The Improved enforcement provision of the Health Information Technology for Economic and Clinical Health (HITECH) Act strengthens HIPAA enforcement by imposing penalties for willful neglect, enhancing the distribution of penalties, introducing tiered penalties, and allowing state attorneys general to take action on behalf of affected residents.
What is HITECH's improved enforcement?
The improved enforcement provisions, outlined in Section 13410 of the HITECH Act, signify a significant step forward in ensuring compliance with regulations related to privacy and security within the healthcare sector. These provisions encompass various aspects, such as penalties for violations arising from willful neglect, the establishment of tiered penalties based on the severity of violations and resulting harm, and the allocation of collected monetary penalties or settlements to support the enforcement of relevant provisions and regulations.
How it impacts the Social Securities Act
Section 1176 of the Social Security Act is changed to demand penalties for breaking HIPAA rules on purpose. All violations by entities covered under HIPAA will face enforcement and penalties as stated in the Social Security Act. Money paid as penalties or settlements for breaking rules in this part or Section 1176 of the Social Security Act will be given to the Office for Civil Rights of the HHS.
Civil money penalties
Civil Money Penalties (CMPs) are financial penalties established within the framework of the HITECH Act to enforce compliance with regulations pertaining to the protection of electronic protected health information (ePHI) and patient privacy within the healthcare industry. These penalties are a response to violations and breaches of HIPAA's Security Rule and related provisions. The CMPs are categorized into tiers based on the nature and extent of the violation and the resulting harm. The tiers include:
- Tier 1 - No knowledge of violation: This tier applies when the person or entity committing the violation did not know and, by exercising reasonable diligence, could not have known about the violation. The penalty for each such violation is set at a minimum amount, which is the lowest penalty level within the CMP framework. The total amount imposed on the person for all violations of an identical requirement or prohibition during a calendar year may not exceed a certain limit.
- Tier 2 - Violation due to reasonable cause: This tier covers violations where the violation occurred due to reasonable cause and was not a result of willful neglect. The penalties in this tier are higher than in Tier 1 but lower than in the subsequent tiers. Similar to Tier 1, there's a cap on the total amount of penalties that can be imposed for all violations of the same type during a calendar year.
- Tier 3 - Violation due to willful neglect (Corrected): This tier addresses violations where the violation was due to willful neglect but was corrected within a specified period. The penalties in this tier are higher than in the previous tiers. If the violation is corrected in a timely manner, the penalty remains at a certain level, not exceeding a certain amount.
- Tier 4 - Violation due to willful neglect (Not Corrected): This tier applies to violations due to willful neglect that were not corrected. The penalties in this tier are the highest within the CMP framework. The total penalty amount for all such violations of an identical requirement or prohibition during a calendar year may not exceed a certain limit.
See also: What is the HITECH Act?
The role of the HHS in enforcement
The HHS plays a role in enforcing health information privacy and security regulations, particularly through its involvement in implementing the HITECH Act. The HITECH Act enhances enforcement mechanisms by introducing CMPs and mandates the HHS establish a methodology to distribute a percentage of collected penalties and settlements to individuals harmed by such violations.