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<p>Earlier this month, the U.S. Department of Health and Human Services,
Office for Civil Rights (OCR), has announced a Health Insurance
Portability and Accountability Act of 1996 (HIPAA) civil money penalty
of $3,217,000.00 against Children’s Medical Center of Dallas
(Children’s), a pediatric hospital that is part of Children’s Health,
the seventh largest pediatric health care provider in the nation. OCR
based this penalty on its finding that Children’s failed to comply with
HIPAA Security Rule over many years and that Children’s impermissibly
disclosed unsecured electronic protected health information (ePHI) when
it suffered two data breaches that were reportable to OCR.</p>
<p><strong>The Breaches </strong></p>
<ul><li>On January 18, 2010, Children’s reported to OCR the loss of an
unencrypted, non-password protected BlackBerry device at an airport on
November 19, 2009. The device contained the ePHI of approximately 3,800
individuals.</li><li>On July 5, 2013, Children’s reported to OCR the
theft of an unencrypted laptop from its premises sometime between April 4
and April 9, 2013. The device contained the ePHI of approximately 2,462
individuals.</li></ul>
<p>Because Children’s devices were unencrypted, Children’s was obligated
to report their loss, along with the unsecured ePHI they contained, to
the HHS. Had Children’s devices been encrypted, it could have taken
advantage of the “safe harbor” rule, pursuant to which covered entities
and business associates are not required to report a breach of
information that is not “unsecured.”</p>
<p><strong>The Investigation</strong></p>
<ul><li>OCR’s investigation revealed that, in violation of HIPAA Rules,
Children’s (1) failed to implement risk management plans, contrary to
prior external recommendations to do so, and (2) knowingly and over the
course of several years, failed to encrypt, or alternatively protect,
all of its laptops, work stations, mobile devices, and removable storage
media. <ul><li>OCR’s investigation established that Children’s knew
about the risk of maintaining unencrypted ePHI on its devices as far
back as 2007.</li><li>Despite this knowledge, Children’s issued
unencrypted BlackBerry devices to nurses and allowed its workforce
members to continue using unencrypted laptops and other mobile devices
until 2013.</li></ul> </li></ul>
<p><strong>The Takeaways</strong></p>
<ul><li><strong>Implement HIPAA Safeguards. </strong> HIPAA covered
entities and business associates should implement appropriate
administrative, physical, and technical safeguards to ensure the
confidentiality, integrity, and availability of ePHI, as required by the
<a class="gmail-logclick gmail-ct_cont" target="_blank" href="https://www.hhs.gov/hipaa/for-professionals/security/index.html">Security Rule</a>.</li><li><strong>Don’t delay. </strong>
If you are a HIPAA covered entity or business associate, your Legal and
IT should ensure that the safeguards are implemented entity-wide and
without any undue delays. Your employees travel for business and
probably take work home. You quite literally could be one lost device
away from a disastrous data breach and a multi-million dollar fine.</li><li><strong>Encrypt your ePHI. </strong>An
important technical safeguard is encryption of ePHI, which is not
expressly, but effectively required under HIPAA, since only breaches of <strong>unsecured</strong> ePHI must be reported to the HHS. <em>See </em><a class="gmail-logclick gmail-ct_cont" target="_blank" href="https://www.gpo.gov/fdsys/granule/CFR-2011-title45-vol1/CFR-2011-title45-vol1-sec164-408">45 C.F.R. § 164.408</a>.</li><li><strong>Don’t lose your encryption key.</strong>
The encryption key should be stored separately from the ePHI. As
specified in the HIPAA Security Rule, ePHI is encrypted by “the use of
an algorithmic process to transform data into a form in which there is a
low probability of assigning meaning without use of a confidential
process or key” (<a class="gmail-logclick gmail-ct_cont" target="_blank" href="https://www.gpo.gov/fdsys/pkg/CFR-2016-title45-vol1/pdf/CFR-2016-title45-vol1-sec164-304.pdf">45 CFR 164.304 definition of encryption</a>) <em>and such confidential process or key that might enable decryption has not been breached</em>.</li><li><strong>Security is (usually) not a DIY project.</strong>
For many covered entities and business associates, implementation of
the Security Rule is outside of their wheelhouse. Hiring a reputable,
skilled technology vendor to implement the physical safeguards, and
hiring an knowledgeable outside legal counsel to ensure compliance with
all aspects of the Security Rule, as well as to ensure a certain level
of privilege protection, can go a long way to avoiding a reportable data
breach.</li></ul>
<p>As discussed in our previous post, <a class="gmail-logclick gmail-ct_cont" target="_blank" href="http://www.carpedatumlaw.com/2017/01/top-five-data-breach-trend-predictions-2017/">“Top Five Data Breach Trend Predictions for 2017,”</a>
medical identity theft is likely to remain cybercriminal’s top target
this year, since medical information is lucrative and easy to exploit.
After all, compared to a stolen credit card number, a stolen medical
record offers so much more personal information. Healthcare
organizations need to ensure they have proper, up-to-date security
measures in place, including data-breach response plans, ePHI
encryption, and adequate employee training about the importance of
security.</p>
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