Jul 05 2010

Risky business

Category: hipaa — DISC @ 11:02 pm
Information Security Wordle: NIST HIPAA Securi...
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By Mary Mosquera

Last year’s HITECH Act toughened the rules and enforcement penalties health information handlers must follow to protect patient privacy.

Under the new policy regime, providers will have to pay more attention to the confidentiality and safety of patient information as they move more of their operations toward electronic health record-keeping.

Without sound security policies and practices, privacy “will be just a principle,” said Sue McAndrew, deputy director for privacy in the Office of Civil Rights, the Health and Human Services Department office that was given responsibility for health privacy and security policy under the new law.

OCR-draft-guidelines-for-security-risk-analysis

“We want it to be a reality for consumers,” she said at a recent privacy and security conference sponsored by OCR and the National Institute for Standards and Technology.

One of the most basic requirements is that providers must now perform a security assessment, a first step in understanding systems and electronic data over which they are temporary stewards.

OCR recently drafted guidance to help providers and payers figure out what is expected of them in doing a risk assessment. While it might sound onerous, a risk assessment might not be as difficult or costly as some providers might believe, even for small practices, privacy.

“When you say, ‘do a security risk assessment’, people’s eyes glaze over,” said Lisa Gallagher, security director of privacy and security for the Healthcare Information and Management Systems Society. “But really, it’s asking, ‘what are the risk areas?’, ‘how could someone get to it?’ and ‘what controls can you put in place to protect it.’”

In its guidance, OCR said organizations should identify and categorize their data collections, document threats to information that might lead to a disclosure of protected data and check to see if their current security measures are adequate.

“For a small organization, it sounds overwhelming and time-consuming, but in a lot of ways, it’s things that they already do,” said Pat Toth, a computer scientist in NIST’s computer security division.

“What small providers need to do is get an understanding of the framework and break down each step,” she said. “It is something that’s going to be living in their organization, so if they do their categorization and get that right, it will set the correct tone for the rest of the process.”

NIST has developed a quick-start guide, a “Cliff’s Notes” of its security publications detailing its risk management framework and risk assessment, in addition to frequently asked questions, to help providers, especially small practices.

For large organizations, risk management starts in the planning and architecture of systems across the enterprise and system life cycle, Toth said.

Besides a risk assessment, OCR is planning stricter reporting of disclosures of health information when electronic health records are used, even when the disclosure is for treatment and billing purposes. Providers will also have to give the reason for the disclosure. In May, OCR published a request for comments on its rulemaking.

The most effective method of accounting for disclosures is by using automated logging features in electronic health records and other computer systems, according to Mac McMillan, chief executive officer of Cynergistek Inc., an IT security consulting firm.

System logs are used to document and maintain a permanent record of all authorized and unauthorized access to and disclosure of confidential information so providers can recover evidence of that access.

“A lot of the difficulty to get accounting of disclosures in place is because of a lack of industry auditing capabilities,” he said at the OCR and NIST conference. “Most systems don’t have the functionality.” Moreover, IT security folks he works with have logging activated, “but they are still manually digesting them,” McMillan said, adding that manual audits are a time-consuming and imprecise process.

Even so, such practices must now be the order of the day under the new privacy and security framework. “The security rule says wherever you have electronic health information, you need to protect it,” said HIMSS’s Gallagher. “You may not even apply for meaningful use incentives. But if you’re keeping data in electronic form, you have to comply with the security rule.”

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Tags: arra and hitech, Civil and political rights, Computer security, Consultants, Electronic health record, General and Freelance, hipaa security, hitech, National Institute of Standards and Technology, Risk management, Security

Mar 02 2010

HITECH Act increases HIPAA security requirements

Category: hipaa — DISC @ 3:03 pm

by Marcia Savage
The health care industry was buzzing with the news: For the first time ever, a hospital was being audited for compliance with HIPAA security requirements. The audit of Piedmont Hospital in Atlanta by the U.S. Department of Health and Human Services’ inspector general in 2007 was surprising for hospitals, health insurers and others in an industry accustomed to a lack of enforcement of federal privacy and security requirements.

A year later, HHS took another unusual step, meting out a $100,000 fine to Seattle-based Providence Health & Services for HIPAA security and privacy violations. The organization had lost backup tapes, optical disks and laptops containing unencrypted protected health information on more than 360,000 patients.

