Failure to adhere to HIPAA regulations results in fines and penalties for violations. Depending on the nature and seriousness of the offence, they may result in both civil and criminal consequences. There are minimum and maximum fines for HIPAA violations, with a calendar-year cap of $1,919,173 for multiple violations of the same HIPAA provision.
HIPAA is enforced by the Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) through routine audits and investigations following a complaint or breach. Since the Enforcement Final Rule of 2006, OCR has the authority to impose monetary fines, appoint corrective action plans, and enter into resolution agreements to guarantee that the covered business complies with HIPAA. Fines and penalties for HIPAA violations can also be imposed by the state attorneys general.
OCR traditionally favours using non-punitive approaches to address infractions, such as voluntary compliance and corrective action plans. However, OCR uses a tiered penalty structure to determine the severity of the breach and impose a proportionate punishment where HIPAA violation fines are required.
HIPAA Violation Fines
HIPAA infractions cost money. Based on the degree of negligence, the fines for noncompliance can range from $100 to $50,000 per infraction (or each record), with a maximum fine of $1.5 million per year for infractions of the same provision. Criminal charges for violations may also lead to jail time.
The quantity of patients and degree of carelessness will affect how much the fines rise. The lowest penalties begin with a breach where you weren’t aware of the violation and, with due diligence, would not have been. Fines are assessed at the other end of the spectrum when a violation results from negligence and is not remedied within 30 days. This is known as mens rea in legalese (state of mind). Therefore, the severity of fines increases from no mens rea (didn’t know) to inferred mens rea (willful neglect).
Reasonable Cause and Willful Neglect are the two main categories into which the fines and charges are divided. Reasonable Cause does not require any jail penalty and can range from $100 to $50,000 per incident. Criminal charges for willful neglect can vary from $10,000 to $50,000 for each instance.