HIPAA Violations and Penalties

In recent years, it has come to light that more employees of medical organizations are stealing private health information because its value in the black market is worth ten times more than your credit card details.

There are a number of potential penalties for violating HIPAA policies, ranging from financial penalties to criminal charges. The severity of the penalty depends on the nature of the violation. Violations of the HIPAA Privacy Rule, which governs the use and disclosure of protected health information, can result in civil or criminal penalties.

Civil penalties for HIPAA Privacy Rule violations can range from $100 to $50,000 per violation, with a maximum penalty of $1.5 million per year for repeated violations.

Criminal penalties for HIPAA Privacy Rule violations can range from fines of up to $50,000 to imprisonment of up to 10 years, or both. Violations of the HIPAA Security Rule, which governs the security of electronic protected health information, can also result in civil or criminal penalties. Civil penalties for HIPAA Security Rule violations can range from $100 to $50,000 per violation, with a maximum penalty of $1.5 million per year for repeated violations. Criminal penalties for HIPAA Security Rule violations can range from fines of up to $250,000 to imprisonment of up to 10 years, or both.

In addition to financial and criminal penalties, individuals who violate HIPAA policies may also be subject to disciplinary action by their employers or professional licensing boards. Hence, it is essential to ensure HIPAA compliance.

What are the Most Common HIPAA Violations?

While private health information violation can occur in a variety of circumstances and several ways, the most common ones, as evident from recent statistics, include the following.

1. Lack of Training

Statistics have shown that despite HIPAA compliance, more than one-fourth of the employees in an organization does not have the required HIPAA compliance training. This leads to higher error margins, unintentional violation of patient confidentiality, and malpractices.

2. Use of Paper

Many HIPAA violations occur as a result of losing paper documents. Storing protected medical information on paper increases the chances of being misplaced, mishandled, or lost. This is why more organizations are switching to digital or cloud storage with powerful anti-viruses and firewalls.

3. Digital Carelessness

Cloud storage and digital devices are usually more secure but are still prone to security breaches. Usually, this is due to human error. Also, using insecure, unregistered, or unreliable technology to store or share health information increases the chances of a security breach.

4. Sharing Information on Social Media

Sharing the patient’s details on social media, employees making Tiktok videos with patients in the room, and uploading pictures of their medication on Facebook are all considered violations.

5. Improper Disposal of Documents Containing Private Health Information

Often, the disposal of documents or hardware containing patient health information means anyone can easily pick them up. Therefore, it is important to shred documents and wipe devices containing private health information before disposing of them.

What are the Penalties for Violating the HIPAA?

There are certain levels of violation of HIPAA laws. These are used to determine the severity of the breach and the underlying penalties. The HITECH Act determines the fine values for HIPAA violations.

HIPAA Tier 1 Violations

This is where the violator was unaware and the violation was unavoidable, had a reasonable amount of care had been taken to abide by HIPAA Rules. This can lead to fines of $100 to $50,000 per violation.

HIPAA Tier 2 Violations

No willful neglect, but the violator was aware, but the violation could not be avoided even with reasonable care. This can lead to a fine of $1,000 to $50,000 per violation.

HIPAA Tier 3 Violations

This includes willful neglect despite attempts to correct the violation. This can result in fines amounting to $10,000 to $50,000 per violation.

HIPAA Tier 4 Violations

This constitutes willful neglect, with no attempts to correct the violation. This can result in a minimum fine of $50,000 per violation.

It is worth noting that the values of these fines can change due to inflation. In addition, a leak due to a security breach incident can lead to separate fines issued for different aspects of the breach under multiple security and privacy standards. If the data leak affects residents in multiple states, the entity may have to pay HIPAA violation fines to attorney generals in each state.

Some states also allow the affected individual to file a civil penalty case against the people/organization responsible for the violation.

Apart from monetary compensation, criminal penalties can also be issued for HIPAA violations based on the severity of the violation. These, too, are divided according to tiers.

  • Tier 1: In case of reasonable cause or unintentional violation, jail time is up to one year.
  • Tier 2: If PHI is obtained with false pretenses, jail time is up to five years.
  • Tier 3: If PHI is obtained for malicious purposes or personal gain, it can lead to jail time of up to ten years.

Often, employees will fail to report their violations to their employers. In such cases, the organization will issue employee sanctions after consultation with the HIPAA Privacy and Security Officers. This will lead to an investigation and audit process, which are both expensive and time-consuming.

Recently more government offices and state attorneys have clamped down and enforced stricter actions against HIPAA violations. For instance, one dental receptionist in New York received 6 years of jail time for stealing PHI. Therefore, ensuring compliance training has become more important than ever.

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Sabrina Cavanagh

Scientific geek and cat person who enjoys adult colouring books, going to the movies and jigsaw puzzles. Loves seafood but allergic to it.