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Consequences of Violating HIPAA Patient Privacy Requirements

The civil monetary penalties authorized under HIPAA vary depending on whether an individual is determined to have committed a single violation or is determined to have committed repeat violations. Under HIPAA, the Department of Health and Human Services may impose a penalty not to exceed $100 per individual for one instance of a HIPAA violation. If an individual is determined to have committed multiple identical violations, then the penalty is capped at $25,000 during a single calendar year.

The Department of Health and Human Services also can bring criminal sanctions against individuals for serious acts of noncompliance. The individual must have knowledge of the HIPAA violation that he/she is committing. Depending on the circumstances of the crime and the perpetrator’s intent, penalties can include a fine of up to $50,000 and/or imprisonment of up to one year for any person who commits a criminal offense. If a person commits an offense under false pretenses, the fine may increase to $100,000 and/or imprisonment of not more than five years. If a person commits an offense with intent to sell, transfer or use individually identifiable health information for commercial advantage, personal gain or malicious harm, the individual may be fined by a court up to $250,000 and/or imprisoned for not more than 10 years.

In addition, a patient who has had his/her protected health information improperly disclosed can file a state law claim against a covered entity for its noncompliance and resulting harm.

Healthcare providers also are exposed with respect to state licensure standards. In other words, healthcare providers are licensed either by state boards of medicine (medical professionals) or state departments of health (healthcare facilities). All licensing entities maintain strict confidentiality obligations on their licensees. Violations of these obligations can lead to suspension or revocation of licenses.

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