But those enforcement actions could be small potatoes compared to what’s ahead. The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act signed into law last year, earmarks about $19 billion in incentives to encourage adoption of electronic health record technology but also expands on HIPAA’s security and privacy requirements. In addition to instituting new breach notification rules and extending the rules to health care business associates, HITECH implements a new tiered system that increases civil monetary penalties for noncompliance and also allows state attorney generals to file civil actions for HIPAA violations.

“HITECH is perceived as the enforcement arm of HIPAA,” says Barry Runyon, research vice president covering health care providers at Gartner. “The stakes are higher and more people can enforce it.

“What it’s done has kind of jump started HIPAA. Health care delivery organizations’ programs languished for a while,” he adds. “When there’s no enforcement, people tend to get complacent. HITECH is making them revisit their security plans and look at their controls — essentially what they should have been doing.”

Let’s take a look at the ramifications of the HITECH Act on security and privacy in the health care industry and its impact so far.

To read further on HITECH Act increases HIPAA security requirements

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Feb 03 2010

UCSF laptop containing patient files stolen

Category: hipaa,Security Breach — DISC @ 3:46 pm

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The Associated Press

SAN FRANCISCO—The medical records of more than 4,000 patients at the University of California, San Francisco may have been compromised after a laptop they were on was stolen.
Officials with the university said Wednesday the laptop was recovered earlier this month after it was taken from a medical school employee during a flight in November. It does not appear that anyone gained access to the computer or the confidential patient information, but officials say the records still could have been exposed.

The files contained patients’ names, medical record numbers, ages and clinical information, but no Social Security numbers or financial data.

School officials say they are notifying the 4,400 patients whose records were on the computer. They were all treated in 2008 and 2009.
———
Information from: San Francisco Chronicle, http://www.sfgate.com/chronicle


Here we have another unnecessary major security breach in a large healthcare organization which resulted in a loss of patient data demonstrating poor baseline security. They clearly are not ready for the new HIPAA provision ARRA and HITECH. Evaluate your current business and system risks to make sure this does not happen to you.
Contact DISC for any question if you think, this may apply to you.

The Practical Guide to HIPAA Privacy and Security Compliance

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Tags: arra and hitech, confidential patient information, Data, hipaa, Medical record, medical records breach, Medicine, Patient files stolen, San Francisco, San Francisco Chronicle, UCSF, University of California San Francisco

Dec 16 2009

Internet security breach found at UCSF

Category: hipaa,Security Breach — DISC @ 2:38 pm

University of California, San Francisco
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By Erin Allday, SF Chronicle

Hackers may have had access to personal information for about 600 UCSF patients as a result of an Internet “phishing” scam, campus officials said Tuesday.

The security breach occurred in September when a faculty physician in the UCSF School of Medicine provided a user name and password in response to a scam e-mail message. The e-mail had been sent by hackers and made to look as though it came from UCSF workers who are responsible for upgrading security on internal computer servers.

The university is not identifying the physician.

A UCSF audit in October found that e-mails in the physician’s account included personal information about patients, including demographic and clinical data, and the Social Security numbers of four patients. It is unknown whether hackers actually accessed the e-mails.

The patients have all been notified of the security breach.

Phishing scams are designed to get people to reveal private information – such as Social Security numbers, credit card information and passwords – when they reply to e-mails that pretend to come from legitimate organizations.

For years, financial institutions and other corporations have been educating people to be cautious of such scams and wary of revealing private information on the Internet.

In response to the latest scam, UCSF officials said the university has been re-educating employees about protecting their user names and passwords.


Here we have another unnecessary healthcare data breach in a university due to phishing which resulted in a loss of private data demonstrating poor baseline security and lack of security awareness training. Healthcare organizations are not ready for HIPAA (ARRA and HITECH provision) compliance. Checkout why Healthcare Organizations May Not Be Prepared for HITECH and Other Security Challenges
Review my threats page and evaluate your current business and system risks to make sure this does not happen to you.


Considering healthcare standard electronic transaction (compliance date, Jan 1, 2012) and HITECH provision (compliance date, Feb 17, 2010) are in the pipeline for healthcare organizations. Do you think it’s about time for them to get their house in order?

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Tags: arra and hitech, arra hitech provisions, Computer security, Credit card, Health Insurance Portability and Accountability Act, hipaa, Identity Theft, phishing, social security, Social Security number

Nov 19 2009

Health Net healthcare data breach affects1.5 million

Category: hipaa,Security Breach — DISC @ 2:10 pm

Health Net, Inc.
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Here we have another unnecessary major security breach in a large healthcare organization which resulted in a loss of patient data demonstrating poor baseline security. They clearly are not ready for the new HIPAA provision ARRA and HITECH. Review my threats page and evaluate your current business and system risks to make sure this does not happen to you.
Contact DISC for any question or high level risk assessment.

