Yes, the DHHS Office of Civil Rights enforces HIPAA Privacy and Security rules. That enforcement is reactive of there is no independent regular compliance certification or monitoring required, however, which is a weakness, but the fact that detection of violation can lead to personal as well as institutional penalties, and that those penalties are criminal as well as civil, means it's not a risk that decision-makers tend to be willing to take on just because it would (so long as undetected) provide a business opportunity.