HIPAA Violation can Result in Time Served

Case:? “T” ??works at a major medical center.”T” was pulled over because his license plate did not match the car’s ?VIN number.? Police found ?prescriptions in the ?car in other people's names, Social Security numbers, ?and other PHI of 14 individuals.? After obtaining a search warrant for “T” apartment, police found? hard and flash drives? containing the personal information of an additional 1,014 patients.

This is a true HIPAA violation case.

Understanding Criminal Penalties for HIPAA Violations: What Healthcare Professionals Need to Know is extremely important because more than just fines are at stake.

In the healthcare industry, safeguarding Protected Health Information (PHI) is a critical responsibility. But what happens when a healthcare professional knowingly misuses or unlawfully obtains PHI? The answer: they may face criminal liability.?

Unlike civil penalties, which are handled by the Department of Health and Human Services’ Office for Civil Rights (OCR), criminal penalties fall under the jurisdiction of the Department of Justice (DOJ). The DOJ interprets “knowingly” as simply being aware that the disclosure constitutes an offense—there’s no requirement that the individual knows they are specifically violating HIPAA.?

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Criminal Penalties and Their Consequences?

Criminal penalties for HIPAA violations can escalate based on the severity of the offense and may lead to imprisonment. Jail time decisions are typically based on one of the following scenarios:?

·????? Wrongful disclosure of PHI

·????? Wrongful disclosure of PHI under false pretenses

·????? Wrongful disclosure of PHI under false pretenses with malicious intent

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The DOJ, in collaboration with the U.S. Attorney’s Office, determines whether criminal charges should be filed. Their decisions are guided by U.S. Code 42, Section 1320d-6, which lays out the legal framework for pursuing criminal penalties.?

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The Role of OCR vs. DOJ?

It’s important to distinguish the roles of the OCR and DOJ:?

·????? OCR: Investigates HIPAA complaints and imposes civil penalties such as fines for violations. However, they cannot initiate criminal charges.?

·????? -DOJ: Handles criminal investigations and prosecutions. OCR may refer cases to the DOJ if criminal conduct is suspected.?

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Final Thoughts?

The legal and ethical responsibility to protect PHI cannot be overstated. A single wrongful disclosure—whether intentional or with malicious intent—can lead to serious consequences, including jail time. Healthcare professionals must remain vigilant and committed to compliance with HIPAA regulations to avoid jeopardizing their careers, reputation, and, most importantly, patient trust.?

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For those in healthcare leadership, this underscores the importance of ongoing HIPAA training, clear organizational policies, and a culture that prioritizes patient privacy.?

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Have you or your organization taken proactive steps to ensure HIPAA compliance? Let’s discuss best practices and strategies to prevent violations.

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