[This post was originally published on 21st September 2021. It has been updated on 22nd July 2025]

HIPAA compliance for chiropractors has been a cornerstone of patient data protection since 1996, yet many chiropractic practices still fall short in meeting these critical standards. Whether you run a solo practice or a multi-provider clinic, adhering to HIPAA regulations for chiropractors is essential to safeguard your patients’ protected health information (PHI) and avoid costly violations.

HIPAA isn’t just about paperwork and signatures; it encompasses comprehensive administrative, physical, and technical safeguards that every chiropractic practice must implement. This guide outlines the common compliance pitfalls, explains how chiropractors can stay HIPAA compliant, and provides a detailed HIPAA checklist for chiropractors.

Why HIPAA Compliance is Non-Negotiable for Chiropractic Practices

The Health Insurance Portability and Accountability Act (HIPAA) was enacted to protect sensitive patient information and ensure that healthcare providers, including chiropractors, handle PHI responsibly. The enforcement arm, the Office for Civil Rights (OCR) under the Department of Health and Human Services (HHS), has the authority to conduct audits and impose penalties on practices that fail to comply.

In 2023, healthcare record breaches hit a record high, with the number of compromised records surging by 156% over 2022, totaling 133,068,542 records. This sharp rise highlights the urgent need for stronger data security measures.

Chiropractic practices, regardless of size, are subject to HIPAA regulations. Ignorance of the law is not a defense, and even minor lapses can lead to significant fines. Implementing HIPAA compliance chiropractic practice standards not only protects your patients but also strengthens your practice’s reputation and trust within the community.

Top Compliance Risks Chiropractors Must Address

1.  Relying on Outdated or Unsupported Software

Many chiropractors underestimate the risks of using outdated software systems. Unsupported applications or systems lacking regular security updates expose practices to malware, ransomware, and unauthorized access to PHI. 

According to the U.S. Department of Health and Human Services (HHS), failure to maintain secure systems is a direct violation of the HIPAA Security Rule, which requires covered entities to protect electronic Protected Health Information (ePHI) through administrative, physical, and technical safeguards.

Why It’s a Problem:

Cybercriminals often exploit well-known vulnerabilities in outdated systems. Even a simple operating system like Windows 7 or an unpatched EHR application can open the door to malware, phishing attacks, or ransomware that compromises sensitive patient data. Practices using unsupported software not only face severe data breaches but also run the risk of heavy financial penalties. Fines for non-compliance can reach up to $50,000 per violation, with a maximum annual penalty of $1.5 million.

How Chiropractors Can Stay HIPAA Compliant:

• Invest in HIPAA Compliance Software for Chiropractors: Choose a modern, cloud-based EHR system specifically designed with HIPAA compliance in mind. Look for features such as automatic log-off, role-based access, encryption, and audit trails. zHealth, for instance, provides a secure chiropractic EHR platform with regular updates to help ensure ongoing compliance.
• Implement a Monthly Software Audit Process: Conduct routine audits to review all applications, operating systems, and medical devices used in your clinic. Identify unsupported tools and replace them with compliant alternatives.
  
• Monitor Vendor Security Practices: Collaborate only with EHR vendors and business associates who are committed to HIPAA compliance. Request documentation on their data security policies, encryption standards, and breach protocols.
• Update Devices and Operating Systems: Make sure all office computers, tablets, and mobile devices used to access patient data are running on supported versions of the OS (e.g., Windows 11, macOS Ventura or later). Outdated firmware and software should be replaced or upgraded immediately.
• Include Software Compliance in Your HIPAA Checklist for Chiropractors: Add software maintenance and vendor vetting into your official HIPAA checklist for chiropractors. This ensures ongoing compliance is part of your operational routines, not an afterthought.

2. Continuing to Use Paper Records

Storing patient records in paper format significantly increases the risk of loss, theft, or unauthorized access. Unlike encrypted digital records, paper files offer no protection if left unattended or improperly stored.

How to Stay Compliant:

• Transition Fully to a HIPAA-Compliant, Cloud-Based EHR:
  Modern chiropractic EHR systems like zHealth provide encrypted data storage, secure access controls, and compliant documentation tools, all of which help ensure HIPAA compliance for chiropractors. Cloud-based solutions offer the added benefit of secure data backup and controlled access from multiple devices.
• Implement Robust Physical Safeguards for Existing Paper Records:
  If your practice still maintains some paper records, store them in locked, access-controlled cabinets within secured office areas. Establish clear policies limiting who can access paper files and monitor compliance through periodic checks.
• Develop and Enforce a Document Retention and Disposal Policy:
  Create a documented procedure for securely disposing of paper records when no longer needed. Use shredding or certified disposal services to prevent unauthorized access. Ensure your disposal practices align with both HIPAA regulations for chiropractors and your state laws.
• Train Staff on Secure Handling of Physical Records:
  Staff should be trained regularly on proper handling, storage, and disposal of paper files. This includes understanding how breaches can occur and their personal responsibility in preventing unauthorized disclosures.
• Consider Hybrid Record Management with a Transition Plan:
  For practices moving gradually to digital systems, maintain a hybrid policy that ensures both digital and paper records meet HIPAA standards. Set clear timelines for full digital adoption and conduct regular audits to assess progress.
• Add Paper Record Management to Your Chiro HIPAA Compliance Checklist:
  Ensure that your HIPAA checklist for chiropractors includes the management of physical records, even if you are primarily a digital practice.

