Can you have a Ransomware attack if you are HIPAA-compliant?

Explore the ways Ransomware can infiltrate a HIPAA-Compliant organization and learn ways to prevent it

Image on Ransomware Attack even if you are HIPAA CompliantThe short answer: Yes

 

The in-depth answer: The Health Insurance Portability and Accountability Act (HIPAA) sets the minimum standards for protecting sensitive patient health information (PHI). The Department of Health and Human Services (HHS) regulates HIPAA compliance, while the Office for Civil Rights (OCR) enforces it. The OCR regularly publishes recommendations on new issues affecting healthcare and investigates common HIPAA violations on a regular basis. However, a HIPAA-compliant organization can still be a target for a ransomware attack. Despite having advanced cybersecurity measures in place to comply with HIPAA, no organization is fully impervious to all cyber threats.

Ransomware Attacks in a HIPAA-compliant Organization

 

HIPAA regulations mandate that healthcare providers protect the privacy and security of patient’s health information. This involves implementing safeguards such as access controls, audit controls, integrity controls, and transmission security. However, these measures primarily focus on ensuring data privacy and security, and although they can help reduce the risk of ransomware attacks, they do not eliminate it completely.

 

Ransomware is malicious software that encrypts the victim’s data. Hackers demands a ransom to restore access to the data once they are paid. They also have the ability to modify the data and sell it, even if they are paid the ransom amount. This leads to serious complications in the Healthcare Industry since their data is targeted due to its critical importance for its high value. Even with HIPAA-compliant measures in place, organizations can fall victim to ransomware attacks via various methods:

  1. Not implementing addressable safeguards:

    Organizations tend to overlook implementing addressable safeguards outlined in the HIPAA Security Rule. These safeguards focus on Authorization / Supervision, Workforce Clearance Procedures, Termination Procedures, Access Authorization, Security Reminders, Log-in Monitoring, Password Management, Protection from Malicious Software, Testing Contingency Plans, etc. Due to this oversight, their systems have vulnerabilities that can be exploited through a targeted cyber attack.

  2. Phishing attacks:

    One of the most common ways attackers can breach security defenses is through phishing emails. These emails trick employees into clicking on malicious links or attachments that install ransomware on the network.

  3. Insufficient Backup and Recovery Systems:

    HIPAA requires that covered entities have backup and disaster recovery measures in place. However, if these measures are not adequately and continuously maintained, tested, and updated, ransomware can infect not only the primary data systems but also backup systems, making data recovery impossible without paying the ransom.

  4. Incomplete or Inadequate Implementation of HIPAA Standards:

    Compliance doesn’t always mean complete protection. Organizations may meet the letter of the law without effectively securing all possible points of vulnerability. For instance, they might overlook the security of medical devices, partner networks, or other systems that connect to their main network.

  5. Exploiting software vulnerabilities:

    Cybercriminals often exploit known vulnerabilities in software applications that are not patched or updated regularly. Through these vulnerabilities, they gain unauthorized access and deploy ransomware.

  6. Insider threats:

    Employees, vendors, or other insiders with malicious intent or those who are simply careless may inadvertently expose the organization to ransomware attacks deliberately.

  7. Brute force attacks:

    In this method, attackers try numerous combinations to guess passwords and gain access to systems or networks. Once they are in, they install ransomware and infiltrate the entire network.

  8. Advanced Persistent Threats (APTs):

    These are long-term targeted attacks where cybercriminals infiltrate networks to mine data or disrupt services. They can plant ransomware and activate it at the most opportune moment. For example, zero-day exploits take advantage of security vulnerabilities that are unknown to the organization and the public. Such vulnerabilities are thus unpatched, making them a lucrative target for attackers.

  9. Network vulnerabilities:

    Weaknesses in network security, such as unsecured Wi-Fi networks or inadequate firewall protection, can create entry points for ransomware.

  10. Physical breaches:

    Access to physical machines (like a stolen laptop that has not been encrypted) can also lead to a breach. HIPAA requires physical safeguards, but like all security measures, they’re not 100% foolproof.

This list is not exhaustive, and HIPAA compliance can help mitigate these risks through required security measures like regular risk assessments, encryption of electronic protected health information (ePHI), maintaining updated and patched systems, and conducting regular staff training on cybersecurity best practices.

However, the cyber security challenges that organizations face are dynamic. They need a comprehensive approach to cybersecurity that goes beyond just HIPAA compliance. This might involve extensive and customized employee training to recognize phishing attempts, regular audits, and penetration tests to identify and patch vulnerabilities, the use of advanced threat detection and response systems, and robust, isolated backup systems to ensure data can be restored in the event of a ransomware attack. In addition, establishing an incident response plan can help minimize damage if an attack occurs.

