Healthcare Cybersecurity

HHS One of Three Departments in Most Critical Need of IT Modernization

Posted by HIPAA Journal

The Government Accountability Office (GAO) has published the findings of an audit of all federal government systems that run on legacy systems. The aim of the audit was to determine the extent to which legacy software and systems are in use, and which departments are in most critical need of modernization.

In total, 65 federal agency systems were assessed at 24 different agencies to produce a list of the top ten systems in need of modernization. GAO then assessed the agencies’ plans to update their systems and measured those plans against IT modernization best practices.

The Department of Health and Human Services (HHS) was in the top three departments in need of modernization, behind the Department of Education (DoE) and the Department of Defense (DoD). Only three departments were deemed to have both high system criticality and a high security risk: HHS, DoE, and the Department of Homeland security.

The level of modernization required by HHS is considerable. One legacy system is 50 years old yet is still being extensively used to support clinical and patient administrative activities. GAO was unable to get an accurate gauge of the age of the systems in HHS. That unknown contributed to the high security risk rating.

The HHS is still using systems that have been written in C++ and MUMPS, both of which are legacy languages. One of the problems faced by the HHS is finding programmers who can code in MUMPS: A clear sign that modernization is desperately needed.

Th system has been developed to include a further 50 modules and is installed and used on hundreds of computers and are many different configuration variations. The system is invaluable, but cumbersome and difficult to develop and maintain.

GAO notes that the continued use of legacy infrastructure and software invariably involves a greater maintenance cost and the systems are exposed to more cybersecurity risks. Modernization is essential for managing those risks and improving efficiency and the effectiveness of the system.

While there are plans to modernize IT in most government departments, the HHS has yet to document a plan for modernizing IT. “When deciding to modernize a legacy system, [HHS] considers the degree to which core mission functions of the agency or other agencies are dependent on the system.” It is understandable why such an update has been put off.

Until a modernization plan is developed and implemented, which incorporates IT modernization and security best practices, the department “will have an increased risk of cost overruns, schedule delays, and project failure,” wrote GAO.

The HHS has recognized the issues raised by GAO and is keen to update its technical architecture and infrastructure, which continues to present many difficult challenges. A contract has been awarded to a third party to research how the HHS can modernize its systems in stages over the course of a year. Once that report has been received, HHS will develop its modernization plan, which it hopes to implement in 2020.

The HHS has one of the largest IT budgets of any government agency. Modernization has potential to reduce that cost, but GAO noted that the modernization will require a considerable capital investment and it is unclear when and if the modernization will actually lead to cost savings.

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Ransomware and Data Destruction Attacks Dominate Healthcare Threat Landscape

Posted by HIPAA Journal

A recent report from Carbon Black has revealed 66% of healthcare organizations have experienced a ransomware attack in the past year and 45% experienced an attack in which data destruction was the main motivation behind the attack.

The figures come from Carbon Black’s latest report: Healthcare Cyber Heists in 2019. Carbon Black sought input from 20 industry leading CISOs and questioned them about the cyberattacks they had experienced in the past year, the tactics used in the attacks, and how the threat landscape is evolving.

Last year was a record-breaking year for healthcare data breaches and attacks are continuing at an unprecedented level. April 2019 was the worst ever month for healthcare data breaches with 46 major breaches (500+ records) reported to the HHS’ Office for Civil Rights.

“The potential, real-world effect cyberattacks can have on healthcare organizations and patients is substantial,” explained Rick McElroy, Carbon Black’s Head of Security Strategy and co-author of the report. “Cyber attackers have the ability to access, steal and sell patient information on the dark web. Beyond that, they have the ability to shut down a hospital’s access to critical systems and patient records, making effective patient care virtually impossible.”

83% of surveyed CISOs believe there has been an increase in cyberattacks over the past 12 months and 66% of CISO’s think attacks have grown in sophistication in the past year.

Two thirds of surveyed organizations have had to deal with an attempted ransomware attack in the past 12 months. A variety of ransomware variants were used although Kryptik/GenKryptik ransomware variants were most common and were used in 74% of attacks.

Almost half of respondents experienced a data destruction attack. These attacks involved the destruction of data in an attempt to paralyze business operations. The attacks are commonly associated with nation-state sponsored hacking groups in Russia, China, and North Korea.

While there were many different methods used to attack healthcare organizations, one of the most common was the use of Excel spreadsheets containing macro-enabled PowerShell to download malware.

One third of CISOs said they had experienced an ‘island hopping’ attack in the past year. This is where hackers have compromised a third party and used it to attack their organization. For example, an attack via partner-provisioned Virtual Desktop Infrastructure access, VPNs, or private network links. One third of CISOs also said counter incident response tactics were used by the hackers to prevent mitigation of a breach and to try to maintain persistent access.

CISOs were also asked about their biggest concerns. Compliance was the most stated area of concern (33%) followed by budget restrictions (22%), loss of patient data (16%), and vulnerable devices (16%).

Compliance as the main concern is worrying. It suggests healthcare organizations believe that becoming compliant with HIPAA equates to robust cybersecurity when that is not the case. Compliance with HIPAA only means an organization has achieved a baseline level of security. Many healthcare organizations that were HIPAA-complaint have still experienced data breaches. It is important for compliance to be viewed as a starting point in an organization’s security program. Once HIPAA compliant, security programs must be developed further.

