So, you suppose that India or China will let us extradite some local on the basis of a HIPAA violation? My, you are an optimist!
Earlier, someone argued that the HIPAA cannot be "violated" overseas . . . I'd like to figure that out before getting into an argument with you.
Incidentally, if your medical records are stolen, do you think your lawyer will go after the medical-provider, or simply consult you to let the state prosecutor's office handle the case?
Not possible in any case since HIPAA specifically exempts third-party outsourcers and Covered Entities from breaches by the third-party outsourcer (unless the outsourcer is itself a Covered Entity, which most would not be).
In other words, there is no law under which an outsourcer can be prosecuted either here or abroad.