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9 of 9 HIPAA Network Considerations

The HIPAA Omnibus Final Rule is now in effect and audits will continue in 2014. The Department of Health and Human Services’ Office for Civil Rights has stated several times that both Covered Entities and Business Associates will be audited.  And the scope of Business Associates has greatly expanded.  I wrote another blog directed towards these new Business Associates.  This final blog of this series focuses on covered entities that work with business associates.

  1. HIPAA Audits will continue
  2. The HIPAA Audit Protocol and NIST 800-66 are your best preparation
  3. Knowledge is a powerful weapon―know where your PHI is
  4. Ignorance is not bliss
  5. Risk Assessment drives your baseline
  6. Risk Management is continuous
  7. Security best practices are essential
  8. Breach discovery times: know your discovery tolerance
  9. Your business associate(s)must be tracked

The HIPAA Omnibus Final Rule changed the Business Associate definition, and also makes Business Associates obligated to comply with HIPAA.  You most likely will have more business associates than previously, and those business associates that have access to your network and/or your PHI data are obligated to be HIPAA compliant.    The Ponemon Institute’s Third Annual Benchmark Study on Patient Privacy and Data Security (December 2012), reveals that 42% of the breaches involved a third party “snafu”.

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8 of 9 HIPAA Network Considerations

Discovering a breach where ePHI has been stolen certainly falls into the ‘not a good day at work’ category.  It can be catastrophic for some, especially if the compromise occurred months ago and wasn’t detected.  Or if a 3rd party discovered the breach for you, which occurs more often than we think, 47-51% from 2010 – 2012 based on the Ponemon Institutes 3rd Annual Benchmark Study on Patent Privacy and Data Security.

On our list of 9 HIPAA Network Considerations, we are onto topic #8, Breach discovery times: know your discovery tolerance.

  1. HIPAA Audits will continue
  2. The HIPAA Audit Protocol and NIST 800-66 are your best preparation
  3. Knowledge is a powerful weapon―know where your PHI is
  4. Ignorance is not bliss
  5. Risk Assessment drives your baseline
  6. Risk Management is continuous
  7. Security best practices are essential
  8. Breach discovery times: know your discovery tolerance
  9. Your business associate(s)must be tracked

From the 2013 Verizon Data Breach Investigations Report, two thirds of the compromises were not discovered for months, or longer.  What is your tolerance for “not knowing?”  Can that discovery time tolerance be justified through reasonable due diligence, or are you back at the “ignorance is bliss” phase (blog #4), which could be interpreted as Willful Neglect in the case of a breach of PHI?

Source: Verizon 2013 Data Breach Investigations Report

Source: Verizon 2013 Data Breach Investigations Report

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7 of 9 HIPAA Network Considerations

The HIPAA Omnibus Final Rule is now in effect and audits will continue in 2014. At the HIMSS Privacy and Security Forum in Boston on Sept. 23, Leon Rodriguez, director of the Department of Health and Human Services’ Office for Civil Rights said to those who are wondering how the new rule will be enforced: “You’ll see a picture of where we’ll spend our energies” based on previous enforcement actions.  Enforcement actions to date have focused on cases involving major security failures, where a breach incident led to investigations that revealed larger systemic issues, Rodriguez said.

On our list of 9 HIPAA Network Considerations, it is timely that our topic in this blog is on #7, Security best practices are essential.

  1. HIPAA Audits will continue
  2. The HIPAA Audit Protocol and NIST 800-66 are your best preparation
  3. Knowledge is a powerful weapon―know where your PHI is
  4. Ignorance is not bliss
  5. Risk Assessment drives your baseline
  6. Risk Management is continuous
  7. Security best practices are essential
  8. Breach discovery times: know your discovery tolerance
  9. Your business associate(s)must be tracked

The general rule for the HIPAA Security Rule is to ensure the confidentiality, integrity, and availability of ePHI that is created, received, maintained, or transmitted [45 CFR 164.306(a)].  Protect against threats to PHI.  That relates directly to network security best practices.  In the 2012 HIPAA audits, security had more than its share of findings and observations, accounting for 60% of the HIPAA audit findings and observations, even though the Security Rule accounted for only 28% of the audit questions.  At the NIST OCR Conference in May, OCR presented the summary below.

7 of 9

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What Moving to the Cloud Means for Healthcare Organizations

This marks the 32nd year I’ve worked in healthcare. It doesn’t seem like very long ago that I worked as a registered nurse, caring for critically ill patients. Although I’m no longer working at a patient’s bedside, today’s healthcare organizations continue to put patient care first -- starting with transformation in healthcare technology.

HealthcareDue to increased digitization of patient data and increased collaboration among insurance providers and doctors, IT innovation and integration in healthcare is on the rise.  A new survey from Black Book shows that economic factors and government regulations are beginning to nudge independent physician practices to the cloud.

As more move to the cloud, the recent package of HIPAA changes known as the “final omnibus rule” clarifies the legal framework for healthcare organizations to work with cloud services, as David F. Carr highlighted in his recent article in Information Week.

This is a fundamental shift for healthcare organizations that could set precedent for other industries like education, financial services and government. Are you ready for it? Read More »

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6 of 9 HIPAA Network Considerations

The HIPAA Omnibus Final Rule, released January 2013, goes into effect this month – Sept 23, 2013. Over the last several weeks, I’ve been posting a blog series around nine HIPAA network considerations.

  1. HIPAA Audits will continue
  2. The HIPAA Audit Protocol and NIST 800-66 are your best preparation
  3. Knowledge is a powerful weapon―know where your PHI is
  4. Ignorance is not bliss
  5. Risk Assessment drives your baseline
  6. Risk Management is continuous
  7. Security best practices are essential
  8. Breach discovery times: know your discovery tolerance
  9. Your business associate(s)must be tracked

This blog focuses on #6 – Risk Management is Continuous.

You can look at the Risk Management implementation specification as the actions taken in response to the Risk Assessment.  The HIPAA Security Rule defines Risk management (Required):  “Implement security measures sufficient to reduce risks and vulnerabilities to a reasonable and appropriate level to comply with [§ 164.306(a)]”

(1) Ensure the confidentiality, integrity, and availability of all electronic protected health information the covered entity creates, receives, maintains, or transmits.

(2) Protect against any reasonably anticipated threats or hazards to the security or integrity of such information.

(3) Protect against any reasonably anticipated uses or disclosures of such information

One common mistake companies make in compliance programs is taking the approach that once the work is done, the network doesn’t have to be looked at again for compliance.  If they put the security programs, processes, and technologies in place, they don’t have to spend time on compliance until next year (or the year after that, or even longer).

This makes compliance a onetime effort that is then ignored.  Worse, securing PHI often follows the same path, making it easy to hack and steal, causing a lot of problems for everyone involved.  Risk management―reducing risk―needs to be a continuous activity.   Through your risk assessment, you’ll know where your PHI is, what your highest risk factors are, and where to implement more continuous risk management tools in the network.

Continuous risk management does not mean tracking every single event on every single device throughout the network.  It may mean turning on automatic alerts on critical devices, setting traffic thresholds in network areas where PHI resides, logging anomalous events in those critical areas, and using network management tools to make sense of all this information the network devices are collecting.

Risk management is about a lot more than achieving HIPAA compliance, reducing risk to PHI and helping to prevent theft of PHI is of critical value.

Recommendation: Understand where you should implement continuous risk management, and what logging, alert, detection, and management tools you already have that can help with risk management.

To learn more about Cisco® compliance solutions and HIPAA services, please visit http://www.cisco.com/go/compliance

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