HIPAA Criminal Enforcement (42 USC 1320d-6)
Criminal sanctions for knowingly obtaining or disclosing PHI in violation of HIPAA, enforced by the Department of Justice rather than HHS, with three tiers escalating to ten years' imprisonment.
Primary source
42 USC 1320d-6 — Office of the Law Revision Counsel →https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320d-6&num=0&edition=prelim
Verified May 23, 2026 · This is the authoritative regulator URL. The summary below is a research aid; the linked source controls.
Additional sources
42 USC 1320d-6 sets criminal penalties for knowingly obtaining or disclosing individually identifiable health information in violation of HIPAA.
Three tiers:
- Base offense: knowingly violating — fine up to $50,000 and imprisonment up to one year.
- False pretenses: committing the offense under false pretenses — fine up to $100,000 and imprisonment up to five years.
- Intent to sell, transfer, or use for commercial advantage, personal gain, or malicious harm: fine up to $250,000 and imprisonment up to ten years.
DOJ — not HHS — prosecutes criminal HIPAA cases. Cases tend to involve workforce members selling celebrity records, identity-theft rings using stolen patient data, and intentional snooping followed by misuse. A 2005 DOJ memorandum extended criminal liability to individual employees (not only entities), settling an early interpretive question.
Coordination with civil enforcement: OCR can refer matters to DOJ; the DOJ frequently exercises declination, in which case OCR can proceed with civil enforcement. Conversely, an HHS civil settlement does not bar parallel state criminal action.
Criminal exposure is rare but real — and it lands on individuals, not just the entity.
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Related across the archive
- RegulationHIPAA Civil Money Penalty Tiers (45 CFR 160.404)The four-tier culpability and penalty structure for HIPAA civil money penalties, with statutory caps adjusted annually for inflation.
- RegulationHIPAA Resolution Agreements and Corrective Action Plans (45 CFR 160.312)OCR's preferred enforcement disposition: a Resolution Agreement that includes a corrective action plan, payment, and reporting obligations spanning two to three years.
- RegulationHIPAA Enforcement Rule Overview (45 CFR 160 Subpart C-E)The framework for HHS investigation and enforcement of HIPAA violations: complaints, compliance reviews, informal resolution, civil money penalties, and the four-tier culpability structure.
- RegulationHITECH Enforcement Changes (42 USC 17939)HITECH expanded HIPAA enforcement with state attorney general civil actions, four-tier penalties, willful neglect mandatory investigation, and a percentage of CMPs to harmed individuals.
- SRAHIPAA Settlements and Civil Money Penalties: A Small-Practice Reading ListHow HHS Office for Civil Rights publishes its enforcement record, the tiered civil money penalty structure at 45 CFR 160.404, and what recent small-practice settlements actually say.
- ComplianceCommunicable Disease Reporting: CDC NNDSS + State Health Department RequirementsFederal 42 USC § 247b + CDC NNDSS + state reportable-disease lists: who reports, what conditions, timelines (immediate to weekly), and 45 CFR § 164.512(b) HIPAA permissibility.
- GlossaryAccounting of DisclosuresThe HIPAA right of an individual to receive a list of disclosures of their PHI made by a covered entity over the prior six years.
- BillingBusiness Associate Agreement Checklist for Small PracticesA working checklist for small practices to identify which vendors need a Business Associate Agreement, what clauses the BAA must contain, and how to track them.
Last reviewed May 23, 2026 · Citation verified May 23, 2026
Research aid, not legal advice. This summary is an administrative research aid prepared by D3rx. It does not certify compliance, provide legal advice, replace counsel, or guarantee an audit outcome. For authoritative regulatory text follow the primary source link at the top of this page. The practice remains responsible for reviewing, adopting, and maintaining its compliance program.