Handling a HIPAA privacy complaint requires documenting the complaint, investigating the alleged conduct, mitigating any improper use or disclosure of protected health information, applying corrective actions, and responding within required timeframes. A HIPAA Covered Entity or Business Associate should have a defined intake process that records the complaint, identifies the individual involved, and preserves relevant evidence such as access logs, policies, and workforce statements. The complaint should be reviewed to determine whether it alleges a potential violation of the HIPAA Privacy Rule, the HIPAA Security Rule, or related organizational policies.
An internal investigation should assess the facts, determine whether protected health information was used or disclosed impermissibly, and evaluate whether safeguards failed or workforce members did not follow required procedures. The investigation should be conducted by the designated privacy official or compliance function and should include interviews, system reviews, and policy analysis. If noncompliance is identified, the organization should take steps to limit further disclosure, correct procedural gaps, and address workforce conduct through retraining or sanctions consistent with established disciplinary policies.
The complainant should receive a written response that explains the outcome of the investigation and any corrective actions taken, without disclosing confidential personnel information. Documentation of the complaint, investigation findings, and response should be retained in accordance with HIPAA documentation retention requirements. When a complaint is submitted to the U.S. Department of Health and Human Services Office for Civil Rights, the organization should cooperate with requests for information, provide timely responses, and implement any required corrective action plans. Proper handling of HIPAA privacy complaints supports regulatory compliance and demonstrates adherence to required administrative safeguards.