What are HIPAA non-compliance penalties?

Non-compliance with HIPAA can result in a range of penalties, both civil and criminal, reflecting the gravity of the HIPAA violation. Civil fines for HIPAA violations range from $100 to $50,000 per violation, with an annual maximum penalty of $1.5 million. The severity of penalties depends on the nature and extent of the breach, and entities may face financial repercussions for each specific violation. In addition to civil fines, HIPAA violations can also lead to criminal penalties. Criminal fines range from $50,000 to $250,000, and individuals found guilty may face imprisonment for up to 10 years, especially in cases involving deliberate intent or unauthorized disclosure of protected health information. These penalties outline the importance of adhering to HIPAA regulations, emphasizing the consequences for failing to safeguard sensitive health information and ensuring compliance within the healthcare industry.

Civil Penalties

Civil fines for HIPAA non-compliance are tiered, taking into account the nature and severity of the violation. The Department of Health and Human Services (HHS) employs a four-tier structure for assessing penalties, ranging from the lowest to the highest level of culpability.

Tier Description Fine per Violation Annual Maximum Penalty
1 Unaware $100 – $50,000 $1.5 million
2 Reasonable Cause $1,000 – $50,000 $1.5 million
3 Willful Neglect – Corrected $10,000 – $50,000 $1.5 million
4 Willful Neglect – Not Corrected $50,000 $1.5 million
  • Unaware (Tier 1): Fines under this tier are applicable when the violation is not due to willful neglect and the entity is unaware of the violation.
  • Reasonable Cause (Tier 2): If the violation is due to reasonable cause and not willful neglect, fines are imposed in this tier.
  • Willful Neglect – Corrected (Tier 3): Fines increase when the violation is due to willful neglect, but the issue is subsequently corrected.
  • Willful Neglect – Not Corrected (Tier 4): The highest fines are levied when the violation is due to willful neglect, and corrective action is not taken.

The fines are per violation and can accumulate, with an annual maximum penalty of $1.5 million for each violation category.

Criminal Penalties

HIPAA violations can also result in criminal penalties, particularly when the breach involves intentional misconduct or egregious negligence. Criminal penalties are classified into two categories: misdemeanor and felony. Cases of misdemeanor can include fines ranging from $50,000 to $100,000 for individuals and imprisonment for up to one year. Felony charges include fines ranging from $100,000 to $250,000 and imprisonment for up to ten years. These criminal penalties are applied to individuals who knowingly obtain or disclose PHI for malicious purposes. The severity of the penalty is contingent on the nature of the violation and the intent behind the wrongful disclosure.

Mitigating Factors

While the outlined penalties serve as a deterrent, HIPAA also recognizes entities that proactively address compliance issues. Demonstrating efforts to correct and prevent violations can mitigate the severity of penalties. Entities can reduce fines by showcasing prompt corrective action, compliance policies, and ongoing education initiatives. The regulatory framework established by HIPAA imposes strict penalties to uphold the safety of patient data within the healthcare domain. These penalties, whether civil or criminal, outline the necessity for healthcare professionals and entities to maintain a strong compliance infrastructure, creating a culture of awareness and responsibility to protect the confidentiality and integrity of patient information.

About the Author

Elizabeth Hernandez
Elizabeth Hernandez is the editor of HIPAA News. Elizabeth is an experienced journalist who has worked in the healthcare sector for several years. Her expertise is not limited to general healthcare reporting but extends to specialized areas of healthcare compliance and HIPAA compliance. Elizabeth's knowledge in these areas has made her a reliable source for information on the complexities of healthcare regulations. Elizabeth's contribution to the field extends to helping readers understand the importance of patient privacy and secure handling of health information. Elizabeth holds a postgraduate degree in journalism. You can follow Elizabeth on twitter at https://twitter.com/ElizabethHzone