The Practical Guide to HIPAA Privacy and Security Compliance

By Robert Westervelt, News Editor
19 Nov 2009 | SearchSecurity.com

Health Net Inc. announced Wednesday that it is investigating a healthcare data security breach that resulted in the loss of patient data, affecting 1.5 million customers.

The Woodland Hills, Calif.-based managed healthcare provider said the lost files, a mixture of medical data, Social Security numbers and other personally identifiable information, were collected over the past seven years and contained on a portable external hard drive, which was lost six months ago. The company said the healthcare data was not encrypted, but was formatted as images and required a specific software application to be viewed. The hard drive contained data on 446,000 Connecticut patients.

The company reported the breach Wednesday to State Attorneys Generals offices in Arizona, Connecticut, New Jersey and New York. Health Net said it was beginning the data security breach notification process of sending out letters to its customers. The company said it expects to send notification letters the week of Nov. 30.

Connecticut Attorney General Richard Blumenthal said he was investigating the matter and why it took Health Net six months to report the healthcare breach.

“My investigation will seek to establish what happened and why the company kept its customers and the state in the dark for so long,” Blumenthal said in a statement. “The company’s failure to safeguard such sensitive information and inform consumers of its loss — leaving them naked to identity theft — may have violated state and federal laws.”

Blumenthal said the hard drive also contained financial data, including bank account numbers. He is seeking coverage for comprehensive, long-term identity theft protection for those customers affected by the breach.

Health Net provides medical coverage for approximately 6.6 million people and its subsidiaries operate in all 50 states. In a statement, the company said the breach took place in its Connecticut office. So far there have not been any reports of fraud tied to the missing data..

“Health Net will provide credit monitoring for over two years – free of charge – to all impacted members who elect this service, and will provide assistance to any member who has experienced any suspicious activity, identity theft or health care fraud between May 2009 and their date of enrollment with our identity protection service,” the company said.

It is the second time in a month that a healthcare provider lost customer data. Anthem Blue Cross and Blue Shield of Connecticut reported a stolen laptop was to blame for a breach compromising the personal information of 850,000 doctors, therapists and other healthcare professionals.

Security experts have long been advocating that enterprises deploy encryption on laptops and other devices that contain sensitive data. Still, all the technology in the world won’t end employee mistakes and carelessness, said Mike Rothman an analyst with Security Incite.

“You can do full disk encryption and all sorts of things to protect the device, but you are still fairly constrained by user sophistication,” Rothman said. “You have to start asking questions from a process standpoint relative to why this stuff was on an external drive in the first place.”

In reality you could turn off all USB ports on your devices, but that could hinder employee productivity, Rothman said. Security always gets back to making sure you have the right processes and policies in place and the right training and awareness so that employees understand what those policies are and ways to audit those processes, he said.

Experts say encryption should be used as a last resort when all other security policies and processes fail. While many enterprises have focused on encrypting laptops at the endpoint, encryption can be a bit trickier for portable hard drives and other removable media. If the drive is being shared between different systems people need to have some way to access the key, said Ramon Krikken, an analyst at the Burton Group.

“A lot of these portable hard drives are older without built-in encryption and to the extent to which you can easily deploy encryption has been a challenge for enterprises,” Krikken said.

Some USB makers market the devices with built-in encryption software. In 2008, Seate Technology extended full disk encryption technology to all its enterprise-class hard drives. The company also began pushing for standards for hard drive encryption in storage systems.

Nagraj Seshadri, head of product marketing at Utimaco the encryption software division of Sophos Plc, said healthcare organizations need to be just as responsible as financial firms when it comes to protecting data.


Perhaps healthcare management still doesn’t realize that they might be potentially liable for lack of reasonable safeguards to protect organization assets. Do you think it’s time for healthcare management to take information security seriously as a potential business risk?

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Tags: arra and hitech, data loss prevention, data security, disk encryption and file encryption, Health care, Health Insurance Portability and Accountability Act, Identity Theft, identity theft and data security breaches, Personally identifiable information, Security, security awareness training

Nov 06 2009

Laptop Heist Exposes Doctors’ Personal Data

Category: hipaa,Security Breach — DISC @ 6:50 pm

doctor

Another stolen laptop puts thousands of people’s personal data at risk but this time it’s the caregivers — not the patients — who are at risk.

