Hospitals Should Review Their HIPAA Sanctions Policy

Dom Nicastro, for HealthLeaders Media , June 29, 2009

The Health Information Technology for Economic and Clinic Health (HITECH) Act changed the ballgame for sanctions related to HIPAA violations.

The Act provides a tiered system for assessing the level and penalty of each violation. CMS, which enforces the HIPAA Security Rule, and the Office for Civil Rights, which enforces the HIPAA Privacy Rule, can supersede the following limits, but with a cap of $50,000 per violation and $1.5 million for the calendar year for the same type of violation. The different tiers are:

  • Tier A is for cases in which offenders didn't realize they violated the Act and would have handled the matter differently if they had
    • Minimum per violation: $100
    • Maximum per calendar year: $25,000
  • Tier B is for violations "due to reasonable cause, and not to willful neglect," though HHS still must define "reasonable cause"
    • Minimum per violation: $1,000
    • Maximum per calendar year: $50,000
  • Tier C is for infringements that the organization corrected, but were due to willful neglect
    • Minimum per violation: $10,000
    • Maximum per calendar year: $250,000
  • Tier D is for violations due to willful neglect that the organization did not correct
    • Minimum per violation: $50,000
    • Maximum per calendar year: $1.5 million

How does the sanction structure look at your facility? HIPAA requires covered entities to have a structured sanction policy in place.

The American Health Information Management Association addressed handling breaches internally in a recent practice brief.

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