Which tier represents violations that have the greatest degree of negligence?

The tier representing violations that have the greatest degree of negligence is Willful Neglect. This classification indicates that an entity or individual knowingly failed to comply with the HIPAA Privacy Rule or did not take necessary steps to correct a known violation. Willful neglect implies a conscious disregard for the rules and a failure to take corrective action even when aware of non-compliance, highlighting a significant lack of responsibility and concern for the privacy and security of Protected Health Information (PHI).

In contrast, the other categories indicate lesser degrees of negligence. Uncorrected Violations suggest that there was a failure to address a violation but does not inherently imply active negligence. Violations due to reasonable cause occur when someone can show that they made a genuine effort to comply with the regulations, suggesting a lack of intent to violate the law. Unknowing Violations refer to situations where an individual or entity was not aware of their non-compliance, reflecting a lack of intent and further lowering the degree of negligence involved. Thus, Willful Neglect represents the most serious level of negligence in the context of HIPAA violations.