November 6, 2009
By Larry Barrett:

More than 10,000 physicians’ and dentists’ personal data was exposed last week in New Hampshire after an employee at Anthem Blue Cross and Blue Shield transferred the health care providers’ Social Security numbers and other data to a personal laptop that was later stolen.

Anthem spokesman Christopher Dugan said the security breach took place at the national level and the files did not include any patients’ personal data.

The Blue Cross Blue Shield Association said the employees’ ill-fated decision to transfer the sensitive information to a personal laptop violated the insurer’s security policies.

Just last week, more than 33,000 patients receiving care from a Daytona Beach, Fla. medical center were notified that their data may have been compromised when a laptop was stolen from an employee’s car.
New Hampshire is one of 43 states that require companies and organizations to notify people when their personal or financial information is accidentally or deliberately compromised.

Anthem officials said it will provide free credit-monitoring services to all the affected physicians and dentists for a year.

It’s not been the best of months for the insurer.

On Oct. 5, Blue Cross warned another 39,000 doctors that a yet another laptop stolen from the company’s Chicago headquarters could have potentially exposed an assortment of personal information including Social Security numbers and tax identification numbers.
A Ponemon Institute by Traverse City, Mich.-based data security researcher Ponemon Institute estimates that more than 12,000 laptops are stolen or lost at airports alone each week.

It also found that the average large company has 640 laptops, 1,985 USB memory sticks, 1,075 smart phones and 1,324 other various data devices stolen or lost each year — ;a total of 800,000 data-sensitive memory devices a year.

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Tags: arra and hitech, crime, data breach, data security, Health Insurance Portability and Accountability Act, hipaa, laptop, Physician, Security, stolen laptop

Nov 03 2009

Healthcare Organizations May Not Be Prepared for HITECH and Other Security Challenges

Category: hipaa — DISC @ 6:22 pm

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Healthcare Organizations May Not Be Prepared for HITECH and Other Security Challenges
HIMSS News
The Healthcare Information and Management Systems Society releases its 2nd Annual Security Survey, sponsored by Symantec

CHICAGO (November 3, 2009) – With the American Recovery and Reinvestment Act underway, healthcare organizations face new challenges to maintain privacy and security of patient health data. However, data gathered from healthcare IT and security professionals indicate that many organizations may not be ready to meet some of the HITECH components of the ARRA legislation and other security challenges, according to the results of the 2009 HIMSS Security Survey, sponsored by Symantec Corp. (Nasdaq: SYMC).

While healthcare organizations recognize that patient data must be protected, the survey results show that:

  • Security budgets remain low
  • Organizations often don’t have a response plan for threats or a security breach
  • A designated Chief Security Officer or Chief Information Security Officer is not in place

    • In addition, the survey reveals that healthcare organizations are not using the current security technologies available to keep patient data safe. Respondents to this survey widely use audit logs with data from firewalls, application logs and server logs as common information sources. Yet, when analyzing the log data, only 25 percent of respondents reported electronic analysis of that data. Respondents indicate they are using firewalls and user access controls, but are not implementing all available technologies to secure data. Only 67 percent of responding organizations use encryption to secure data in transmission, and fewer than half encrypt stored data.

    “Healthcare organizations are continually looking for ways to save money,” said David Finn, health IT officer, Symantec Corp. “One of the best ways to accomplish these goals is through investing in technologies that will automate and reduce the risks of a security incident and lower the chances of a compliance issue. Although awareness about these issues is high, many providers have not yet made significant moves to the address these concerns.”

    Other key survey results include:

    Security Budget: Approximately 60 percent of respondents reported that their organization spends three percent or less of their organization’s IT budget on information security. This is consistent to the level of spending identified in the 2008 study.

    Maturity of Environment: Respondents characterized their environment at a middle rate of maturity, with an average score of 4.27 on a scale of one to seven, where one is not at all mature and seven is a high level of maturity.

    Formal Security Position: Fewer than half of respondents indicated that their organization has either a formally designated CISO (Chief Information Security Officer) or CSO (Chief Security Officer).

    Patient Data Access: Surveyed organizations most widely implement user-based and role-based controls to secure electronic patient information. Approximately half of respondents reported that their organization allows patients/surrogates to access electronic patient information. Patients/surrogates are most likely to be granted access to high level clinical information, such as diagnosis or lab results.

    Management of Security Environment: Nearly all respondents reported that their organization actively works to determine the cause/origin of security breaches. However, only half have a plan in place for responding to threats or incidents related to a security breach.

    Security Controls: Most respondents reported that they use the information generated in their risk analysis to determine which security controls should be used at their organization. About 85 percent of respondents reported that they monitor the success of these controls and two-thirds of these respondents measure the success of these controls.

