Penalties for HIPAA violations include civil monetary penalties that can range from $145 to $2,190,294 per violation based on the level of culpability and correction, criminal fines up to $250,000 with imprisonment up to 10 years for wrongful conduct involving individually identifiable health information, and enforcement outcomes that can also require corrective action measures and monitoring through resolution agreements.
Civil monetary penalties assessed by the Department of Health and Human Services Office for Civil Rights are structured in four tiers that align the penalty range to the organization’s knowledge and conduct. For violations assessed at the lowest tier, the per-violation range is $145 to $73,011. For reasonable cause violations, the per-violation range is $1,461 to $73,011. For willful neglect that is corrected, the per-violation range is $14,602 to $73,011. For willful neglect that is not corrected within the required period, the per-violation minimum is $73,011 and the per-violation maximum is $2,190,294. The inflation-adjusted annual cap for violations of an identical provision can reach $2,190,294 in a calendar year, and the Office for Civil Rights has also published an enforcement discretion approach that applies lower annual limits for tiers 1 through 3 and maintains a separate annual cap of $1,500,000 for tier 4.
Criminal penalties apply when a person knowingly and wrongfully obtains, uses, or discloses individually identifiable health information in violation of the statute. A basic offense can be punished by a fine up to $50,000 and imprisonment up to one year. Offenses committed under false pretenses can be punished by a fine up to $100,000 and imprisonment up to five years. Offenses committed with intent to sell, transfer, or use the information for commercial advantage, personal gain, or malicious harm can be punished by a fine up to $250,000 and imprisonment up to 10 years.
Enforcement exposure is not limited to federal civil monetary penalties and federal criminal prosecution. State attorneys general can bring civil actions under their HIPAA enforcement authority, and organizations can incur additional obligations through settlements that require policy revisions, workforce retraining, risk analysis and risk management remediation under the HIPAA Security Rule, and ongoing reporting or monitoring terms tied to the identified compliance failures.