CyberSecurity Standards for HIPAA Entities Expected in Upcoming Rule

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) reported that a total of 11 health data breaches have each affected over one million people this year, bringing the total number of people affected by data breaches in 2024 to about 140 million Americans.

Those 11 health data breaches include one that occurred at the Centers for Medicare & Medicaid Services (CMS) itself, affecting over 3 million people. A significant majority of these breaches were caused by cyberattacks, and a recent study found that these cyberattacks, by shutting down whole hospital systems, have a direct impact on patient health.

It’s not surprising then, that last week, OCR sent a proposed rule on cybersecurity to the White House for final review. OCR says the intent of the rule is to improve “cybersecurity in the health care sector by strengthening requirements for HIPAA (Health Insurance Portability and Accountability Act) regulated entities.”

Although little is known about the specific requirements in the proposed rule, by reading the tea leaves, we can venture some guesses on what it will generally include, based on comments by D.C. lawmakers and HHS itself in numerous forums.

We’ll give you two new terms – each with their own implicitly required government acronym – that we’re probably going to hear a lot more about when this rule is published as early as next month:

• Systemically Important Entities (SIEs); and
• Cybersecurity Performance Goals (CPGs).

Let’s start with CPGs. These were published about a year ago by CMS, with not much fanfare. That’s because they were voluntary best business practices that healthcare entities could implement – or not.

Now, the government has or will publish these CPGs for nearly every industry through the respective federal agencies, but since healthcare has become the number-one target for cybercriminals, the healthcare CPGs will likely be the first that will be required through these upcoming regulations.

The healthcare CPGs are split into two categories: Essential and Enhanced. The Essential category is intended to encompass business practices that are really a baseline for what the industry calls “good cybersecurity hygiene.” These include technological protections like multifactor authentication and strong encryption protections, as well as more behavioral practices like workforce trainings and revoking credentials for employees who leave the workforce.

The Enhanced CPGs are best practices that healthcare entities should employ as their organization’s technology matures. These include network segmentation and conducting attack simulations.

HHS has telegraphed that the Essential CPGs may make up the basis for required cybersecurity standards that could be imposed on healthcare entities in the upcoming rule.

Now, not all healthcare entities may be required to comply with all of the Essential CPGs. HHS has also focused much of its attention on the aforementioned  SIEs: entities that are identified based on their potential to affect national critical functions.

In English, SIEs are healthcare entities – let’s call them chokepoints in the industry – of which, should they be attacked or impacted, the consequences would be more widespread than just that that one entity and its customers.

In summary, we expect this rule will likely require at least some HIPAA entities, including plans, providers, and clearinghouses, to implement specific security standards, and these SIEs may be given more requirements because of their reach and impact.

Will this cost healthcare entities money? Certainly.

Healthcare is famously behind other U.S. industries in terms of technology – that is why cybercriminals focus on healthcare instead of other industries – and it will cost both individual organizations and the industry at large to address that.

The proposed healthcare cybersecurity rule is expected to be published in November.

Given the possible costs, let’s hope it also offers some resources and help for the industry in the fortification of its cyber defenses.