    Risk Analysis: Three-quarters of surveyed organizations conduct a formal risk analysis (only half of these conduct this assessment on a yearly basis or more frequently), which has remained the same in the past year. Three-quarters of organizations that did conduct risk assessments found patient data at risk due to inadequate security controls, policies and processes. Conducting this analysis positions organizations to identify gaps in their security controls and/or policies and procedures.

    Security in a Networked Environment: Nearly all respondents reported that their organizations share patient data in electronic format. Respondents are most likely to report that they share data with state government entities. Respondents also reported that the area in which they are most likely to share data in the future is with Health Information Exchanges (HIEs)/Regional Health Information Organizations (RHIOs). Approximately half of these organizations (41 percent) indicated that these sharing arrangements have resulted in the use of additional security controls beyond those that were already in place at their organization. This is consistent with the data reported in the 2008 survey.

    Future Use of Security Technologies: E-mail encryption and single sign on and were most frequently identified by respondents as technologies that were not presently installed at their organization but were planned for future installation.

    Medical Identity Theft: One-third of respondents reported that their organization has had at least one known case of medical identity theft at their organization. However, only a handful of these organizations experienced direct consequences from the breach.

    “Healthcare organizations must approach all IT activities, including data security, with effective management and efficient use of their budgets, staff and technologies,” said Lisa Gallagher, HIMSS Senior Director, Privacy and Security. “IT and security professionals must recognize the need for securing patient data by using available technologies and preparing for compliance with current ARRA laws and future regulations. This complex operating environment, as well as our national goals for health IT, demands such action to ensure quality, safety and improved healthcare delivery.”

    Targeting Chief Information Officers and Chief Security Officers and other Information Technology (IT) executives, the 2009 HIMSS Security Survey focused on an assessment of 196 information technology (IT) and security professionals in the healthcare field of their own readiness for today’s risks and security challenges.

    About Symantec
    Symantec is a global leader in providing security, storage and systems management solutions to help consumers and organizations secure and manage their information-driven world. Our software and services protect against more risks at more points, more completely and efficiently, enabling confidence wherever information is used or stored. More information is available at www.symantec.com.

    About HIMSS
    The Healthcare Information and Management Systems Society (HIMSS) is a comprehensive healthcare-stakeholder membership organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded in 1961 with offices in Chicago, Washington D.C., Brussels, Singapore, and other locations across the United States, HIMSS represents more than 23,000 individual members, of which 73% work in patient care delivery settings. HIMSS also includes over 380 corporate members and nearly 30 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare public policy and industry practices through its educational, professional development, and advocacy initiatives designed to promote information and management systems’ contributions to ensuring quality patient care. Visit www.himss.org for more information.

    For more information, contact:
    Joyce Lofstrom/HIMSS
    312-915-9237 – jlofstrom@himss.org

    Pamela Reese/Symantec
    424-750-7858 – pamela_reese@symantec.com

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    Tags: arra and hitech, arra hitech provisions, arra hitech security "business associate", Chief Information Security Officer, Chief security officer, Computer security, Health care, Healthcare Information and Management Systems Society, hipaa laws, Information Technology, Security, status of arra and hitech, Symantec

    Oct 30 2009

    HIPAA and business associate

    Category: hipaa — DISC @ 10:14 pm

    medical-symbol
    How ARRA and HITECH provisions affect HIPAA compliance
    AIS reported taht the new HITECH Act requires hospitals, providers, health plans and other HIPAA covered entities (CEs) to meet a February 2010 deadline for revising their business associate (BA) agreements. New language in BA amendments should require BAs to comply with (a) the HIPAA Security Rule,(b) new security breach notification rules and related strategies that CEs choose to implement, and (c) new privacy obligations imposed on CEs by the HITECH Act. Developing and maintaining effective BA relationships should be a top compliance priority for CEs, since privacy and security breaches often take place at the BA level and can be just as damaging to a covered entity’s reputation. With February approaching and lots of tricky questions to resolve, covered entities need a quick crash course in what their options are for designing and implementing these amendments in the next three months.

    While the HITECH Act did not come right out and say “business associate agreements must be revised,” it does stipulate that certain provisions “shall be incorporated into the business associate agreement between the business associate and the covered entity.” Among them: business associate agreements must be amended to reflect the new mandate that BAs must comply with the Security Rule, should be amended to provide the covered entity with adequate notice in the event of a security breach, and should incorporate new privacy obligations imposed on CEs by the HITECH Act

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