HIPAA Violation Consequences 101

Posted by Tonni Islam

You may have the best patients and healthcare staff in the world. However, a data breach or other violation of HIPAA can be detrimental to your healthcare organization, especially for patient outcomes.

That’s why you need to understand what’s at risk if you fall out of compliance with HIPAA. Read the blog post below to understand what kind of HIPAA violation sanctions arise from data breaches and how to avoid them.

What Is A HIPAA Violation?

HIPAA has specific regulations that cover privacy and security. This of course applies to insurance companies, medical office staff, doctors and nurses. If you fail to comply with these rules, there are harsh penalties that range from financial to legal.

Medical care should be private between the patient and their care provider. Gossip and public sharing of this information are typically prohibited. One exception is speaking with a parent about the health of a minor.

Read this post on HIPAA administrative safeguards to ensure you’re in compliance.

Illegal Vs. Unintentional HIPAA Violations

A penalty for an intentional violation is typically more severe than an accidental violation. For instance, sharing information with someone who does not have the authorization to access it intentionally would have more harsh penalties.

Compare this to a violation such as accidentally not logging out of the medical records system at the workstation, which could be deemed unintentional.

Protected Information

Protected health information (PHI) cannot be accessed inappropriately or stolen. This is a federal crime and there will be a HIPAA penalty as a result. Not all HIPAA infractions are crimes. It depends on the severity and/or type of the error.

Now let’s talk about different penalties for HIPAA violations:

The Tiers Of HIPAA Penalties

As mentioned, the severity of the offense and the intention can affect the level of penalty that will result. Let’s explore the tiers for HIPAA violation penalties:

Tier 1

This type of penalty is when you are not able to prevent the violation from occurring. It means that you were typically not aware of it and had no way to stop it.

The Tier 1 HIPAA violation fines range from $100 to $50,000 for each infraction. Your history of violations can also factor into this.

Tier 2

If you should have known about the infraction but did not, then this would typically fall under Tier 2. Penalties can range from $1,000 to $50,000 per violation in this group.

Tier 3

This involves willfully neglecting the HIPAA regulations. In other words, it means that you intentionally avoided correcting an issue or allowed something to happen that could have been prevented.

It can result in a fine of $10,000 to $50,000 per violation. The level of harm that occurred can affect your penalty.

Tier 4

Tier 4 refers to when you did not try to correct the issue, you neglected it, and did nothing to keep it from happening.

For instance, consistently staying logged into electronic records could result in a Tier 4 penalty. This would be a minimum fine of $50,000. Jail time can also result from these types of penalties.

Optimize Your Compliance Program Today

If you’re looking for state-of-the-art HIPAA compliance software, then ComplyAssistant can help. Our software will help you streamline your procedures, collect evidence of operational compliance, and prevent errors from occurring in the future.

Reach out today for a free demo — let’s protect your patients and your organization together.