HIPAA violation fines can be issued by the Department of Health and Human Service’ Office for Civil Rights (OCR) and state attorneys general.
In the majority of cases, covered entities and business associates accept there have been potential failures to comply with certain elements of HIPAA Rules and a settlement amount is agreed and the case is resolved with no admission of liability. In addition to the settlement, a corrective action plan is issued to address HIPAA failures.
When HIPAA-covered entities disagree with the findings of the investigation, a civil monetary penalty may be issued.
While OCR issues fines for HIPAA violations, attorneys general tend to choose to pursue financial penalties against HIPAA-covered entities under state laws rather than HIPAA, if equivalent laws exist at the state level. Actions for violations of state laws tend to be easier to win and the penalty structure at the state level may allow higher financial penalties to be issued.
Only a handful of states have exercised their right under HIPAA/HITECH to pursue financial penalties for violations of HIPAA Rules against HIPAA-covered entities and their business associates.
Penalty Structure for HIPAA Violations
The penalty amounts are adjusted annually to account for cost of living increases. The last update was in November 2021 and saw the maximum penalties increased in line with inflation to the amounts shown in the table below.
|Penalty Tier||Level of Culpability||Minimum Penalty per Violation (adjusted for inflation)||Max Penalty per Violation (adjusted for inflation)||Annual Penalty Limit (adjusted for inflation)|
|Tier 1||Lack of Knowledge||$120||$60,226||$30,113|
|Tier 2||Reasonable Cause||$1,205||$60,226||$120,452|
|Tier 3||Willful Neglect||$12,045||$60,226||$301,130|
|Tier 4||Willful neglect (not corrected within 30 days0||$60,226||$1,806,757||$1,806,757|
Further, OCR issued a Notice of Enforcement Discretion in April 2019 stating the annual penalty limits in three of the penalty tiers would be reduced following a reexamination of the language of the HITECH Act. The cap on the annual penalty limit was changed to $25,000 (now $30,113) for tier 1, $100,000 (now $120,452) for tier 2, and $250, 000 (now $301,130) for tier 3. The maximum annual penalty for tier 4 remains unchanged at $1,500,000 (now $1,806,757).
State attorneys general can issue fines for HIPAA violations up to a maximum of $25,000 per violation category, per year. The maximum penalty is also adjusted annually in line with inflation.
Listed below are the HIPAA violation fines and settlements issued by the HHS’ Office for Civil Rights since the HIPAA Enforcement Rule was signed into law.
2022 HIPAA Violation Fines and Settlements
|2022||ACPM Podiatry||$100,000||Civil Monetary Penalty||HIPAA Right of Access failure|
|2022||Memorial Hermann Health System||$240,000||Settlement||HIPAA Right of Access failure|
|2022||Southwest Surgical Associates||$65,000||Settlement||HIPAA Right of Access failure|
|2022||Hillcrest Nursing and Rehabilitation||$55,000||Settlement||HIPAA Right of Access failure|
|2022||MelroseWakefield Healthcare||$55,000||Settlement||HIPAA Right of Access failure|
|2022||Erie County Medical Center Corporation||$50,000||Settlement||HIPAA Right of Access failure|
|2022||Fallbrook Family Health Center||$30,000||Settlement||HIPAA Right of Access failure|
|2022||Associated Retina Specialists||$22,500||Settlement||HIPAA Right of Access failure|
|2022||Coastal Ear, Nose, and Throat||$20,000||Settlement||HIPAA Right of Access failure|
|2022||Lawrence Bell, Jr. D.D.S||$5,000||Settlement||HIPAA Right of Access failure|
|2022||Danbury Psychiatric Consultants||$3,500||Settlement||HIPAA Right of Access failure|
