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HIPAA Penalties For Noncompliance With Administration Simplification Standards
The law calls for civil penalties for noncompliance with Administration Simplification standards, and both civil and criminal penalties for privacy and security breaches.
General penalty for failure to comply:
- Each violation: $100 penalty. For example: sending a claim file in a non-standard format (such as those used currently) or using a non-standard payer-assigned identifier.
- The maximum penalty for all violations of an identical requirement may not exceed $25,000 per year. For example, 250 non-standard claim files or proprietary identifiers would add up to the $25,000 yearly maximum. Considering that there are as few as 15 and as many as 30 different standards named in HIPAA, and the potential penalty can grow quickly to more than $500,000.
Wrongful disclosure of individually identifiable health information:
- Wrongful disclosure offense: $50,000 penalty, imprisonment of not more than one year, or both.
- Offense under false pretenses: $100,000 penalty, imprisonment of not more than five years or both.
- Offense with intent to sell information: $250,000 penalty, imprisonment of not more than 10 years or both.
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