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

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

From hefty fines to eroded patient trust, the risks of non-compliance with HIPAA regulations are considerable for healthcare organizations of all sizes. 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 improved patient and customer engagement. 

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: consuming employees, 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 human resources, for an extended period, affecting their ability to deliver their products and services.

Unfortunately, when it comes to patients’ healthcare, operational issues can have devastating ripple effects, e.g., an individual not being able to acquire a required prescription or medical device on time.

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, eroding patient trust and harming 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 fallout.

What Does HIPAA-Compliant Email Require?

So, now that 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 the 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.
• 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 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 examples:

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.

In 2024, Community Health Systems suffered a Business Email Compromise (BEC) attack. Cybercriminals masqueraded as trusted vendors, convincing finance and IT staff to transfer funds and data. This breach impacted 4 million patients, exposing PHI and highlighting the importance of email authentication protocols like DMARC, SPF, and DKIM.

Both examples highlight that healthcare companies are frequent targets of malicious action and can’t afford, quite literally, 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 cover 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, highly flexible encryption, integration with EHR, CDP and RCM systems, and the industry’s best support and expertise. 

Protect Your Organization From HIPAA Violations With LuxSci

With LuxSci’s secure email gateway and secure high-volume email solutions, your organization can safeguard patient data, avoid costly breaches, and mitigate all the risks of non-compliant email to avoid HIPPA violations. Best of all, with the ability to securely include PHI in your email communications, you can better engage with patients with personalized messages: 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.