Pension & Benefits News HHS increases penalties for HIPAA noncompliance
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Tuesday, November 12, 2019

HHS increases penalties for HIPAA noncompliance

By Pension and Benefits Editorial Staff

The Department of Health and Human Services (HHS) has issued a final rule that includes the agency’s annual inflation-related adjustments to civil monetary penalties for certain violations of the Health Insurance Portability and Accountability Act (HIPAA). The annual adjustments are required by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015, and were effective as of November 5, 2019.

The HIPAA civil monetary penalties have been adjusted as follows:

  • Penalty for each pre-February 2009 violation of the HIPAA administrative simplification provision: $159 (up from $155), with a calendar year cap of $39,936 (up from $38,954).
  • Penalty for each February 2009 or later violation of a HIPAA administrative simplification provision in which a covered entity or business associate did not know and, by exercising reasonable diligence, would not have known that violation occurred: $117 minimum (up from $114), $58,490 maximum (up from $57,051), with a calendar year cap of $1,754,698.
  • Penalty for each February 2009 or later violation of a HIPAA administrative simplification provision in which it is established that the violation was due to reasonable cause and not willful neglect: $1,170 minimum (up from $1,141), $58,490 maximum (up from $57,051), with a calendar year cap of $1,754,698.
  • Penalty for each February 2009 or later violation of a HIPAA administrative simplification provision in which the violation was due to willful neglect and timely corrected (generally within 30 days): $11,698 minimum (up from $11,410), $58,490 maximum (up from $57,051), with a calendar year cap of $1,754,698.
  • Penalty for each February 2009 or later violation of a HIPAA administrative simplification provision in which the violation was due to willful neglect, but not timely corrected: $58,490 minimum (up from $57,051), $1,754,698 maximum (up from $1,711,533), with a calendar year cap of $1,754,698.

The annual adjustment is based on the Consumer Price Index for all Urban Consumers (CPI-U). The new amounts apply only to penalties assessed on or after November 5, 2019, for violations occurring on or after November 2, 2015.

SOURCE: 84 FR 59549, November 5, 2019.

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