|2022||Oklahoma State University – Center for Health Sciences||$875,000||Settlement||Risk analysis, security incident response and reporting, evaluation, audit controls, breach notifications, & the impermissible disclosure of the PHI of 279,865 individuals|
|2022||Dr. Brockley||$30,000||Settlement||HIPAA Right of Access|
|2022||Jacob & Associates||$28,000||Settlement||HIPAA Right of Access, notice of privacy practices, HIPAA Privacy Officer|
|2022||Dr. U. Phillip Igbinadolor, D.M.D. & Associates, P.A.,||$50,000||Civil Monetary Penalty||Impermissible disclosure on social media|
|2022||Northcutt Dental-Fairhope||$62,500||Settlement||Impermissible disclosure for marketing, notice of privacy practices, HIPAA Privacy Officer|
2021 HIPAA Violation Fines and Settlements
|2021||Advanced Spine & Pain Management||$32,150||Settlement||HIPAA Right of Access failure|
|2021||Denver Retina Center||$30,000||Settlement||HIPAA Right of Access failure|
|2021||Dr. Robert Glaser||$100,000||Civil Monetary Penalty||HIPAA Right of Access failure|
|2021||Rainrock Treatment Center LLC (dba monte Nido Rainrock)||$160,000||Settlement||HIPAA Right of Access failure|
|2021||Wake Health Medical Group||$10,000||Settlement||HIPAA Right of Access failure|
|2021||Children’s Hospital & Medical Center||$80,000||Settlement||HIPAA Right of Access failure|
|2021||The Diabetes, Endocrinology & Lipidology Center, Inc.||$5,000||Settlement||HIPAA Right of Access failure|
|2021||AEON Clinical Laboratories (Peachstate)||$25,000||Settlement||HIPAA Security Rule failures (risk assessment, risk management, audit controls, and lack of documentation of HIPAA Security Rule policies and procedures)|
|2021||Village Plastic Surgery||$30,000||Settlement||HIPAA Right of Access failure|
|2021||Arbour Hospital||$65,000||Settlement||HIPAA Right of Access failure|
|2021||Sharpe Healthcare||$70,000||Settlement||HIPAA Right of Access failure|
|2021||Renown Health||$75,000||Settlement||HIPAA Right of Access failure|
|2021||Excellus Health Plan||$5,100,000||Settlement||Multiple violations: Risk analysis failure, risk management failure, lack of information system activity reviews, lack of technical policies to prevent unauthorized ePHI access, and a breach of 9,358,891 records.|
|2021||Banner Health||$200,000||Settlement||HIPAA Right of Access failure|
2020 HIPAA Violation Fines and Settlements
|2020||Peter Wrobel, M.D., P.C., dba Elite Primary Care||$36,000||Settlement||HIPAA Right of Access failure|
|2020||University of Cincinnati Medical Center||$65,000||Settlement||HIPAA Right of Access failure|
|2020||Dr. Rajendra Bhayani||$15,000||Settlement||HIPAA Right of Access failure|
|2020||Riverside Psychiatric Medical Group||$25,000||Settlement||HIPAA Right of Access failure|
|2020||City of New Haven, CT||$202,400||Settlement||Failure to terminate access rights, risk analysis failure, failure to implement Privacy Rule policies, failure to issue unique IDs, impermissible disclosure of the PHI of 498 individuals|
|2020||Aetna||$1,000,000||Settlement||Failure to conduct an evaluation in response to environmental or operational changes affecting ePHI security, identity check failure, minimum necessary information failure, lack of admin, technical, and physical safeguards|
|2020||NY Spine||$100,000||Settlement||HIPAA Right of Access failure|
|2020||Dignity Health, dba St. Joseph’s Hospital and Medical Center||$160,000||Settlement||HIPAA Right of Access failure|
|2020||Premera Blue Cross||$6,850,000||Settlement||Risk assessment failure, risk management failure, insufficient hardware, and software controls,|
