How to File a Complaint Regarding HIPAA Policy

by Francine Richards; Updated September 26, 2017

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects the privacy of health information of individuals. Covered entities, subject to HIPAA rules, are doctors, doctor’s offices, hospitals, health plans, health information clearinghouses and health care management companies. Anyone can file a complaint when she believes she has encountered a HIPAA violation. The U.S. Department of Health & Human Services’ Office for Civil Rights (OCR) handles HIPAA complaints and enforces the act. The complaint procedures involve completing OCR forms and submitting them to OCR for review, determination and penalty assignment.

Step 1

Contact your employer’s Chief Security Officer (CSO) if you work for an entity covered under HIPAA rules and the violation occurred at work. The CSO will review the violation with the company’s attorneys and handle the complaint internally and with the OCR as necessary.

Step 2

Visit the OCR website and click the words “Health Information Privacy Complaint Form Package” to open the two PDF documents that make up the OCR Health Information Privacy Complaint Form Package. The package will open with a complaint and consent form.

Step 3

Fill out and print the complaint and consent forms. Mail or fax the forms, along with any supporting documentation such as notarized written witness statements, to the OCR regional office located closest to where the violation occurred. A list of OCR regional offices is located on the OCR website. If you prefer, send the forms via encrypted email to OCRComplaint@hhs.gov. File complaints within 180 days of the violation.

Step 4

Wait for a ruling by the OC, which will investigate your HIPAA policy complaint. If the OCR determines a violation has occurred, it will enforce penalties and corrective action for the violator.

Step 5

Contact an attorney if you wish to pursue a lawsuit against the covered entity based on the privacy violation. The case may go to court or settle with the violator. If going to court, bring the OCR determination, supporting statements, witnesses and your attorney.

About the Author

Francine Richards is a licensed multi-state insurance agent with years of human resources and insurance industry experience. Her work has appeared on Blue Cross Blue Shield websites and newsletters, the Houston Chronicle and The Nest. Richards holds a Bachelor of Arts in communications from the University of Maryland.

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