The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that governs the use and disclosure of protected health information (PHI). PHI is any information about a person’s health, treatment, or medical condition that can be used to identify them. Penalties for HIPAA violations can result in heavy fines for both covered entities (such as healthcare providers and insurance companies) and individuals. In this blog post, we will look at some of the penalties regulators can impose for HIPAA violations.
Under HIPAA, two types of penalties can be imposed for violations: civil and criminal.
Civil Penalties
Civil penalties are those issued by the Department of Health and Human Services (HHS) Office for Civil Rights (OCR). They may be imposed on any person or entity who knowingly violates HIPAA rules, such as not properly securing protected health information or disclosing it without authorization. The amount of the penalty depends on the nature and extent of the violation. It can range from $100 up to $50,000 per violation with an annual maximum of $1.5 million. In addition to fines, OCR has the authority to impose corrective action plans and even suspend covered entities’ ability to provide healthcare services if they do not comply with HIPAA.
Criminal Penalties
Criminal penalties are those issued by the Department of Justice (DOJ). These include jail time, fines, and exclusion from government healthcare programs. The maximum criminal penalty for knowingly disclosing or obtaining PHI in violation of HIPAA is 10 years in prison and up to a $250,000 fine. In addition, individuals convicted of a HIPAA violation may be subject to exclusion from Medicare or other federal healthcare programs such as Medicaid.
Penalties for HIPAA Violations
There are four categories of violations and penalties for HIPAA violations:
1. Tier 1 Violations
The first category of violations includes any violations that organizations do not correct within a certain amount of time after they receive notifications from HHS. These violations lead to penalties ranging from $100 to $50,000 per violation, with a maximum of $1.5 million for all violations in a single year.
2. Tier 2 Violations
The second tier includes violations that could have been avoided but were not due to the organization’s willful neglect. These violations result in penalties ranging from $1,000 to $50,000 per violation and up to $1.5 million for all violations within a single year.
3. Tier 3 Violations
The third tier applies when an organization demonstrated a pattern or practice of violating HIPAA rules over a period. These violations lead to penalties ranging from $10,000 to $50,000 per violation and a maximum of $1.5 million for all violations within a single year.
4. Tier 4 Violations
The fourth tier applies when an organization engaged in reckless or intentional disregard of HIPAA rules. Also, when the potential harm caused by its actions could have been avoided with reasonable care. These violations can result in criminal penalties such as jail time, fines up to $250,000 per violation, and exclusion from government healthcare programs.
Bottom Line
HIPAA violations can have grave consequences for both covered entities and individuals. It is important for everyone involved in healthcare to understand their HIPAA obligations and take steps to ensure they are compliant with the law. Doing so will help protect patients’ privacy and keep everyone involved in healthcare out of legal trouble.
It is important to note HIPAA rules apply not only to covered entities and their business associates but to any individual or entity who works with PHI. This includes contractors, subcontractors, and volunteers who must abide by HIPAA laws.
Medical ITG helps healthcare organizations stay on top of their HIPAA compliance obligations. We offer a full suite of services, including training, audits and assessments, and consulting, to help you keep your organization compliant with the law. Contact us today for more information.
Resource: https://www.hipaajournal.com/what-are-the-penalties-for-hipaa-violations-7096/