|2020||CHSPSC LLC||$2,300,000||Settlement||Risk analysis failure, failure to implement information system activity reviews, security incident procedure failure, and insufficient access controls.|
|2020||Athens Orthopedic Clinic PA||$1,500,000||Settlement||Failures to conduct a risk analysis, risk management failure, lack of audit controls, no HIPAA policies and procedures, lack of business associate agreements, and no HIPAA Privacy Rule training to the workforce.|
|2020||Housing Works, Inc.||$38,000||Settlement||HIPAA Right of Access failure|
|2020||All Inclusive Medical Services, Inc.||$15,000||Settlement||HIPAA Right of Access failure|
|2020||Beth Israel Lahey Health Behavioral Services||$70,000||Settlement||HIPAA Right of Access failure|
|2020||King MD||$3,500||Settlement||HIPAA Right of Access failure|
|2020||Wise Psychiatry, PC||$10,000||Settlement||HIPAA Right of Access failure|
|2020||Lifespan Health System Affiliated Covered Entity||$1,040,000||Settlement||Lack of encryption, device and media controls, and business associate agreement failures.|
|2020||Metropolitan Community Health Services dba Agape Health Services||$25,000||Settlement||Systemic noncompliance with the HIPAA Security Rule|
|2020||Steven A. Porter, M.D||$100,000||Settlement||Risk analysis and risk management failures|
2019 HIPAA Violation Fines and Settlements
|2019||West Georgia Ambulance||$65,000||Settlement||Risk analysis failure; no security awareness training program; failure to implement HIPAA Security Rule policies and procedures.|
|2019||Korunda Medical, LLC||$85,000||Settlement||HIPAA Right of Access failure.|
|2019||Sentara Hospitals||$2,175,000||Settlement||Breach notification failure; business associate agreement failure|
|2019||University of Rochester Medical Center||$3,000,000||Settlement||Loss of flash drive/laptop; no encryption; risk analysis failure; risk management failure; lack of device media controls.|
|2019||Elite Dental Associates||$10,000||Settlement||Social media disclosure; notice of privacy practices; impermissible PHI disclosure.|
|2019||Bayfront Health St Petersburg||$85,000||Settlement||HIPAA Right of Access failure|
|2019||Medical Informatics Engineering||$100,000||Settlement||Risk analysis failure; impermissible disclosure of 3.5 million records|
|2019||Touchstone Medical imaging||$3,000,000||Settlement||No BAAs; insufficient access rights; risk analysis failure; failure to respond to a security incident; breach notification failure; media notification failure; impermissible disclosure of 307,839 individuals’ PHI.|
|2019||Texas Department of Aging and Disability Services||$1,600,000||Civil Monetary Penalty||Risk analysis failure; access control failure; information system activity monitoring failure; impermissible disclosure of 6,617 patients ePHI|
|2019||Jackson Health System||$2,154,000||Civil Monetary Penalty||Multiple Privacy Rule, Security Rule, and Breach Notification Rule violations|
2018 HIPAA Violation Fines and Settlements
|2018||Fresenius Medical Care North America||$3,500,000||Settlement||Risk analysis failures, impermissible disclosure of ePHI; Lack of policies covering electronic devices; Lack of encryption; Insufficient security policies; Insufficient physical safeguards|
|2018||Filefax, Inc.||$100,000||Settlement||Impermissible disclosure of PHI|
|2018||University of Texas MD Anderson Cancer Center||$4,348,000||Civil Monetary Penalty||Impermissible disclosure of ePHI; No Encryption|
|2018||Massachusetts General Hospital||$515,000||Settlement||Filming patients without consent|
|2018||Brigham and Women’s Hospital||$384,000||Settlement||Filming patients without consent|
|2018||Boston Medical Center||$100,000||Settlement||Filming patients without consent|