3. Neglecting Proper Staff Training on HIPAA Rules

One of the most common causes of HIPAA violations in chiropractic practices isn’t sophisticated cyberattacks, it’s human error. Staff members, whether clinical, front desk, or administrative, are often the weakest link in HIPAA compliance for chiropractors. Even with the best HIPAA compliance software in place, your practice is at risk if employees lack proper training or fail to follow established policies.

Why It’s a Problem:

HIPAA requires all covered entities to provide training on privacy, security, and breach notification rules. Yet, a significant percentage of data breaches occur because staff were either unaware of compliance procedures or disregarded them. Simple mistakes, like discussing patient information in public areas, leaving sensitive data on open screens, or mishandling patient records, can lead to reportable HIPAA violations.
In fact, the HIPAA Journal reports that more than 20% of healthcare data breaches in 2024 were directly linked to internal negligence or human error, emphasizing the need for continuous education.

How to Stay Compliant:

• Schedule mandatory HIPAA compliance training for all employees and business associates.
• Maintain records of all training sessions, including attendance and comprehension tests.
• Reinforce training with periodic refreshers and updates on HIPAA regulations for chiropractors.

4. Failing to Conduct Regular Risk Assessments

Risk assessments are not just a HIPAA recommendation, they are a regulatory requirement under the HIPAA Security Rule. Every chiropractic practice that handles, HCFA forms, billing, and stores or transmits electronic Protected Health Information (ePHI) is required to conduct a thorough risk analysis to identify potential vulnerabilities in its security systems and processes.

Unfortunately, many chiropractors either skip this crucial step or perform it irregularly, exposing their practice to compliance risks, security breaches, and federal penalties.

In 2024, OCR enforcement data showed that over 65% of HIPAA penalties issued were linked to incomplete or missing risk assessments. This highlights how critical this process is—not just for regulatory compliance but also for protecting patient information and your practice’s reputation.

How to Stay Compliant:

• Conduct a comprehensive security risk assessment at least once a year.
• Use available tools, such as the ONC’s Security Risk Assessment Tool, to evaluate your practice’s compliance.
• Review all data handling workflows, including storage, access, transmission, and third-party interactions.
• Document identified risks and implement action plans to address them.

5. Ignoring Data Backup and Disaster Recovery Requirements

Data loss isn’t just an IT issue, it’s a serious HIPAA compliance risk for chiropractic practices. The HIPAA Security Rule mandates that all covered entities, including chiropractors, implement a robust data backup and disaster recovery plan to protect electronic Protected Health Information (ePHI). 

Natural disasters, cyberattacks, equipment malfunctions, or even simple human error can lead to catastrophic data loss if a reliable backup system isn’t in place.

Why It’s a Problem:

Losing access to patient data due to ransomware, system crashes, or disasters can disrupt your practice, erode patient trust, and result in severe HIPAA violations. The OCR enforces the HIPAA Contingency Plan Standard, which requires chiropractors to maintain retrievable exact copies of ePHI and have procedures in place for restoring data after emergencies.

In 2024 alone, healthcare ransomware attacks increased by over 90% compared to the previous year, according to cybersecurity reports. Many victims had no usable data backups, leading to extended downtimes, breach penalties, and compromised patient care.

How to Stay Compliant:

• Choose a chiropractic EHR with automatic, encrypted data backups included.
• Test your backup and recovery process regularly to ensure data integrity.
• Establish a written disaster recovery plan and review it annually with your compliance officer.
• Confirm that your EHR vendor meets HIPAA backup and recovery standards.

Comprehensive Chiro HIPAA Compliance Checklist

• Perform annual risk assessments and document results.
• Appoint a HIPAA compliance officer to oversee all compliance activities.
• Conduct regular HIPAA training for staff and business associates.
• Review and verify HIPAA compliance of all vendors, including EHR and billing services.
• Implement strong technical safeguards like encryption, firewalls, and access controls.
• Maintain secure data backup and implement a disaster recovery plan.
• Update compliance policies regularly and ensure staff adherence.
• Monitor devices and systems continuously for security threats.

HIPAA Compliance Violation Penalties Chiropractors Should Know

 Source: https://www.calhipaa.com/hipaa-violations/

Understanding the severity of penalties reinforces the need for rigorous adherence to HIPAA rules for chiropractors.

Partnering with zHealth for Complete HIPAA Compliance

zHealth provides chiropractic practices with HIPAA compliance software designed to meet the strictest data protection standards. Our solution includes:

• Encrypted data storage
• Automatic backups and recovery
• Access control features
• Ongoing compliance support and system updates

We help ensure your chiropractic practice not only meets HIPAA regulations but also operates efficiently with reduced compliance risks.

Take Control of Your HIPAA Compliance Today

HIPAA compliance is an ongoing process, not a one-time checklist. By adopting this chiro HIPAA compliance checklist and leveraging HIPAA compliance software for chiropractors, you can protect your practice from costly violations and enhance patient trust.

Contact zHealth today for a free demo and discover how our HIPAA-compliant chiropractic EHR software can safeguard your practice while simplifying your daily operations.

Schedule a 1:1 Demo

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