HIPAA Fines, Penalties, and Settlements

HIPAA Penalties 2022

OCR is continuing to crack down on violations of the HIPAA Rules, with violations of the HIPAA Right of Access one of OCR’s main enforcement priorities in 2021, as it has been since the HIPAA Right of Access enforcement initiative was launched in late 2019. It is likely that HIPAA violation fines in 2022 will continue to be imposed at high levels for violations of the HIPAA Right of Access, although questions have been raised about HIPAA fines for other violations.

The HIPAA violation penalty that was imposed in 2018 on the University of Texas MD Anderson Cancer Center for a data breach and lack of encryption was overturned on appeal in 2021. On January 14, 2021, a three-member panel for the Fifth Circuit Court of Appeals unanimously vacated the $4,348,000 penalty. Since then, only one HIPAA penalty has been imposed for violations of the HIPAA Rules other than the HIPAA Right of Access.  The decision by the Court of Appeals could be affecting OCR’s willingness to pursue financial penalties for certain HIPAA violations and may encourage HIPAA-covered entities subject to HIPAA violation cases in 2022 to appeal any proposed penalties.

OCR now has a new Director, Lisa J. Pino, who at the time of writing has only been in the position for a short time. it is therefore too early to tell what approach when will take regarding HIPAA enforcement. As and when 2022 HIPAA penalties are announced they will be listed below.

We will list the latest HIPAA penalties in 2022 as and when they are announced by OCR.

2022 HIPAA Fines and Settlements

No HIPAA penalties announced to date

OCR HIPAA Fines 2021

There was a reduction in the number of financial penalties for HIPAA violations in 2021 from the record number of penalties of 2020, with OCR’s decision to finalize penalties potentially being affected by the COVID-19 pandemic. That said, penalties have continued to be imposed at relatively high levels, with most of the recent HIPAA violation cases 2021 imposed for violations of the HIPAA Right of Access. Out of the 14 HIPAA violation cases in 2021 that have resulted in financial penalties, 12 have been for HIPAA Right of Access violations.

In January 2021, one of the largest ever HIPAA fines was imposed on Excellus Health Plan. The settlement resolved a HIPAA case that stemmed from an investigation of a breach of the PHI of 9,358,891 individuals that was reported to OCR in 2015. Aside from that penalty, most of the settlements and civil monetary penalties have been for relatively small amounts and have resulted from investigations of complaints from patients than reports of data breaches. As well as the 2021 HIPAA fines being lower, there was a much higher percentage of financial penalties imposed on small healthcare providers than in previous years. That trend is likely to continue in 2022.

2021 HIPAA Settlements

HIPAA Regulated EntityReasonIndividuals ImpactedAmount
Advanced Spine & Pain ManagementHIPAA Right of Access failure1$32,150
Denver Retina CenterHIPAA Right of Access failure1$30,000
Rainrock Treatment Center LLC (dba monte Nido Rainrock)HIPAA Right of Access failure1$160,000
Wake Health Medical GroupHIPAA Right of Access failure1$10,000
Children’s Hospital & Medical CenterHIPAA Right of Access failure1$80,000
The Diabetes, Endocrinology & Lipidology Center, Inc.HIPAA Right of Access failure1$5,000
AEON Clinical Laboratories (Peachstate)HIPAA Security Rule failures (risk assessment, risk management, audit controls, and documentation of HIPAA Security Rule policies and proceduresUnknown$25,000
Village Plastic SurgeryHIPAA Right of Access failure1$30,000
Arbour HospitalHIPAA Right of Access failure1$65,000
Sharpe HealthcareHIPAA Right of Access failure1$70,000
Renown HealthHIPAA Right of Access failure1$75,000
Excellus Health PlanMultiple HIPAA Violations: Risk analysis, risk management, information system activity reviews, technical policies to prevent unauthorized ePHI access, breach of 9,358,891 records.9,358,891$5,100,000
Banner HealthHIPAA Right of Access failure2$200,000

2021 Civil Monetary Penalties for HIPAA Violations

HIPAA-Regulated EntityReasonIndividuals ImpactedAmount
Dr. Robert GlaserHIPAA Right of Access failure1$100,000

OCR HIPAA Fines 2020

2020 saw more financial penalties imposed on HIPAA-covered entities and business associates than in any other year since OCR started enforcing HIPAA compliance. 19 settlements were reached to resolve potential violations of the HIPAA Rules. OCR continued with its HIPAA Right of Access enforcement initiative that commenced in late 2019 and by year-end had settled 11 cases where patients had not been provided with timely access to their medical records for a reasonable cost-based fee.

2020 saw the second-largest settlement to resolve HIPAA violations. The health insurer Premera Blue Cross paid OCR $6,850,000 to resolve potential HIPAA violations discovered during the investigation of its 2015 breach of the ePHI of 10,466,692 individuals.