|2018||Anthem Inc||$16,000,000||Settlement||Risk Analysis failures; Insufficient reviews of system activity; Failure related to response to a detected breach; Insufficient technical controls to prevent unauthorized ePHI access|
|2018||Allergy Associates of Hartford||$125,000||Settlement||PHI disclosure to a reporter; No sanctions against employees|
|2018||Advanced Care Hospitalists||$500,000||Settlement||Impermissible PHI Disclosure; No BAA; Insufficient security measures; No HIPAA compliance efforts prior to April 1, 2014|
|2018||Pagosa Springs Medical Center||$111,400||Settlement||Failure to terminate employee access; No BAA|
|2018||Cottage Health||$3,000,000||Settlement||Risk analysis failure; Risk management failure; No BAA|
2017 HIPAA Violation Fines and Settlements
|2017||21st Century Oncology||$2,300,000||Settlement||Multiple HIPAA Violations|
|2017||Memorial Hermann Health System||$2,400,000||Settlement||Careless Handling of PHI|
|2017||St. Luke’s-Roosevelt Hospital Center Inc.||$387,000||Settlement||Unauthorized Disclosure of PHI|
|2017||The Center for Children’s Digestive Health||$31,000||Settlement||Lack of a Business Associate Agreement|
|2017||Cardionet||$2,500,000||Settlement||Impermissible Disclosure of PHI|
|2017||Metro Community Provider Network||$400,000||Settlement||Lack of Security Management Process|
|2017||Memorial Healthcare System||$5,500,000||Settlement||Insufficient ePHI Access Controls|
|2017||Children’s Medical Center of Dallas||$3,200,000||Civil Monetary Penalty||Impermissible Disclosure of ePHI|
|2017||MAPFRE Life Insurance Company of Puerto Rico||$2,200,000||Settlement||Impermissible Disclosure of ePHI|
|2017||Presense Health||$475,000||Settlement||Delayed Breach Notifications|
2016 HIPAA Violation Finesand Settlements
|2016||University of Massachusetts Amherst (UMass)||$650,000||Settlement||Failure to Manage Security Risks|
|2016||St. Joseph Health||$2,140,500||Settlement||Failure to Conduct Risk Analysis|
|2016||Care New England Health System||$400,000||Settlement||Lack of a Business Associate Agreement|
|2016||Advocate Health Care Network||$5,550,000||Settlement||Multiple HIPAA Violations|
|2016||University of Mississippi Medical Center||$2,750,000||Settlement||Multiple HIPAA Violations|
|2016||Oregon Health & Science University||$2,700,000||Settlement||Lack of a Business Associate Agreement|
|2016||Catholic Health Care Services of the Archdiocese of Philadelphia||$650,000||Settlement||Failure to Safeguard ePHI|
|2016||New York Presbyterian Hospital||$2,200,000||Settlement||Filming Patients without Authorization|
|2016||Raleigh Orthopaedic Clinic, P.A. of North Carolina||$750,000||Settlement||Lack of Business Associate Agreement|
|2016||Feinstein Institute for Medical Research||$3,900,000||Settlement||Impermissible Disclosure of PHI|
|2016||North Memorial Health Care of Minnesota||$1,550,000||Settlement||Lack of a Business Associate Agreement|
|2016||Complete P.T., Pool & Land Physical Therapy, Inc.||$25,000||Settlement||Impermissible Disclosure of PHI|
|2016||Lincare, Inc.||$239,800||Civil Monetary Penalty||Failure to Safeguard PHI|
2015 HIPAA Violation Finesand Settlements
|2015||University of Washington Medicine||$750,000||Settlement||Failure to Conduct Risk Analysis|
|2015||Triple S Management Corporation||$3,500,000||Settlement||Multiple HIPAA Violations|
|2015||Lahey Hospital and Medical Center||$850,000||Settlement||Multiple HIPAA Violations|
|2015||Cancer Care Group, P.C.||$750,000||Settlement||Failure to Conduct Risk Analysis|
|2015||St. Elizabeth’s Medical Center||$218,400||Settlement||Multiple HIPAA Violations|
|2015||Cornell Prescription Pharmacy||$125,000||Settlement||Improper Disposal of PHI|
