Implications of HIPAA Non-Compliance
To protect patient health information (PHI) from access by unauthorized entities, The Health Information Portability and Accountability Act (HIPAA) was enacted. With the advancement in technology, patient data has now become extensively digitized. Hence, it has become important to safeguard the privacy of patient health information. All medical providers have to adhere to the data protection regulation if they fit the definition of a covered entity.
“Covered entity” under the HIPAA Privacy Rule, include health plans, health care clearinghouses, and health care providers that transmit health information electronically. Covered entities under the HIPAA Privacy Rule must comply with the Rule’s requirements for safeguarding the privacy of protected health information.
Hence, HIPAA compliance is a necessity in today’s environment as non-compliance brings risks of fines, prison, & lawsuits that can impact either individuals or corporate entities. As part of the HIPAA Act, the federal government has established a tiered civil penalty structure for HIPAA violations, the details of which are given below.
- If the individual did not know (and by exercising reasonable diligence would not have known) that he/she violated HIPAA, then the individual faces a minimum penalty of $100 per violation, with an annual maximum of $25,000 for repeat violations and a maximum penalty of $50,000 per violation, with an annual maximum of $1.5 million.
- If the HIPAA violation is due to reasonable cause and not due to willful neglect then the individual faces a minimum penalty of $1,000 per violation, with an annual maximum of $100,000 for repeat violations and a maximum penalty of $50,000 per violation, with an annual maximum of $1.5 million.
- If the HIPAA violation is due to willful neglect and if the violation is corrected within the stipulated time period then the individual faces a minimum penalty of $10,000 per violation, with an annual maximum of $250,000 for repeat violations and a maximum penalty of $50,000 per violation, with an annual maximum of $1.5 million.
- If the HIPAA violation is due to willful neglect and is not corrected then the individual faces a minimum penalty of $50,000 per violation, with an annual maximum of $1.5 million and a maximum penalty of $50,000 per violation, with an annual maximum of $1.5 million.
Apart from penalties, the individual also faces imprisonment that can range from one year to five years in prison.
In such circumstances, medical practitioners and health care providers need to take all possible measures to ensure HIPAA compliance. And the most possible means to ensure compliance with HIPAA and HITECH Acts is by deploying an automated compliance management solution to spot errors in processes or systems and to prevent small problems escalating into large ones. Thus with such a solution, healthcare organizations can ensure implementation of appropriate controls and safeguards to prevent unauthorized access and disclosure of sensitive patient data.
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