2020 OCR HIPAA Settlements

HIPAA-Regulated EntityReasonIndividuals ImpactedAmount
Peter Wrobel, M.D., P.C., dba Elite Primary CareHIPAA Right of Access failure2$36,000
University of Cincinnati Medical CenterHIPAA Right of Access failure1$65,000
Dr. Rajendra BhayaniHIPAA Right of Access failure1$15,000
Riverside Psychiatric Medical GroupHIPAA Right of Access failure1$25,000
City of New Haven, CTFailure to terminate access rights; risk analysis failure; failure to implement Privacy Rule policies; failure to issue unique IDs to allow system activity to be tracked; impermissible disclosure of the PHI of 498 individuals498$202,400
AetnaLack of technical and nontechnical evaluation in response to environmental or operational changes; identity check failure; minimum necessary information failure; impermissible disclosure of 18,849 records; lack of administrative, technical, and physical safeguards18,849$1,000,000
NY SpineHIPAA Right of Access failure1$100,000
Dignity Health, dba St. Joseph’s Hospital and Medical CenterHIPAA Right of Access failure1$160,000
Premera Blue CrossRisk assessment failure; risk management failure; insufficient hardware and software controls; unauthorized access to the PHI of 10,466,692 individuals10,466,692$6,850,000
CHSPSC LLCFailure to conduct a risk analysis; failures to implement information system activity reviews, security incident procedures, and access controls, and a breach of the ePHI of more than 6 million individuals6,121,158$2,300,000
Athens Orthopedic Clinic PAFailure to conduct a risk analysis; lack of risk management and audit controls; failure to maintain HIPAA policies and procedures; business associate agreement failure; and the failure to provide HIPAA Privacy Rule training to the workforce.208,557$1,500,000
Housing Works, Inc.HIPAA Right of Access failure1$38,000
All Inclusive Medical Services, Inc.HIPAA Right of Access failure1$15,000
Beth Israel Lahey Health Behavioral ServicesHIPAA Right of Access failure1$70,000
King MDHIPAA Right of Access failure1$3,500
Wise Psychiatry, PCHIPAA Right of Access failure1$10,000
Lifespan Health System Affiliated Covered EntityLack of encryption; insufficient device and media controls; lack of business associate agreements; impermissible disclosure of 20,431 patients’ ePHI20,431$1,040,000
Metropolitan Community Health Services dba Agape Health ServicesLongstanding, systemic noncompliance with the HIPAA Security Rule1,263$25,000

OCR HIPAA Fines 2019

HIPAA enforcement continued at a high level in 2019. Eight settlements were reached with HIPAA-covered entities and business associates to resolve HIPAA violations and two civil monetary penalties were issued. The financial penalties were imposed to resolve similar violations of HIPAA Rules as previous years, but 2019 also saw the first financial penalties issued under OCR’s new HIPAA Right of Access initiative. Two covered entities settled cases over the failure to provide patients with a copy of their medical records, in the requested format, in a reasonable time frame.

2019 OCR HIPAA Settlements

HIPAA-Regulated EntityReasonIndividuals ImpactedAmount
West Georgia AmbulanceRisk analysis failure; no security awareness training program; failure to implement HIPAA Security Rule policies and procedures.500$65,000
Korunda Medical, LLCHIPAA Right of Access failure.1 or more$85,000
Sentara HospitalsBreach notification failure; business associate agreement failure577$2,175,000
University of Rochester Medical CenterLoss of flash drive/laptop; no encryption; risk analysis failure; risk management failure; lack of device media controls.43$3,000,000
Elite Dental AssociatesSocial media disclosure; notice of privacy practices; impermissible PHI disclosure.Unconfirmed$10,000
Bayfront Health St PetersburgHIPAA Right of Access failure1$85,000
Medical Informatics EngineeringRisk analysis failure; impermissible disclosure of 3.5 million records3,500,000$100,000
Touchstone Medical imagingNo BAAs; insufficient access rights; risk analysis failure; failure to respond to a security incident; breach notification failure; media notification failure; impermissible disclosure of 307,839 individuals’ PHI.307,839$3,000,000

2019 OCR Civil Monetary Penalties

HIPAA-Regulated EntityReasonIndividuals ImpactedAmount
Texas Department of Aging and Disability ServicesRisk analysis failure; access control failure; information system activity monitoring failure; impermissible disclosure of 6,617 patients ePHI6,617$1,600,000
Jackson Health SystemMultiple Privacy Rule, Security Rule, and Breach Notification Rule violations25,661$2,154,000

OCR HIPAA Fines 2018

There was a year-over-year increase in HIPAA violation penalties in 2018. 11 financial penalties were agreed in 2018: 10 settlements and one civil monetary penalty. Two records were broken in 2018. 2018 saw the largest ever HIPAA settlement agreed – A $16 million financial penalty for Anthem Inc., to resolve HIPAA violations discovered during the investigation of its 78.8 million record breach in 2015. HIPAA-covered entities also paid more in fines than in any other year since OCR started enforcing compliance with HIPAA Rules: $28,683,400.