2014 HIPAA Violation Finesand Settlements
|2014||Anchorage Community Mental Health Services||$150,000||Settlement||Failure to Manage Risks to ePHI|
|2014||Parkview Health System, Inc.||$800,000||Settlement||Failure to Safeguard PHI|
|2014||New York and Presbyterian Hospital and Columbia University||$4,800,000||Settlement||Failure to Conduct Risk Analysis|
|2014||QCA Health Plan, Inc., of Arkansas||$250,000||Settlement||Failure to Safeguard ePHI|
|2014||Concentra Health Services||$1,725,220||Settlement||Failure to Safeguard ePHI|
|2014||Skagit County, Washington||$215,000||Settlement||Failure to Safeguard ePHI|
2013 HIPAA Violation Finesand Settlements
|2013||Adult & Pediatric Dermatology, P.C.||$150,000||Settlement||Failure to Safeguard ePHI|
|2013||Affinity Health Plan, Inc.||$1,215,780||Settlement||Failure to Permanently Erase ePHI|
|2013||WellPoint||$1,700,000||Settlement||Failure to Safeguard ePHI|
|2013||Shasta Regional Medical Center||$275,000||Settlement||Disclosure of PHI Without Patient Consent|
|2013||Idaho State University||$400,000||Settlement||Failure to Safeguard ePHI|
2012 HIPAA Violation Finesand Settlements
|2012||The Hospice of Northern Idaho||$50,000||Settlement||Theft of an Unencrypted Laptop|
|2012||Massachusetts Eye and Ear Infirmary and Massachusetts Eye and Ear Associates, Inc.||$1,500,000||Settlement||Multiple HIPAA Violations|
|2012||Alaska DHSS||$1,700,000||Settlement||Failure to Perform Risk Analysis/Risk Management Failures|
|2012||Phoenix Cardiac Surgery||$100,000||Settlement||Lack of HIPAA Safeguards|
|2012||Blue Cross Blue Shield of Tennessee||$1,500,000||Settlement||Failure to Implement Appropriate Administrative Safeguards|
2011 HIPAA Violation Finesand Settlements
|2011||University of California at Los Angeles Health System||$865,500||Settlement||Failure to Restrict Access to Medical Records|
|2011||General Hospital Corp. & Massachusetts General Physicians Organization Inc.||$1,000,000||Settlement||Failure to Safeguard PHI|
|2011||Cignet Health of Prince George’s County||$4,300,000||Civil Monetary Penalty||Denying Patients Access to Medical Records|
2010 HIPAA Violation Finesand Settlements
|2010||Management Services Organization Washington Inc.||$35,000||Settlement||Risk Analysis Failures / Insufficient Security Measures|
|2010||Rite Aid Corporation||$1,000,000||Settlement||Multiple HIPAA Violations|
2009 HIPAA Violation Finesand Settlements
|2009||CVS Pharmacy Inc.||$2,250,000||Settlement||Multiple HIPAA Violations|
2008 HIPAA Violation Finesand Settlements
|2008||Providence Health & Services||$100,000||Settlement||Failure to Implement Appropriate Administrative Safeguards|
Attorneys General HIPAA Finesand Settlements
|2021||New Jersey||Regional Cancer Care Associates (Regional Cancer Care Associates LLC, RCCA MSO LLC, and RCCA MD LLC)||$425,000||105,000||Settlement||Failure to ensure the confidentiality, integrity, and availability of PHI, failure to protect against reasonably anticipated threats, failure to implement security measures to reduce risks, failure to conduct an accurate risk assessment, lack of a security awareness and training program.|
|2021||New Jersey||Command Marketing Innovations, LLC and Strategic Content Imaging LLC||$130,000 (Plus $65,000 suspended)||55,715||Settlement||Failure to ensure the confidentiality of PHI, lack of PHI safeguards, failure to review security measures following changes to procedures.|
|2021||New Jersey||Diamond Institute for Infertility and Menopause||$495,000||14,663||Settlement||Multiple Privacy Rule and Security Rule failures, and violations of Consumer Fraud Act.|
