HIPAA Risk and Enforcement: Penalties and Consequences for Non-Compliance

The sensitivity of health information prompted federal governments to establish compliance rules to guarantee that patients’ privacy is always respected.

Protected health information (PHI) and electronic PHI are now more secure thanks to the passage of the Healthcare Insurance Portability and Accountability Act (HIPAA). You run the danger of receiving harsh fines if your business doesn’t follow HIPAA regulations.

In this article, we will tell you about the HIPAA Risks and Enforcement and penalties for noncompliance. 

What Amounts to HIPAA Violations?

What exactly do HIPAA violations entail? When a HIPAA-covered entity or a business partner disobeys one or more of the requirements of the HIPAA Privacy, Security, or Breach Notification Rules, it commits a HIPAA violation.

A violation could be intentional or accidental. When excessive PHI is released and the threshold for the minimal necessary information is broken, this is an example of an unintended HIPAA breach.

PHI disclosures must be kept to the absolute minimum of details required to fulfill the disclosed purpose. Unintentional HIPAA infractions are subject to financial penalties, however, these are less severe than those for deliberate violations of the HIPAA Rules.

Deliberate violations include intentionally prolonging the 60-day window once a breach is discovered before notifying affected patients and delaying breach notification letters from being sent.

Negligence leads to a lot of HIPAA infractions, like skipping an organization-wide risk assessment. Failures in risk assessment have regularly resulted in financial penalties for HIPAA violations.

The penalty structure are as follows:

Tier 1: A violation that, notwithstanding reasonable efforts to comply with HIPAA Rules, the covered entity was uninformed of and could not have been avoided. $100 minimum fine per infraction, maximum $50,000.

Tier 2: A breach that the covered entity should have known about but was unable to stop, despite exercising reasonable caution. (But not to the extent of wilful disregard for HIPAA Regulations). $1,000 minimum fine per infraction, maximum $50,000.

Tier 3: In circumstances where an effort has been made to fix the violation, a violation that occurred as a direct result of “willful neglect” of HIPAA Rules. A minimum penalty of $10,000 and a maximum penalty of $50,000.

Tier 4: A HIPAA rule violation that amounts to deliberate disregard in which no effort has been made to remedy the situation within 30 days. $50,000 minimum fine for each violation.

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