2018 OCR HIPAA Settlements

HIPAA-Regulated EntityReasonIndividuals ImpactedAmount
Cottage HealthRisk analysis and risk management failures; No BAA62,500$3,000,000
Pagosa Springs Medical CenterFailure to terminate employee access; No BAA557+$111,400
Advanced Care HospitalistsImpermissible PHI Disclosure; No BAA; Insufficient security measures; No HIPAA compliance efforts prior to April 1, 20149,255$500,000
Allergy Associates of HartfordPHI disclosure to a reporter; No sanctions against employees1$125,000
Anthem IncRisk analysis failure; Insufficient reviews of system activity; Failure to respond to a detected breach; Insufficient technical controls to prevent unauthorized ePHI access78,800,000$16,000,000
Boston Medical CenterFilming patients without consentUnspecified$100,000
Brigham and Women’s HospitalFilming patients without consentUnspecified$384,000
Massachusetts General HospitalFilming patients without consentUnspecified$515,000
Filefax, Inc.Impermissible disclosure of physical PHI – Left unprotected in truck2,150$100,000
Fresenius Medical Care North America5 breaches: Investigation revealed risk analysis failures; Impermissible disclosure of ePHI; Lack of policies covering electronic devices; Lack of encryption; Insufficient security policies; Insufficient physical safeguards521$3,500,000

2018 Civil Monetary Penalties for HIPAA Violations

HIPAA-Regulated EntityReasonIndividuals ImpactedAmount
University of Texas MD Anderson Cancer Center3 breaches resulting in an impermissible disclosure of ePHI; No Encryption34,883$4,348,000

OCR HIPAA Fines 2017

A summary of the 2017 OCR penalties for HIPAA violations.

2017 OCR HIPAA Settlements

HIPAA-Regulated EntityBreach SummaryIndividuals ImpactedSettlement Amount
Memorial Healthcare SystemImpermissible access of PHI by employees; Impermissible disclosure of PHI to affiliated physicians’ offices115,143$5,500,000
CardionetTheft of an unencrypted laptop computer1,391$2,500,000
Memorial Hermann Health SystemDisclosure of patient’s PHI to the media1$2,400,000
21st Century OncologyMultiple HIPAA violations2,213,597$2,300,000
MAPFRE Life Insurance Company of Puerto RicoTheft of an unencrypted USB storage device2,209$2,200,000
Presense HealthDelayed breach notifications836$475,000
Metro Community Provider NetworkLack of a security management process to safeguard ePHI3,200$400,000
Luke’s-Roosevelt Hospital Center Inc.Impermissible disclosure of PHI to patient’s employer1$387,000
The Center for Children’s Digestive HealthLack of a business associate agreementN/A$31,000

2017 Civil Monetary Penalties for HIPAA Violations

HIPAA-Regulated EntityBreach SummaryIndividuals ImpactedPenalty Amount
Children’s Medical Center of DallasTheft of unencrypted devices6,262$3,200,000

OCR HIPAA Fines 2016

2016 was a record year for financial penalties to resolve violations of HIPAA Rules. 2016 saw 12 settlements agreed and one civil monetary penalty issued by OCR.

2016 OCR HIPAA Settlements

HIPAA-Regulated EntityBreach SummaryIndividuals ImpactedSettlement Amount
Feinstein Institute for Medical ResearchImproper disclosure of research participants’ PHI13,000$3,900,000
Advocate Health Care NetworkTheft of desktop computers; Loss of laptop; Improper accessing of data at a business associate3,994,175$5,550,000
University of Mississippi Medical CenterUnprotected network drive10,000$2,750,000
Oregon Health & Science UniversityLoss of unencrypted laptop; Storage on cloud server without BAA4,361$2,700,000
New York Presbyterian HospitalFilming of patients by a TV crewUnconfirmed$2,200,000
North Memorial Health Care of MinnesotaTheft of laptop computer; Improper disclosure to a business associate299,401$1,550,000
St. Joseph HealthPHI made available through search engines31,800$2,140,500
Raleigh Orthopaedic Clinic, P.A. of North CarolinaImproper disclosure to a business associate17,300$750,000
University of Massachusetts Amherst (UMass)Malware infection1,670$650,000
Catholic Health Care Services of the Archdiocese of PhiladelphiaTheft of mobile device412$650,000
Care New England Health SystemLoss of two unencrypted backup tapes14,000$400,000
Complete P.T., Pool & Land Physical Therapy, Inc.Improper disclosure of PHI (website testimonials)Unconfirmed$25,000

 2016 Civil Monetary Penalties for HIPAA Violations

HIPAA-Regulated EntityBreach SummaryIndividuals ImpactedPenalty Amount
Lincare, Inc.Improper disclosure (unprotected documents)278$239,800

Source: What are the Penalties for HIPAA Violations? (hipaajournal.com)

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