|2021||Multistate||American Medical Collection Agency||$21 million (suspended)||21,000,000||Settlement||Security failures including the failure to detect a data breach.|
|2020||Multistate||CHSPSC LLC||$5,000,000||6.1 million||Settlement||Failure to implement and maintain reasonable security practices|
|2020||Multistate||Anthem Inc||$48.2 million||78.8 million||Settlement||Multiple violations of HIPAA and state laws|
|2019||Multistate||Premera Blue Cross||$10,000,000||10.4 million||Settlement||Multiple HIPAA violations|
|2019||Multistate||Medical Informatics Engineering||$900,000||3.5 million||Settlement||Multiple HIPAA violations|
|2019||CA||Aetna||$935,000||1,991||Settlement||2 mailings exposed PHI (Afib, HIV)|
|2018||MA||McLean Hospital||$75,000||1,500||Settlement||Loss of backup tapes|
|2018||NJ||EmblemHealth||$100,000||6,443 (81,000)||Settlement||Mailing error exposed SSNs|
|2018||NJ||Best Transcription Medical||$200,000||1,650||Settlement||Exposure of ePHi via search engines|
|2018||CT||Aetna||$99,959||13,160||Settlement (Multistate action)||2 mailings exposed PHI (Afib, HIV data)|
|2018||NJ||Aetna||$365,211.59||13,160||Settlement (Multistate action)||2 mailings exposed PHI (Afib, HIV data)|
|2018||DC||Aetna||$175,000||13,160||Settlement (Multistate action)||2 mailings exposed PHI (Afib, HIV data)|
|2018||MA||UMass Memorial Medical Group / UMass Memorial Medical Center||$230,000||15,000||Settlement||Failure to secure ePHI and multiple breaches|
|2018||NY||Arc of Erie County||$200,000||3,751||Settlement||Failure to secure ePHI|
|2018||NJ||Virtua Medical Group||$417,816||1,654||Settlement||Multiple violations of HIPAA Rules|
|2018||NY||EmblemHealth||$575,000||81,122||Settlement||Impermissible disclosure of ePHI|
|2018||NY||Aetna||$1,150,000||12,000||Settlement||2 mailings exposed PHI (Afib, HIV data)|
|2017||CA||Cottage Health System||$2,000,000||More than 54,000||Settlement||Failure to adequately protect medical records|
|2017||MA||Multi-State Billing Services||$100,000||2,600||Settlement||Theft of unencrypted laptop containing PHI|
|2017||NJ||Horizon Healthcare Services Inc.,||$1,100,000||3.7 million||Settlement||Loss of unencrypted laptop computers|
|2017||VT||SAManage USA, Inc.||$264,000||660||Settlement||Spreadsheet indexed by search engines and PHI viewable|
|2017||NY||CoPilot Provider Support Services, Inc||$130,000||221,178||Settlement||Delayed breach notification|
|2015||NY||University of Rochester Medical Center||$15,000||3,403||Settlement||List of patients provided to nurse who took it to a new employer|
|2015||CT||Hartford Hospital/ EMC Corporation||$90,000||8,883||Settlement||Theft of unencrypted laptop containing PHI|
|2014||MA||Women & Infants Hospital of Rhode Island||$150,000||12,000||Settlement||Loss of backup tapes containing PHI|
|2014||MA||Boston Children’s Hospital||$40,000||2,159||Settlement||Loss of laptop containing PHI|
|2014||MA||Beth Israel Deaconess Medical Center||$100,000||3,796||Settlement||Loss of laptop containing PHI|
|2013||MA||Goldthwait Associates||$140,000||67,000||Settlement||Improper disposal|
|2012||MN||Accretive Health||$2,500,000||24,000||Settlement||Mishandling of PHI|
|2012||MA||South Shore Hospital||$750,000||800,000||Settlement||Loss of backup tapes containing PHI|
|2011||VT||Health Net Inc.||$55,000||1,500,000||Settlement||Loss of unencrypted hard drive/delayed breach notifications|
|2011||IN||WellPoint Inc.||$100,000||32,000||Settlement||Failure to report a breach in a reasonable timeframe|
|2010||CT||Health Net Inc.||$250,000||1,500,000||Settlement||Loss of unencrypted hard drive/delayed breach notifications|
Cases have been included if there have been potential violations of HIPAA Rules even if the financial penalty was issued for violations of state laws.
