What are the penalties for HIPAA violations?

July 16, 2024

The Health Insurance Portability and Accountability Act safeguards the security and confidentiality of sensitive health information. However, despite regulations, violations are common. This can have grave consequences for healthcare providers as well as organizations. 

HIPAA violations are the result of several reasons. This includes unauthorized access to the records of patients. HIPAA violations are real and involve fines and criminal charges. This depends on the intent and the severity of the violation. Keep reading to explore more about HIPAA violation fines. 

What are the civil monetary penalties for HIPAA violations?

Civil monetary penalties are fines that are imposed by the United States. The fines are heavy. They are at a loss for not protecting the sensitive information. The amount of the fine varied, especially based on the severity of the violation. If a healthcare entity does not comply with the regulations and is not aware of the violation, then the penalties for non compliance HIPAA might be lower. However, if the violation is performed intentionally, then the penalty is much higher. 

HIPAA violation fines can range from 0 to $1,000 per violation. Thus, if a single breach affects multiple individuals, then each individual causes a separate violation. This increases the amount of the penalty. Thus, CMPs help prioritize the protection of patient health information. Additionally, it helps individuals comply with the regulations of HIPAA and safeguards the privacy of patients while instilling trust in the system. 

Read More: What is HIPAA Violation?

Criminal HIPAA penalties: What are their legal ramifications? 

Criminal penalties that violate HIPAA can have legal consequences imposed by the government. This is when individuals recklessly or intentionally disregard the privacy rights of patients. While the CMPs address the violations through HIPAA fines, criminal penalties, on the other hand, involve imprisonment. 

HIPAA violations that lead to criminal penalties involve breaches. Such breaches involve intentionally disclosing the information of patients. These are grave violations under the Criminal Enforcement section of HIPAA. It outlines various offenses along with the corresponding penalties. 

It is crucial to understand the legal ramifications and raise awareness of the offenses and their consequences. The criminal penalties usually depend on the violation and its nature. Additionally, the outcomes range from convictions to misdemeanor charges. 

Misdemeanor offenses happen due to disregard for HIPAA requirements. So what is the maximum penalty for violating HIPAA? It can be a maximum penalty for HIPAA violation of $50,000 per violation. It may also cause imprisonment for one year. This includes knowingly obtaining or disclosing PHI without authorization or acquiring PHI under any false objective. 

On the other hand, felony offenses take place when there is deliberate intention towards harming patients or exploiting personal health information. Such examples include the following: 

• Identity theft 
• Phi for personal gain 
• Using PHI to commit any healthcare fraud 

The felony convictions carry penalties and include a fine of up to $250,000 and imprisonment for up to ten years.

What are the factors that influence the severity of HIPAA violation penalties?

Here are the primary factors influencing the severity of HIPAA violation penalties: 

1. Nature of the violation: The severity of the penalties depends on the nature of the violation. Malicious acts usually suffer harsher consequences as compared to other errors that are unintentional.
2. Extent of harm: The level of harm plays a crucial role. breaches that cause tangible harm, such as theft of identity or loss of finance, result in severe penalties. 
3. Size and resources of the entity: Larger healthcare entities often face heavy penalties for HIPAA violations. Smaller organizations receive penalties that are more severe. This is due to the limited capabilities they have. 
4. Compliance history: The compliance history matters significantly as it can influence the severity of the severity of the penalty.. Repeat offenders who have a track record of non-compliance may face penalties. 
5. Intent: The intent is another crucial factor, as if a violation is caused purposefully, the penalties will be different. On the other hand, if it is caused unintentionally, then it is likely to result in less harsh penalties. 

How can healthcare entities reduce risk?

Healthcare stakeholders and organizations can manage information security risks by adopting proper measures as stipulated under HIPAA. HIPAA rules and policies cover rules for the handling of protected health information, also referred to as PHI, and focus on the protection of patient records. Here’s how healthcare entities can reduce risks:

• HIPAA Compliance Training:  Perhaps annual or bi-annual seminars where staff members are reminded of HIPAA and its regulations with regards to the privacy of PHI and the consequences of violating the regulations.
• Risk Assessments: Performing risk analysis exercises in an effort to determine gaps within software, workflows, and tangible assets. This involves the evaluation of risks that may be associated with various threats, such as the stealing of data, other people accessing wrong information, and even natural calamities. 
• Secure Data Storage: Ensuring proper handling in storing and transferring PHI through encryption of stored information, protection of important documentation, and securing backups in case of data loss.

Read More: Who Must Comply with HIPAA Rules and Regulations?

Conclusion 

It is vital to examine the consequences pertaining to HIPAA noncompliance as a way for healthcare organizations to preserve patient privacy and safeguard sensitive information. Ensuring compliance with HIPAA regulations is not just a legal responsibility but a core responsibility of any organization to uphold the integrity of people’s health information. 

This shows why it is crucial to follow HIPAA standards, and penalties act as a warning signal, discouraging individuals from being careless or vying to defy the set measures. It is therefore crucial that healthcare facilities dedicate sufficient resources toward HIPAA compliance by training staff, reliably assessing risks of violation, safeguarding data, and developing credible contingency procedures for breaches to avoid HIPAA violation fines.