1.25 million, but it also faced class-action lawsuits and a severe blow to its reputation.

Example of a Data Breach Suffered by a Smaller Healthcare Company

Alarmingly, as cybercriminals grow in numbers and capability, smaller healthcare organizations are under threat from cyber attacks and the resulting exposure of PHI. Again, in 2023, a small healthcare provider in California suffered a data breach compromising sensitive patient data, including names, Social Security numbers, health insurance details, and medical records. The breach led to a class-action lawsuit and subsequent settlement, allowing affected patients to claim up to $8,050 in compensation.

Now, while the scale of this breach was limited, it highlights that even smaller healthcare companies are frequent targets of malicious action and can’t afford, quite literally, in some cases, to have a weak cybersecurity posture that doesn’t meet HIPAA standards.

5 Key Strategies for Ensuring HIPAA-Compliant Email Communication 

Having explored the requirements of HIPAA-compliant email communication and the repercussions of falling afoul of HIPAA regulations, let’s move on to how you can mitigate the risks of non-compliant email.

  1. Conduct Regular Security Audits

    Regular security assessments enable organizations to proactively identify vulnerabilities within their networks – instead of merely responding to threats. Your security audits should include the evaluation of encryption protocols, access control policies, and user authentication, in alignment with HIPAA regulations. You should conduct a security audit annually or when you make changes to IT infrastructure that are likely to impact PHI.
  2. Invest in Employee Training

    Human error is a leading cause of HIPAA violations and, if left unchecked, will undermine your other risk mitigation measures. Structured cybersecurity awareness training sessions help employees understand the importance of secure communication practices, recognize types of cyber threats they’re likely to encounter (e.g., phishing), and what to do if they notice anything suspicious (i.e., who to contact).
  3. Implement Access Control and User Authentication Measures

    Ensuring that PHI can only be accessed by those authorized to handle it, and for good reason, is essential for HIPAA-compliant email. This could include policies such as the principle of least privilege, where employees are given the minimum amount of access to patient data required to perform their job, as well as a robust password policy and MFA.
  4. Establish a BAA with Your Email Provider

    A BAA isn’t just a formality—it’s a legally binding contract that holds your email provider accountable for HIPAA-compliant email communication. The offer of a BAA signifies an email provider’s commitment to data privacy and that they have invested in the necessary infrastructure to best secure sensitive patient data.
  5. Adopt a Secure Email Platform

    Deploying a HIPAA-compliant email platform is the cornerstone of safeguarding PHI, providing policies and controls designed with the security and compliance needs of healthcare specifically in mind.  LuxSci is an example of such a solution: offering end-to-end encryption, seamless integration, and an intuitive user experience.

Protect Your Organization From The Risks of Non-Compliant Email With LuxSci

Implementing the security measures required for HIPAA-compliant email doesn’t have to be a daunting task. With LuxSci’s secure email hosting and secure high-volume email solutions, your organization can best safeguard patient data, avoid costly breaches, and mitigate all the risks of non-compliant email. Best of all, with the ability to securely include PHI in your email communications, you can better engage with patients: building trust, helping patients become more involved in their healthcare journeys, and, ultimately, driving better health outcomes.

Contact LuxSci today to learn how we can support your email compliance journey using our best-in-class HIPAA compliant infrastructure.