HIPAA Violation Fines. FAQs
Does the above list represent all the HIPAA violation fines issued by OCR?
As of June 2022, despite receiving more than 300,00 complaints and reports of data breaches, the HHS´ Office for Civil Rights has only issued fines or agreed settlements in 110 cases. Most of the other cases – in which a violation of HIPAA is considered to have occurred – have been resolved by technical assistance and/or corrective action plans.
Can OCR also pursue criminal charges for violations of HIPAA?
If the Office for Civil Rights reviews a case and believes there are grounds for a possible criminal conviction, the case is referred to the Department of Justice. The Department of Justice has the authority to pursue criminal charges for violations of HIPAA and several individuals responsible for violating HIPAA have received jail sentences. These include:
- Florida Medical Clinic Worker Sentenced to 48 Months in Jail over Theft of PHI
- 3-Year Jail Term for VA Employee Who Stole Patient Data
- Former New York Dental Practice Receptionist Sentenced to 2-6 years for HIPAA Violation
- UPMC Patient Care Coordinator Gets 1 Year Jail Term for HIPAA Violation
Why are so many of the latest settlements for HIPAA Right of Access failures?
Since 2019, the Office for Civil Rights has been running a Right of Access enforcement initiative to address the increasing number of complaints from patients who have experienced obstacles or delays in accessing copies of PHI. This does not mean OCR is turning a blind eye to other types of HIPAA violation and the agency continues to investigate other violations and data breaches.
Why are some HIPAA violation fines more than the annual penalty limit?
The annual penalty limit applies per violation type. Therefore, if a covered entity is found non-compliant in (for example) four areas, the non-compliant covered entity could receive four fines, each up to the maximum penalty per violation or annual penalty limit (per violation) depending on their level of culpability.
What do the four penalty/level of culpability tiers represent?
Tier 1: A violation that a Covered Entity or Business Associate was unaware of and could not have realistically avoided had a reasonable amount of care had been taken to comply with HIPAA.
Tier 2: A violation that a Covered Entity or Business Associate should have been aware of but could not have avoided even with a reasonable amount of care to comply with HIPAA.
Tier 3: A violation suffered as a direct result of “willful neglect” in cases where a Covered Entity or Business Associate has been an attempt made to correct the violation.
Tier 4: A violation of HIPAA attributable to willful neglect, where no attempt has been made to correct the violation by a Covered Entity or Business Associate.
The maximum annual penalty for tier 4 remains unchanged at $1,500,000 (now $1,806,757). State attorneys general can issue fines for HIPAA violations up to a maximum of $25,000 per violation category, per year. The maximum penalty is also adjusted annually in line with inflation.
HIPAA violations are expensive. The penalties for noncompliance are based on the level of negligence and can range from $100 to $50,000 per violation (or per record), with a maximum penalty of $1.5 million per year for violations of an identical provision.
The largest HIPAA violation penalty – $16 million – was paid by Anthem Inc. in 2018 and resolved an investigation into its 78.8 million record data breach that was discovered in 2015. Following on from that settlement, in 2020 Anthem Inc settled a multi-state action and paid $48.2 million in penalties.
1. 2018 Anthem, $16 million. In 2018, Anthem, one of the nation's largest health benefits companies, had the largest health data breach, followed by the largest HIPAA settlement in history. Their $16 million dollar fine accompanied a corrective action plan to bring them into compliance with HIPAA requirements.
The penalties for HIPAA noncompliance are based on the perceived level of negligence and can range from $100 to $50,000 per individual violation, with a max penalty of $1.5 million per calendar year for violations. Additionally, violations can also result in jail time for the individuals responsible.
Depending on the nature of the violation, the incident may warrant disciplinary action against the individual concerned which could see the employee suspended pending an investigation. Termination for a HIPAA violation is a possible outcome.
