ePHI is defined as:
- Identifiable data: Any type of electronic data that can tie back to a specific patient, such as names, geographical data, dates, photographs, or unique identifying numbers (Source: Tausight).
- Electronic form: PHI that is saved, transferred, or received in digital format (Source: Record Nations).
- Designated Record Set (DRS): A group of records that would be included in a HIPAA-covered entity’s designated record set, excluding psychotherapy notes and information compiled for civil, criminal, or administrative actions (Source: Understanding Electronic Health Information).
Key Takeaways
- ePHI is a subset of Protected Health Information (PHI) and refers specifically to electronic data.
- ePHI includes identifiable data that can be linked to a patient, such as names, addresses, and medical records.
- HIPAA-covered entities and business associates must implement appropriate safeguards to protect ePHI throughout its lifecycle.
- Cloud Service Providers (CSPs) that create, receive, maintain, or transmit ePHI on behalf of covered entities or business associates are considered business associates under HIPAA.
ePHI Violation Penalty Terms
ePHI violation penalties refer to the fines and penalties imposed on organizations and individuals that violate the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. These penalties are designed to ensure compliance with the regulations governing the protection of Electronic Protected Health Information (ePHI).
Tiered Penalty Structure
The HIPAA violation penalties are tiered, with increasing severity based on the nature and intent of the violation. The tiers are:
- Tier 1: Maximum penalty: Up to $50,000, up to one year in prison, or both. This tier includes obtaining ePHI under false pretenses or disclosing it without permission.
- Tier 2: Maximum penalty: Up to $100,000, up to five years of prison time, or both. The most severe violation is when the individual who commits the crime wrongfully obtains ePHI with the intent to sell, transfer, or use the data for personal gain, commercial advantage, or malicious harm.
Willful Neglect
In cases of willful neglect and failure to correct the violation within the required time period, the penalty range is $50,000 per violation, with an annual maximum of $1.5 million.
Key Takeaways
- ePHI violation penalties are designed to ensure HIPAA compliance and protect ePHI.
- The tiered penalty structure reflects the severity of the violation, with increasing fines and potential prison time for more egregious offenses.
- Willful neglect and failure to correct violations can result in significant fines, up to $1.5 million annually.