What are the HIPAA Violation Penalties for Unauthorized Disclosure?

The HIPAA violation penalties for unauthorized disclosure can range from $100 to $50,000 per violation, with a maximum annual penalty of $1.5 million, depending on the level of negligence and intent behind the violation, and can also result in civil and criminal charges in severe cases. The HIPAA Privacy Rule establishes national standards for the protection of certain health information and outlines the penalties for non-compliance, particularly unauthorized disclosure of PHI.

Definition of Unauthorized Disclosure

PHI includes any individually identifiable health information held or transmitted by a covered entity or business associate. Covered entities include healthcare providers, health plans, and healthcare clearinghouses. Business associates are individuals or entities that perform functions or activities involving PHI on behalf of covered entities. Unauthorized disclosure refers to any impermissible use or disclosure of PHI that is not in accordance with the HIPAA Privacy Rule’s requirements. This can include sharing patient information without proper authorization, discussing sensitive health information inappropriately, or accidentally revealing PHI through unsecured means.

HIPAA Penalties for Unauthorized PHI Disclosure

The penalties for unauthorized disclosure under HIPAA are categorized into four tiers based on the level of culpability associated with the violation: (1) the person did not know and could not reasonably have known of the violation, (2) the violation was due to reasonable cause and not willful neglect, (3) the violation was due to willful neglect that is timely corrected, and (4) the violation was due to willful neglect that is not timely corrected.

For violations falling under tier 1, where the person did not know and could not reasonably have known of the violation, the penalty ranges from $100 to $50,000 per violation. The HHS may impose this penalty in cases where the violation was accidental and the individual or entity was unaware of the breach of privacy. For violations falling under tier 2, where the violation was due to reasonable cause and not willful neglect, the penalty ranges from $1,000 to $50,000 per violation. This category includes situations where the violation occurred due to a reasonable cause, such as human error, but the responsible entity made efforts to address and rectify the issue promptly.

For tier 3 violations, where the violation was due to willful neglect that is timely corrected, the penalty ranges from $10,000 to $50,000 per violation. Willful neglect implies that the violation was intentional or occurred due to reckless indifference to the privacy rules. However, if the violation is corrected within a specific timeframe, a lower penalty may be imposed. For tier 4 violations, where the violation was due to willful neglect that is not timely corrected, the penalty is $50,000 per violation. In cases where the violation is severe, intentional, and not corrected within the required period, the maximum penalty is applied.

Individuals involved in unauthorized disclosure may also face criminal charges, leading to fines and imprisonment. Criminal penalties can be applied for knowingly obtaining or disclosing PHI in violation of HIPAA law. The severity of the criminal penalties depends on the nature and intent of the unauthorized disclosure. To mitigate the risk of unauthorized disclosure and its associated HIPAA penalties, healthcare professionals should prioritize patient privacy and diligently follow the HIPAA Privacy Rule’s guidelines. This includes implementing strict privacy and security measures, providing proper training to staff, ensuring that PHI is accessed only by authorized personnel, and obtaining valid patient authorizations before disclosing sensitive health information to third parties.

Unauthorized disclosure of PHI is a serious offense under HIPAA, and the penalties can be severe. As a healthcare professional, it is necessary to be fully aware of the HIPAA Privacy Rule’s requirements, exercise caution in handling patient information, and take proactive steps to protect patient privacy and safeguard against any unauthorized disclosures.

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Christine Garcia is the staff writer on Calculated HIPAA. Christine has several years experience in writing about healthcare sector issues with a focus on the compliance and cybersecurity issues. Christine has developed in-depth knowledge of HIPAA regulations. You can contact Christine at [email protected]. You can follow Christine on Twitter at https://twitter.com/ChrisCalHIPAA