October 9, 2026 The latest HIPAA settlement doesn’t involve a hospital system or a massive ransomware attack. It involves a practice that probably looks a lot like yours. Shen Smiles is a solo dental practice in Drums, Pennsylvania. It started with a former patient’s complaint about getting their health records. It led to a broader OCR investigation and a $140,000 settlement. The lesson? Every HIPAA-regulated organization, big or small, can face enforcement.   What happened? Under federal law, patients must be given access to their records within 30 days, with one possible 30-day extension if the patient is notified in writing within the first 30 days. In April 2020, a former patient’s attorney filed a complaint with the Office for Civil Rights (OCR). The complaint alleged that the patient had requested their records multiple times without receiving access. The public documents don’t say when the first request was made. OCR’s investigation went beyond the original complaint. According to the resolution agreement, OCR found that patient records weren’t properly maintained and that staff hadn’t received formal HIPAA Privacy Rule training. OCR also said the practice couldn’t produce evidence that it had HIPAA policies and procedures in place, including for patient access requests, or that it had reasonably safeguarded patient information. During the investigation, the practice stated that it couldn’t provide the records because a workforce member had stolen them. The public documents don’t address whether a breach assessment was done. As a general rule, though, HIPAA presumes that an impermissible acquisition, access, use, or disclosure of unsecured patient information is a breach. A breach can require notifying HHS and affected patients, including steps patients can take to protect themselves. These are baseline requirements every covered entity is expected to have in place. Policies and training give a team a HIPAA playbook. Without one, staff at any practice may not know what to do when a patient asks for records or records go missing. OCR proposed a $140,000 civil money penalty in July 2024. Shen Smiles requested a hearing before an administrative law judge, but the two sides reached a resolution agreement in August 2026, before the hearing took place. Under the agreement, the practice agreed to pay $140,000. The agreement is not an admission of liability.   The Takeaway for Practices Patient access has been an OCR priority for years through its HIPAA Right of Access Initiative, and this case marks its 56th Right of Access enforcement action. It also took more than six years from complaint to resolution. As this case shows, a single complaint can lead to a broader look at your compliance program. Now is the time to ask: Do we have written HIPAA policies our team can find? Do we have a process to answer every record request within 30 days? Can we prove every team member has completed HIPAA training? If any of those gave you pause, now’s the time to fix it, before OCR comes asking. Looking for the first step? Meet with one of our compliance experts to see where you currently stand.