HIPAA Compliance for Medical Practices
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HIPAA Compliance for Medical Practices
HIPAA Compliance and HIPAA Risk management Articles, Tips and Updates for Medical Practices and Physicians
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HIPAA Compliant Technology and the Importance of Encryption

The Health Insurance Portability and Accountability Act (HIPAA) sets the standard for protecting sensitive patient data. This means that any covered entity (CE) or business associate (BA) that deals with protected health information (PHI) must ensure that all the required physical, network, and process security measures are in place and followed. The HIPAA Privacy Rule addresses the storage, accessing and sharing of PHI, whereas the HIPAA Security Rule outlines the security standards which protect health data created, received, maintained or transmitted electronically; known as electronic protected health information (ePHI).

The Health Information Technology for Economic and Clinical Health (HITECH) Act was passed as a supplemental act in 2009, and was formed in response to the improvements and increase in health technology development, and the increased use of ePHI.  Transmission Security is required of HIPAA compliant hosts to protect against unauthorized public access of ePHI; however, both authentication and encryption are stated to be addressable, rather than required. This concerns all methods of transmitting data, whether it be email, Internet, or even over a private network, such as a private cloud.

Confusion around some of the items classified as addressable within these technical standards, especially around encryption, increases the risk of fines for organizations that choose not to address these standards. Fines are very likely to be handed to organizations should they experience a data breach as a result of not using encryption, even if a risk assessment is in place. Encryption is expected to be one of the key areas OCR focus on when conducting phase 2 HIPAA audits later this year.

Using Technology to Comply with HIPAA

Mechanisms exist to meet the requirements of the HIPAA safeguards, starting with use of a HIPAA compliant network hosting provider.  HIPAA compliant networks must have robust firewalls in place to protect an organization’s network from hackers or data thieves. Secure platforms are required for all organizations that transmit ePHI. These platforms should deploy encryption when transmitting ePHI, and have administrative controls to safeguard the integrity of ePHI. These platforms should also have the capacity to retract messages in the event of a breach risk and be able to remotely remove a mobile device from the system if it is lost by its owner, stolen or otherwise disposed of. In addition to this, all devices used to store or transmit ePHI, such as laptops and mobile devices, should be password protected and encrypted.

The Ramifications of Failing to Encrypt

Since 2012, the U.S. Department of Health and Human Services (HHS) has issued large monetary fines for violations of the HIPAA Privacy Rule following the introduction of HITECH. Some of its biggest fines have been due to lost or stolen laptops which were unencrypted.  In April 2014, Concentra Health Services were fined $1,725,220 to settle HIPAA Privacy violations which occurred after an unencrypted laptop was stolen from one its offices.  Some organizations may wrongly conclude that encryption is technically not required in all cases under the HIPAA Security Rule, as it is an “addressable” standard under HIPAA, meaning that it is required only where reasonable and appropriate based on a risk assessment.  However, these fines raise the question of how encryption of mobile devices containing ePHI is viewed. It is clear from the Concentra Health Service settlement that conducting risk assessments is not enough to avoid penalties under HIPAA. Rather, the risks identified in the assessment must be addressed completely and consistently.  Using encryption of ePHI during transmission is another important consideration organizations need to assess when completing risk assessments. When transmitting data between devices, it is crucial that organizations select a vendor that is HIPAA compliant – without doing so, there is potential to expose organizations to enormous risk of data breaches.


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The Black Market For Stolen Health Care Data

The Black Market For Stolen Health Care Data | HIPAA Compliance for Medical Practices | Scoop.it

President Obama is at Stanford University today, hosting a cybersecurity summit. He and about a thousand guests are trying to figure out how to protect consumers online from hacks and data breaches.

Meanwhile, in the cyber underworld, criminals are trying to figure out how to turn every piece of our digital life into cash. The newest frontier: health records.

I grab a chair and sit down with Greg Virgin, CEO of the security firm RedJack.

"There are a lot of sites that have this information, and it's tough to tell the health records from the financial records," he says.

We're visiting sites that you can't find in a Google search. They have names that end with .su and .so, instead of the more familiar .com and .org.

After poking around for about an hour, we come across an advertisement by someone selling Medicare IDs.

We're not revealing the site address or name because we don't want the dealer to know we're watching.

According to the online rating system — similar to Yelp, but for criminal sales — the dealer delivers what's promised and gets 5 out of 5 stars. "He definitely seems legit" — to the underworld, Virgin says.

The dealer is selling a value pack that includes 10 people's Medicare numbers – only it's not cheap. It costs 22 bitcoin — about $4,700 according to today's exchange rate.

Security experts say health data is showing up in the black market more and more. While prices vary, this data is more expensive than stolen credit card numbers which, they say, typically go for a few quarters or dollars.

Health fraud is more complex. Records that contain your Social Security number or mother's maiden name are used for identity theft. Virgin predicts hackers could be using them for corporate extortion.

"A breach happens at one of these companies. The hackers go direct to that company and say, 'I have your data.' The cost of keeping this a secret is X dollars and the companies make the problems go away that way," he says.

Health care companies saw a 72 percent increase in cyberattacks from 2013 to 2014, according to the security firm Symantec. Companies are required to publicly disclose big health data breaches. And there have been more than 270 such disclosures in the last two years.

Jeanie Larson, a health care security expert, says cyber-standards are too low for hospitals, labs and insurers. "They don't have the internal cybersecurity operations."

Companies subject to federal HIPAA rules, which were designed to protect privacy, choose to interpret them loosely — in a way that gets around the basics, like encryption.

"A lot of health care organizations that I've talked to do not encrypt data within their own networks, in their internal networks," she says.

They assume, incorrectly, that the walls around the network are safe.

Larson is part of the industry group National Health ISAC which is trying to raise the bar and make hospitals more like banks when it comes to investing in security.

"The financial sector has done a lot with automating and creating fraud detection type technologies, and the health care industry's just not there," she says.

Orion Hindawi with Tanium, a firm that monitors computer networks, says health care providers are far from there. They've been racing to grow, to digitize health records, to make mobile apps, to acquire other companies — all this without having a basic handle on how big their networks even are.

"I was working with a customer recently, and I asked them how many computers they had. And they told me between 300,00 and 500,000 computers," Hindawi says.

Meaning his client basically didn't know.

"We see that often when we walk into a customer [office]," Hindawi says.

He wasn't surprised to hear that the health care company Anthem suffered a major cyberattack. Anthem revealed last week that as many as 80 million people's records may have been stolen. Hindawi says he expects to see many more Anthems.


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