Unknowing
$145 minimum per violation
per violation
The covered entity did not know and, by exercising reasonable diligence, would not have known that a violation occurred.
HIPAA penalties
Penalties are adjusted for inflation annually, calculated per violation — not per incident — and enforced against practices of every size. Here is the full 2026 breakdown.
Penalty tiers
2026 inflation-adjusted amounts per 45 CFR 160.404.
Unknowing
$145 minimum per violation
per violation
The covered entity did not know and, by exercising reasonable diligence, would not have known that a violation occurred.
Reasonable Cause
$1,461 minimum per violation
per violation
The violation was due to reasonable cause — not willful neglect. The entity should have known but did not act with intentional disregard.
Willful Neglect — Corrected
$14,602 minimum per violation
per violation
The violation resulted from willful neglect, but the entity corrected the violation within 30 days of discovery.
Willful Neglect — Not Corrected
$73,011 minimum per violation
per violation
The violation resulted from willful neglect and was not corrected within 30 days.
Codified annual cap for identical violations of the same provision: $2,190,294 (45 CFR §102.3, 2025-adjusted amounts effective January 28, 2026).
Calculation
HIPAA penalties are assessed per violation, not per incident. This distinction matters. A single unsecured email containing PHI sent to 50 patients is 50 separate violations. A database breach exposing 5,000 records can be aggregated into thousands of individual violations.
OCR considers multiple factors when determining the penalty amount within each tier:
Corrective action plans — often imposed alongside monetary penalties — require years of monitored compliance and operational changes that typically cost far more than the fine itself.
Criminal enforcement
The Department of Justice can pursue criminal charges for HIPAA violations independently of OCR's civil enforcement. Criminal penalties apply to individuals — not just organizations — and carry imprisonment.
Knowingly obtaining or disclosing PHI
$50,000 fine
Up to 1 year imprisonment
Under false pretenses
$100,000 fine
Up to 5 years imprisonment
For personal gain or malicious harm
$250,000 fine
Up to 10 years imprisonment
Enforcement record
These are publicly available OCR resolution agreements — not hypotheticals.
| Entity | Year | Violation | Settlement |
|---|---|---|---|
| Banner Health | 2023 | Failure to implement security measures, inadequate risk analysis, lack of monitoring for unauthorized access | $1,250,000 |
| L.A. Care Health Plan | 2023 | Failure to conduct an accurate and thorough risk assessment, failure to implement security measures, failure to implement policies and procedures for access to ePHI | $1,300,000 |
| Yakima Valley Memorial Hospital | 2024 | Failure to implement security measures to reduce risk to ePHI — 23 security guards accessed medical records of 419 patients without authorization | $240,000 |
| Dental practice (individual provider) | 2022 | Impermissible disclosure of PHI on a social media review response, followed by failure to implement a corrective action plan | $23,000 |
Source: HHS Office for Civil Rights enforcement actions. Settlements include resolution agreements and corrective action plans.
FAQ
There is no meaningful average because the range is wide — from $145 per-violation minimum at Tier 1 up to a codified annual cap of $2,190,294 for identical violations of the same provision per 45 CFR §102.3 (2025-adjusted amounts, effective January 28, 2026). Most OCR resolutions for independent practices are settlement/resolution amounts under a corrective action plan rather than adjudicated CMPs, and typically fall between $50,000 and $250,000. A settlement/resolution amount is not the same thing as an assessed CMP; the two should not be conflated.
Yes. OCR has fined solo practitioners, small dental offices, and independent clinics. Practice size is a factor in penalty calculation, but it does not provide immunity. A solo dentist who responds to a Yelp review by disclosing patient information faces the same penalty structure as a hospital system. Small practices are often less likely to contest penalties due to limited legal resources.
Tier 4 (willful neglect, not corrected within 30 days) carries a $73,011 per-violation minimum under 45 CFR §102.3. The applicable culpability tier in any given matter is fact-specific and determined case by case. OCR has treated a missing or inadequate risk analysis as a serious enforcement priority — many resolution agreements reference it — but a missing risk analysis is not automatically classified as willful neglect. Other common findings in higher-tier matters include absent BAAs and failure to respond to known vulnerabilities.
Conduct and document an accurate, thorough Security Risk Analysis, reviewed periodically and whenever material changes affect the practice's risk environment. Execute BAAs with vendors that create, receive, maintain, or transmit PHI on your behalf in a business-associate capacity. Train your workforce and document completions. Implement the technical safeguards required by the Security Rule. Respond to incidents within required timelines. The consistent theme in reduced penalties is documented evidence of good-faith compliance efforts — even imperfect programs fare better than none.
Prevention over penalties
Continuous compliance monitoring, automated risk assessments, workforce training, and vendor management — the controls OCR looks for when deciding penalty tiers. Five minutes to start.