Despite all these measures, it’s important to remember that no organization can be completely immune to ransomware attacks. Therefore, continuous improvement of your security posture and preparedness for potential attacks is critical.

In the event of a ransomware attack, HIPAA mandates specific steps and reporting procedures, including notifying affected individuals, the Department of Health and Human Services, and potentially the media depending on the scale of the breach. Therefore, compliance does not guarantee the prevention of attacks, but it does establish a strong foundation for preventing, detecting, and responding to such cyber threats, thereby reducing the possibility of risks in the long run.

 

How databrackets can help you create a secure IT infrastructure

Experts at databrackets have extensive experience working with Healthcare Providers, Cyber Liability Insurance Providers, Managed Service Providers (MSPs), FDA Regulated industries etc. Our services range from Security Risk Analysis, HIPAA compliance, Pen Testing & Vulnerability Scans, Implementation of Cyber Security Technology, Managed Security Services, and Security Risk Analysis for MIPS, among others.

Our team has supported organizations across a wide variety of industries to align their processes with security frameworks like HIPAA, 21 CFR Part 11, ISO 27001, SOC 2, NIST SP 800-53, NIST Cybersecurity Framework, NIST SP 800-171, GDPR, CMMC etc.

We are constantly expanding our library of assessments and services to serve organizations across industries. Schedule a Consultation if you would like to Connect with an Expert to understand how we can customize our services to meet your specific requirements.

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Author: Aditi Salhotra, Digital Marketing and Business Development, databrackets.com

Aditi is a Digital Marketing and Business Development Professional at databrackets.com. She graduated with honors in Marketing from Sheridan College, Canada. In addition to her current profile, she contributes to Product Development and Content Creation. She is a strong advocate of Good Cyber Hygiene and white hat SEO techniques. She is proud of the company’s mission to safeguard organizations from cyber threats and ensure their business continuity in adverse situations. 

Technical Expert: Srini Kolathur, Director, databrackets.com

The technical information presented in this blog has been carefully reviewed and verified by our Director, Srini Kolathur. Srini is results-driven security and compliance professional with over 20 years of experience supporting, leading, and managing global IT security, compliance, support, and risk assessment in fortune 100 companies. Some of his key areas of focus are SOC 2, ISO 27001, NIST 800-171, NIST 800-53, NIST Cybersecurity Framework,  HIPAA, Security Risk Assessment, CMMC 2.0 among others. He is a CMMC Registered Practitioner (RP), CISSP, CISA, CISM, MBA. He is active in several community groups including Rotary International and TiE.

Experts at databrackets have extensive experience working with Healthcare Providers, Cyber Liability Insurance Providers, Managed Service Providers (MSPs), FDA Regulated industries etc. Our services range from Security Risk Analysis, HIPAA compliance, Pen Testing & Vulnerability Scans, Implementation of Cyber Security Technology, Managed Security Services, and Security Risk Analysis for MIPS, among others.

Our team has supported organizations across a wide variety of industries to align their processes with security frameworks like HIPAA, 21 CFR Part 11, ISO 27001, SOC 2, NIST SP 800-53, NIST Cybersecurity Framework, NIST SP 800-171, GDPR, CMMC etc.

We are constantly expanding our library of assessments and services to serve organizations across industries. Schedule a Consultation if you would like to Connect with an Expert to understand how we can customize our services to meet your specific requirements.

HIPAA Complaint Process Infographic Released by HHS

The Centers for Medicare & Medicaid Services (CMS) has released a new infographic on how alleged violations of the HIPAA Administrative Simplification requirements are processed.

Find out what happens when a complaint is filed:

If you have a complaint about a potential HIPAA Administrative Simplification violation, you can submit it to the CMS complaint enforcement process. Look for more information about CMS compliance and enforcement coming soon.

https://asett.cms.gov/ASETT_HomePage

 

Indiana Medical Records Service Pays $100,000 to Settle HIPAA Breach

23rd May 2019

Medical Informatics Engineering, Inc. (MIE) has paid $100,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services, and has agreed take corrective action to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. MIE is an Indiana company that provides software and electronic medical record services to healthcare providers.

 

On July 23, 2015, MIE filed a breach report with OCR following the discovery that hackers used a compromised user ID and password to access the electronic protected health information (ePHI) of approximately 3.5 million people. OCR’s investigation revealed that MIE did not conduct a comprehensive risk analysis prior to the breach. The HIPAA Rules require entities to perform an accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of an entity’s electronic protected health information.

