HIPAA, MSP, and SBC Penalties Indexed as of March 17, 2022

These penalties were indexed in November 2021, but they’re being updated effective March 17, 2022, for violations occurring on/after November 2, 2015.

Regulators also increased the price transparency penalty for hospitals from $304/day maximum fine to $5,500 per day, taking the calendar year max from $100K to over $2 million.  They also increased the $10,000 penalty for a provider’s failure to comply with the No Surprises Act to $10,622.

 

 

	Assessments on/after Nov 15, 2021	Assessments on/after Nov 15, 2021
HIPAA Privacy & Security violations
Unintentional violations Due to reasonable cause and not willful neglect Willful violations corrected within 30 days	Minimum: $120 Minimum: $1,205 Minimum: $12,045	Minimum: $127 Minimum: $1,280 Minimum: $12,794
Caps for each violation above Unclear how these published CY caps tie into the 2019 Notice of Enforcement Discretion which should have lowered the CY caps to $25K/$100K/$250K for tiers 1/2/3 above	Maximum: $60,226 CY cap: $1,806,757	Maximum: $69,973 CY cap: $1,919,173
Willful violations not corrected within 30 days	Minimum: $60,226 CY cap: $1,806,757	Minimum: $63,973 CY cap: $1,919,173
Medicare Secondary Payer (MSP) violations Employer incenting or coercing someone not to enroll in a group health plan that would be primary to Medicare Responsible reporting entity (RRE) failing to identify situations where group plan is primary	$9,753 $1,247	$10,360 $1,325
Summary of Benefits and Coverage (SBC) violations	$1,190	$1,264

 

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