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If you received a healthcare data breach notice, read it to learn which information was involved and what steps the organization recommends. The exposure depends on the specific incident; a general guide cannot establish whether your information was affected. Verify the organization’s contact details independently, then watch for unfamiliar medical bills, insurance activity, or other signs of misuse.
What information may be exposed in a healthcare data breach?
There is no standard set of information exposed in every healthcare breach. The notice should describe the types of information involved, to the extent possible. Depending on the incident, that may include identifying information such as your name, Social Security number, health insurance account number, or Medicare number. It may also include medical records or claims associated with care, prescriptions, or medical devices. Do not assume a particular category was exposed unless your notice or the organization confirms it.
Medical identity theft occurs when someone uses personal information to obtain care, prescriptions, or devices, or to submit insurance claims. The FTC describes the practice and its potential impact in What To Know About Medical Identity Theft.
What should I do after receiving a breach notice?
1. Read the notice carefully
Look for the incident description, the types of information involved, steps you can take, what the organization has done to investigate or limit the effects, and contact information. HHS says individual notices should include these details to the extent possible. Keep the notice for reference.
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2. Verify contact details before responding
Use a website you already know is genuine, or a phone number from trusted existing records or the organization’s official website. Do not provide medical or financial information to someone who contacts you unexpectedly by phone, email, or text. The FTC also advises protecting documents that contain medical information; shred them before disposal rather than placing them intact in the trash. See its medical identity theft guidance.
3. Watch for activity you do not recognize
- Review Explanation of Benefits (EOB) statements and provider bills for care you did not receive.
- Check pharmacy activity for prescriptions you did not obtain.
- Pay attention to debt collection notices or warnings that your insurance benefits have reached a limit.
These signs do not by themselves prove identity theft, but they are reasons to contact the insurer or provider named in the records.
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4. Respond to suspected medical identity theft
If you find suspicious activity, contact your insurer’s fraud department and the providers where your information may have been used. Ask for the relevant records, review them, and report inaccurate medical-record information to the provider in writing. The FTC’s medical identity theft guidance also points consumers to IdentityTheft.gov for a recovery plan and steps for reporting medical billing errors.
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Review your credit reports for unfamiliar medical debt. The FTC directs consumers to AnnualCreditReport.com for free reports, and to IdentityTheft.gov for steps to report medical billing errors to credit bureaus.
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If your Social Security number or other identity information was exposed, consider whether a credit freeze fits your situation. A freeze is free, does not affect your credit score, and can make it harder for someone to open new credit accounts in your name. You must request it separately from Equifax, Experian, and TransUnion. See the FTC’s Credit Freezes and Fraud Alerts for details.
What must an organization do after a reportable breach?
Under HIPAA’s Breach Notification Rule, covered entities and business associates must notify affected people after a breach of unsecured protected health information, subject to the rule’s definition and exceptions. An impermissible use or disclosure is generally presumed to be a breach unless the regulated organization demonstrates a low probability that protected health information was compromised through a risk assessment.
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For affected individuals, notification must be provided without unreasonable delay and no later than 60 days after discovery. HHS says the notice should explain the breach, information involved, steps individuals can take, the organization’s investigation and mitigation, and how to contact it. The 60-day limit is the organization’s deadline, not a personal deadline for you. See HHS’s Breach Notification Rule.
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Does HIPAA cover every health app or service?
No. HIPAA applies to covered entities such as health plans, certain healthcare providers, and healthcare clearinghouses, as well as business associates in specified circumstances. The FTC Health Breach Notification Rule applies to certain vendors of personal health records, related entities, and third-party service providers that are not covered by HIPAA. Which rule applies depends on the organization and how it handles the data; the presence of health information alone does not establish HIPAA coverage. HHS explains the distinction in Collecting, Using, or Sharing Consumer Health Information?
How can I report a suspected privacy violation?
If you believe a HIPAA or Part 2 rule was violated, you can file a complaint with the HHS Office for Civil Rights (OCR). HHS says complaints generally should be filed within 180 days of when you knew of the violation, though OCR may extend the period for good cause. Review HHS’s complaint process for filing instructions.
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