Don’t Overlook These Business Associates: The Hidden Risks to HIPAA Compliance

In the complex web of healthcare data management, Covered Entities (CEs) must not only safeguard their own systems but also those of their Business Associates (BAs). While the importance of Business Associate Agreements (BAAs) is widely understood, some BAs may slip through the cracks, leading to potential HIPAA breaches. Let’s delve into often-forgotten Business Associates, real-world examples of their oversight, and the critical need for comprehensive training and policies even among subcontractors.

  1. Cloud Service Providers (CSPs)

Cloud Service Providers, essential for storing and processing healthcare data, often act as Business Associates. However, CEs may overlook the need for a BAA or fail to adequately assess the security measures of their chosen CSP.

Example: In 2019, a healthcare provider faced a $100,000 HIPAA settlement due to using a cloud storage service without a BAA. The oversight exposed ePHI of over 1,600 individuals, highlighting the repercussions of neglecting BAA requirements.

  1. IT Support and Maintenance Providers

CEs frequently rely on external IT support for network maintenance, software updates, and troubleshooting. Yet, overlooking the BAA requirement with these providers can leave vulnerabilities unaddressed.

Example: In 2017, a healthcare organization faced a $2.5 million HIPAA settlement after a data breach involving its IT vendor. The vendor lacked a BAA, leading to unauthorized access to patient records stored on the network.

  1. Medical Transcription Services

Medical transcription services convert spoken medical reports into text, often handling sensitive patient information. Failure to establish a BAA with these providers can expose ePHI to unauthorized access.

Example: In 2018, a medical transcription company faced a $200,000 HIPAA settlement due to a data breach affecting thousands of patients. The lack of a BAA contributed to the unauthorized disclosure of patient records.

Subcontractors: A Critical Consideration

Even when subcontractors have access to CE policies and training materials, they must maintain their own robust HIPAA training and policies. Merely inheriting the CE’s policies and training does not absolve subcontractors of their responsibility to uphold HIPAA compliance.

Case Study: In 2020, a healthcare data analytics firm faced scrutiny after a subcontractor mishandled ePHI. Despite having access to the CE’s policies and training, the subcontractor’s lack of internal safeguards led to a data breach, emphasizing the importance of independent compliance measures.


The chain of HIPAA compliance is only as strong as its weakest link, and overlooking Business Associates can lead to costly breaches and violations. Cloud Service Providers, IT support vendors, and medical transcription services are just a few examples of often-forgotten BAs. Additionally, subcontractors must maintain their own rigorous compliance measures, regardless of their access to CE policies and training.

To safeguard patient data effectively, CEs must conduct thorough assessments of all Business Associates, establish robust BAAs, and ensure that subcontractors maintain independent HIPAA compliance protocols. In addition to these actions, healthcare organizations should also consider emerging resources for bolstering their HIPAA compliance efforts. One such avenue worth exploring is EPI Compliance, a dynamic platform designed to streamline compliance processes and enhance data security measures. By leveraging EPI Compliance’s innovative solutions, clients can proactively manage risks associated with Business Associates, ensuring comprehensive adherence to HIPAA regulations. As the healthcare landscape continues to evolve, investing in forward-thinking compliance solutions like EPI Compliance can position organizations for sustained success in safeguarding patient data and maintaining regulatory compliance.