$16 Million Anthem HIPAA Breach Settlement Takes OCR HIPAA Penalties Past $100 Million Mark.
- In the largest HIPAA settlement to date, Anthem Inc., a division of Blue Cross Blue Shield, will pay the Office of Civil Rights $16 million. ...
- Prior to this settlement, the largest fine ever paid to OCR for violations of HIPAA law was $5.5 million.
ProPublica has created and launched a new database that allows consumers to search for privacy violations by health care providers after an investigation revealed hundreds of repeat HIPAA offenders, Charles Ornstein and Annie Waldman report for ProPublica.
Thus, whether a family member or other person is a personal representative of the individual, and therefore has a right to access the individual's PHI under the Privacy Rule, generally depends on whether that person has authority under State law to act on behalf of the individual.
Even if you mean no harm or don't think the patient will ever find out, it still violates the person's privacy. You'll always need to get a client's expressed consent when sharing anything that potentially exposes their protected health information (PHI). Even if you're asking for their testimonial.
PHI is important to individuals and valuable to hackers which makes it vital for organizations to protect. HIPAA lays out all the requirements and safeguards that should be put in place so that each person's identifiable health information is kept secure from cyber criminals.
- The 5 Most Common HIPAA Violations.
- HIPAA Violation 1: A Non-Encrypted Lost or Stolen Device. ...
- HIPAA Violation 2: Lack of Employment Training. ...
- HIPAA Violation 3: Database Breaches. ...
- HIPAA Violation 4: Gossiping and Sharing PHI. ...
- HIPAA Violation 5: Improper disposal of PHI.
Impermissible disclosures of PHI. Improper disposal of PHI. Failure to conduct a risk analysis.
Those who violate HIPAA may face fines from $100-250,000 per offense (with an annual cap at $1.5 million) and/or a 1-10 year prison sentence. Employers may find it difficult to enforce sanctions on employees who break the rules. However, it is important to do so consistently for the wellbeing of the company.
The tiers for HIPAA criminal penalties are: Tier 1: Reasonable cause or no knowledge of violation – Up to 1 year in jail. Tier 2: Obtaining PHI under false pretenses – Up to 5 years in jail. Tier 3: Obtaining PHI for personal gain or with malicious intent – Up to 10 years in jail.
Patient names (first and last name or last name and initial) are one of the 18 identifiers classed as protected health information (PHI) in the HIPAA Privacy Rule. HIPAA does not prohibit the electronic transmission of PHI.
Impermissible disclosures of PHI. Improper disposal of PHI. Failure to conduct a risk analysis.
What is the maximum monetary civil penalty for the HIPAA violation of uncorrected willful neglect? ›
Where a violation is due to willful neglect (a conscious and intentional failure to comply or a reckless indifference to the obligation to comply), but was corrected in a timely manner (generally within 30 days of discovery), the penalty range is $10,000 to $50,000 for each violation.
Personal gain – if the offense is committed with intent to sell, transfer, or use PHI for commercial advantage, personal gain, or malicious harm, a fine of not more than $250,000, imprisoned for not more than 10 years, or both.
What is the most serious consequence for intentionally breaching PHI security? You can be fined and fired.
Under HIPAA, use or disclosure of PHI, for the purpose of calling a patient's name in a waiting room, without patient authorization, is generally permitted. Several conditions must be met for this general rule to apply. When a name is called, other patients may hear the identity of the person whose name is called.
Similarly, if the subject of the gossip is not a patient who has rights under the HIPAA Privacy Rule, the gossip is not a violation of HIPAA; and, even if the individual is an employee of a Covered Entity and the gossip relates to a patient in their care, gossip is not a violation of HIPAA if none of the 18 identifiers ...
HIPAA Violation 1: A Non-Encrypted Lost or Stolen Device
One of the most common HIPAA violations is that a lost or stolen device can easily result in theft or unauthorized access to PHI. Fines of up to $1.5 million – per violation category, per year that the violation has been allowed to persist.