What Happens if You Break HIPAA Rules?

If you break HIPAA rules, the consequences can range from internal resolution by the employer, potential removal from your position, sanctions from professional boards, to the imposition of criminal charges including fines and imprisonment, with the severity of the punishment dependent on factors such as the extent and intent of the violation, actions taken to address it, and the resulting damage, highlighting the importance of adhering to HIPAA regulations in the healthcare sector.

Internal Resolution by Employers

Healthcare organizations often opt for an internal resolution process when a breach of HIPAA rules occurs, wherein employers take immediate and decisive actions to address the violation within the organizational framework. This may involve conducting internal investigations, implementing corrective measures, and establishing protocols to prevent the recurrence of similar violations in the future. For more severe breaches of HIPAA rules, individuals may find themselves facing the risk of removal from their positions within the healthcare entity. This is a severe consequence that not only affects the individual’s professional standing but also serves as a deterrent to others, emphasizing the seriousness of non-compliance with HIPAA regulations. Violating HIPAA regulations can also impact an individual’s professional standing within their respective healthcare community. Professional boards may impose sanctions, ranging from warnings and reprimands to temporary or permanent restrictions on practice. These sanctions emphasize the commitment of the profession to maintaining ethical standards and patient confidentiality.

Criminal Charges and Legal Ramifications

In the most serious instances of HIPAA violations, criminal charges may be imposed, introducing legal ramifications that can have extensive consequences. Criminal charges may include fines and imprisonment, and the severity of these penalties is contingent on various factors that are carefully evaluated by law enforcement and legal authorities. The consequences of HIPAA violations are tied to a range of factors that influence the severity of punishments. These factors include the nature and extent of the violation, whether it was intentional or a result of negligence, the actions taken to address and rectify the violation, the presence of malicious intent or personal gain, and the overall impact on patients and the healthcare system.

Enforcement Measures for HIPAA Violations

Enforcement measures for HIPAA violations are structured under a system aimed at ensuring compliance and acting as a deterrent for future infractions. Civil penalties, designed to address a variety of violations, range from $100 per violation to a maximum of $25,000 for repeated instances of a similar nature. The imposition of civil penalties is intricately linked to an individual’s awareness of the violation and the prompt correction of the breach within specified timeframes. Conversely, criminal punishments for willful violations carry more severe consequences, entailing a minimum fine of $50,000 and a maximum criminal penalty of $250,000, potentially leading to imprisonment based on the violation’s severity and circumstances.

Importantly, the consequences of violating HIPAA rules exhibit variability based on an individual’s role within the healthcare system, distinguishing among covered entities, business associates, and members of their workforce. Tailored repercussions include internal resolutions, termination of employment contracts, sanctions from professional boards, and potential criminal charges. These consequences intricately consider factors like the extent and intent of the violation, underscoring the importance of recognizing distinct responsibilities associated with each role within the healthcare sector when addressing HIPAA violations. A detailed framework surrounds civil penalties imposed by regulatory bodies, such as HHS’ Office for Civil Rights, reflecting an approach applicable not only to data breaches but to any breach of HIPAA regulations. The severity of these penalties, ranging from $137 to $2,067,813 per violation, is contingent on factors like willful neglect and the prompt correction of the violation. State Attorneys General, empowered by the HITECH Act, can pursue civil penalties, provided they establish harm to a state resident resulting from a HIPAA violation. This system acknowledges the diverse roles within the healthcare sector, ensuring consequences align with specific responsibilities associated with each role, promoting a comprehensive regulatory framework dedicated to safeguarding patient information.

Tiered Criminal Violations Under HIPAA

HIPAA outlines distinct tiers of criminal violations, each linked to specific prison sentences. Negligent violations, arising from a lack of awareness or negligence, may result in a prison term of up to 12 months. Obtaining protected health information under false pretenses carries a maximum prison term of five years. Willfully violating HIPAA rules with malicious intent or for personal gain can lead to a substantial prison term of up to 10 years. Aggravated identity theft under HIPAA mandates a mandatory two-year jail term. This tiered structure not only emphasizes the severity of HIPAA violations but also delineates the legal consequences based on the nature and intent of the breach, providing a comprehensive framework for enforcing compliance and ensuring the integrity of patient data security.


Understanding the potential consequences of HIPAA violations highlights the importance of strict adherence to HIPAA regulations in the healthcare sector. Adherence to HIPAA regulations is key for safeguarding patient information, maintaining trust between healthcare providers and patients, and upholding the ethical standards that are necessary for the integrity of the healthcare profession. Compliance with HIPAA regulations is not only a legal obligation but also a key component of the ethical practice of healthcare.

Daniel Lopez

Daniel Lopez is the HIPAA expert behind HIPAA Coach. Daniel has over 10 years experience as a HIPAA trainer and has developed deep experience in teaching HIPAA to healthcare professionals. Daniel has contributed to numerous publications including expert articles on The HIPAA Guide. Daniel is currently a staff writer on HIPAA at the Healthcare IT Journal. Daniel was a subject matter expert for ComplianceJunction's online HIPAA training. Daniel's academic background in Health Information Management is the foundation of his HIPAA expertise. Daniel's primary professional interest is protecting patient privacy, which he believes is the core of the HIPAA regulations and the best route to HIPAA compliance. You can reach Daniel on the contact page of HIPAA Coach and follow him on Twitter https://twitter.com/DanielLHIPAA