What are the consequences of violating HIPAA?


Editorial team Published on

HIPAA violation consequences include tiered civil monetary fines, criminal penalties ranging from large fines to imprisonment, and professional disciplinary actions.

Civil Penalties

Enforced by the Department of Health and Human Services (HHS) Office for Civil Rights, civil fines use a tiered structure based on culpability and whether the violation was corrected:

  • Tier 1 (Unknowing): $100 to $50,000 per violation, with an annual cap of $25,000 for repeat offenses.
  • Tier 2 (Reasonable Cause): $1,000 to $50,000 per violation, with an annual cap of $100,000.
  • Tier 3 (Willful Neglect - Corrected): $10,000 to $50,000 per violation, with an annual cap of $250,000 if fixed within 30 days.
  • Tier 4 (Willful Neglect - Uncorrected): $50,000 per violation, with an annual maximum of $1.5 million.

Criminal Penalties

Handled by the Department of Justice (DOJ) for intentional or malicious offenses:

  • Level 1 (Knowingly obtaining/disclosing PHI): Fines up to $50,000 and up to 1 year in prison.
  • Level 2 (Offenses under false pretenses): Fines up to $100,000 and up to 5 years in prison.
  • Level 3 (Intent to sell or use for commercial gain/malicious harm): Fines up to $250,000 and up to 10 years in prison.

Professional and Organizational Consequences

  • Employment Actions: Termination, suspension, or reprimand by the healthcare employer.
  • Licensure Loss: Revocation or suspension of medical, nursing, or professional licenses.
  • Reputational Damage: Loss of patient trust and severe public relations damage for organizations.