10 Feb HHS Releases Inflation-Adjusted Federal Civil Penalty Amounts
HHS Releases Inflation-Adjusted Federal Civil Penalty Amounts
The Department of Health and Human Services has released recent adjustments to the Annual Civil Monetary Penalties. Continue reading this blog post from UBA for the adjusted federal civil penalty amounts.
The Department of Health and Human Services (HHS) issued its Annual Civil Monetary Penalties Inflation Adjustment. Here are some of the adjustments:
Medicare Secondary Payer:
- For failure to provide information identifying situations where the group health plan is primary, the maximum penalty increases from $1,181 to $1,211 per failure.
- For an employer who offers incentives to a Medicare-eligible individual to not enroll in an employer-sponsored group health plan that would otherwise be primary, the maximum penalty increases from $9,239 to $9,472.
- For willful or repeated failure to provide requested information regarding group health plan coverage, the maximum penalty increases from $1,504 to $1,542.
- Summary of Benefits and Coverage: For failure to provide, the maximum penalty increases from $1,128 to $1,156 per failure.
- Health Insurance Portability and Accountability Act (HIPAA)
| Tier | Penalty |
| 1. Did Not Know Covered entity or business associate did not know (and by exercising reasonable diligence would not have known) that it violated the provisions of the Administrative Simplification Regulation. | $117 – $58,490 for each violation, up to a maximum of $1,754,698 for identical provisions during a calendar year. |
| 2. Reasonable Cause The violation was due to reasonable cause and not willful neglect. | $1,170 – $58,490 for each violation, up to a maximum of $1,754,698 for identical provisions during a calendar year. |
| 3. Willful Neglect (Corrected) The violation was due to willful neglect, but the violation is corrected during the 30-day period beginning on the first date the liable person knew (or by exercising reasonable diligence would have known) of the failure to comply. | $11,698 – $58,490 for each violation, up to a maximum of $1,754,698 for identical provisions during a calendar year. |
| 4. Willful Neglect (Not Corrected) The violation was due to willful neglect and the violation is not corrected as described in Tier 3. | $58,490 minimum for each violation, up to a maximum of $1,754,698 for identical provisions during a calendar year. |
| The adjustments are effective for penalties assessed on or after November 5, 2019, for violations occurring after November 2, 2015. |
SOURCE: Hsu, K. (23 January 2020) “HHS Releases Inflation-Adjusted Federal Civil Penalty Amounts” (Web Blog Post). Retrieved from https://blog.ubabenefits.com/hhs-releases-inflation-adjusted-federal-civil-penalty-amounts-1