“Entities entrusted with medical records must be on guard against hackers,” said OCR Director Roger Severino. “The failure to identify potential risks and vulnerabilities to ePHI opens the door to breaches and violates HIPAA.”

In addition to the $100,000 settlement, MIE will undertake a corrective action plan to comply with the HIPAA Rules that includes a complete, enterprise-wide risk analysis.

The resolution agreement and corrective action plan may be found at https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/mie/index.html.

New HHS Fact Sheet on Direct Liability of Business Associates under HIPAA

24th May 2019

The HHS Office for Civil Rights (OCR) has issued a new fact sheet that provides a clear compilation of all provisions through which a business associate can be held directly liable for compliance with certain requirements of the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules (“HIPAA Rules”), in accordance with the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.  In 2013, under the authority granted by the HITECH Act, OCR issued a final rule that, among other things, identified provisions of the HIPAA Rules that apply directly to business associates and for which business associates are directly liable. 

OCR has the authority to take enforcement action against business associates only for those requirements and prohibitions of the HIPAA Rules that appear on the following list. 

  1. Failure to provide the Secretary with records and compliance reports; cooperate with complaint investigations and compliance reviews; and permit access by the Secretary to information, including protected health information (PHI), pertinent to determining compliance.
  2. Taking any retaliatory action against any individual or another person for filing a HIPAA complaint, participating in an investigation or other enforcement processes, or opposing an act or practice that is unlawful under the HIPAA Rules.
  3. Failure to comply with the requirements of the Security Rule.
  4. Failure to provide breach notification to a covered entity or another business associate.
  5. Impermissible uses and disclosures of PHI.
  6. Failure to disclose a copy of electronic PHI to either the covered entity, the individual, or the individual’s designee (whichever is specified in the business associate agreement) to satisfy a covered entity’s obligations regarding the form and format, and the time and manner of access under 45 C.F.R. §§ 164.524(c)(2)(ii) and 3(ii), respectively.
  7. Failure to make reasonable efforts to limit PHI to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request.
  8. Failure, in certain circumstances, to provide an accounting of disclosures.
  9. Failure to enter into business associate agreements with subcontractors that create or receive PHI on their behalf, and failure to comply with the implementation specifications for such agreements.
  10. Failure to take reasonable steps to address a material breach or violation of the subcontractor’s business associate agreement.

“As part of the Department’s effort to fully protect patients’ health information and their rights under HIPAA, OCR has issued this important new fact sheet clearly explaining a business associate’s liability,” said OCR Director Roger Severino.  “We want to make it as easy as possible for regulated entities to understand, and comply with, their obligations under the law.”

The new fact sheet may be found at https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/business-associates/index.html along with OCR’s guidance on business associates.

Tennessee diagnostic medical imaging services company pays $3,000,000 to settle breach exposing over 300,000 patients’ protected health information

May 6, 2019

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Touchstone Medical Imaging (“Touchstone”) has agreed to pay $3,000,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS), and to adopt a corrective action plan to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Security and Breach Notification Rules. Touchstone, based in Franklin, Tennessee, provides diagnostic medical imaging services in Nebraska, Texas, Colorado, Florida, and Arkansas.

In May 2014, Touchstone was notified by the Federal Bureau of Investigation (FBI) and OCR that one of its FTP servers allowed uncontrolled access to protected health information (PHI).  This uncontrolled access permitted search engines to index the PHI of Touchstone’s patients, which remained visible on the Internet even after the server was taken offline. 

Touchstone initially claimed that no patient PHI was exposed.  However, during OCR’s investigation, Touchstone subsequently admitted that the PHI of more than 300,000 patients was exposed including, names, birth dates, social security numbers, and addresses.  OCR’s investigation found that Touchstone did not thoroughly investigate the security incident until several months after notice of the breach from both the FBI and OCR.  Consequently, Touchstone’s notification to individuals affected by the breach was also untimely.  OCR’s investigation further found that Touchstone failed to conduct an accurate and thorough risk analysis of potential risks and vulnerabilities to the confidentiality, integrity, and availability of all of its electronic PHI (ePHI), and failed to have business associate agreements in place with its vendors, including their IT support vendor and a third-party data center provider as required by HIPAA.

In addition to the monetary settlement, Touchstone will undertake a robust corrective action plan that includes the adoption of business associate agreements, completion of an enterprise-wide risk analysis, and comprehensive policies and procedures to comply with the HIPAA Rules. 

The resolution agreement and corrective action plan may be found at http://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/tmi/index.html.