The report shows organizations have realized the importance of staff security awareness training, not just for compliance but for improving security posture. 84% of organizations provide staff security awareness training at least annually with 45% providing more frequent training sessions.

When asked to rate their security posture, most CISOs believed there was still considerable room for improvement. 74% gave their organization a B or less (25% B, 16% B-, 33% C).

While the majority of organizations that engage in threat hunting say that it has significantly improved their cybersecurity posture, only one third of respondents said they had a threat hunting team. Carbon Black notes that threat hunting is no longer reserved for the security elite. Threat hunting software is available to help businesses of all sizes gain better visibility and find and address threats before they result in a data breach.

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Fresh BlueKeep Warning Issued by Microsoft: Public Exploits Exist and Attacks Imminent

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Microsoft has issued a fresh warning about the recently discovered BlueKeep vulnerability in Remote Desktop Services (CVE-2019-0708) following the online publication of proof-of-concept exploits for the flaw.

Microsoft released fixes for the flaw on May 14, 2019. As was the case with the vulnerability that was exploited in the WannaCry ransomware attacks in 2017, patches were also released for unsupported Windows versions.

The vulnerability is critical and could be exploited remotely via Remote Desktop Protocol (RDP) without any user interaction required. As one security researcher has shown, finding devices that have not been patched is far from difficult. Robert Graham of Errata Security performed a scan of the internet and found almost 1 million devices that have still not had the patch applied or protected using Microsoft’s recommended mitigations. Graham is not the only person to have performed scans for vulnerable devices. There has been a major increase in scans in recent days. It appears that cybercriminals are preparing for attacks.

The fresh warning is an unusual step for Microsoft to take. It has satisfied its obligations through the release of patches and has even issued patches for unsupported Windows versions. The decision to release a further warning was due to the growing risk of exploitation of the vulnerability. Several security firms claim to have developed exploits for the flaw and proof-of-concept exploit code has now been leaked online. Microsoft is confident that viable exploits exist for the vulnerability.

Several people have posted fake POC code for the vulnerability online, although security researcher Chase Dardaman tested one public DOS POC for BlueKeep which he confirmed to be genuine.

“It’s been only two weeks since the fix was released and there has been no sign of a worm yet. This does not mean that we’re out of the woods,” said Simon Pope, Director of Incident Response, Microsoft Security Response Center (MSRC) in a recent TechNet blog post. “If we look at the events leading up to the start of the WannaCry attacks, they serve to inform the risks of not applying fixes for this vulnerability in a timely manner.”

It took just two months from the MS17-010 patch being released before the global WannaCry ransomware attacks were conducted using the EternalBlue exploit. Yet even with major attacks occurring, many organizations still failed to take action. Now two years on, WannaCry ransomware attacks are still occurring and patches still are not being applied. One report last week indicated 40% of healthcare organizations have been attacked with WannaCry in the past 6 months and the attacks show no sign of stopping.

The latest flaw does not affect Windows 8 and Windows 10, but older Windows versions – Windows XP, Windows 7, Windows 2003 and Windows Server 2008 – are vulnerable. Many businesses have upgraded to Windows 10, but legacy Windows operating systems are still extensively used in healthcare, at least on some devices.

The advice from Microsoft has not changed. “We strongly advise that all affected systems should be updated as soon as possible,” said Pope. “It only takes one vulnerable computer connected to the internet to provide a potential gateway into these corporate networks, where advanced malware could spread, infecting computers across the enterprise.”

The NSA has also issued an alert via its Central Security Service division in an attempt to prevent another global malware attack like WannaCry, which used the NSA-developed EternalBlue exploit.

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40% of Healthcare Delivery Organizations Attacked with WannaCry Ransomware in the Past 6 Months

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Healthcare organizations have been slow to correct the flaw in Remote Desktop Services that was patched by Microsoft on May 14, 2019, but a new report from cybersecurity firm Armis has revealed many healthcare organizations have still not patched the Windows Server Message Block (SMB) flaw that was exploited in the WannaCry ransomware and NotPetya wiper attacks in May and June 2017.

The WannaCry attacks served as a clear reminder of the importance of prompt patching. Microsoft released patches for the vulnerability on March 2017. On May 12, 2017, the WannaCry ransomware attacks started. In the space of just a few days, more than 200,000 devices were infected in 150 countries.

The hackers behind the attack used the NSA exploits EternalBlue and DoublePulsar to spread the malware across entire networks. The National Health Service (NHS) in the UK was hit particularly badly due to the extensive use of legacy systems and the failure to apply patches promptly. Around one third of NHS Trusts in the UK were affected, 19,000 appointments had to be cancelled at a cost of around £20 million, and the cleanup cost was around £72 million.

Globally, the attacks are estimated to have cost $4 billion, with $325 million of that amount paid in ransoms to recover files that were encrypted by the ransomware.

WannaCry is still active and is being used in attacks around the globe, even though the attacks could be prevented by applying Microsoft’s MS17-010 patch.

According to the Armis report, around 40% of healthcare delivery organizations have experienced at least one WannaCry ransomware attack in the past 6 months. It is a similar story in manufacturing, where 60% of companies in the sector have experienced at least one attack in the past 6 months.

The problem is the continued reliance on legacy software. “In healthcare organizations, many of the medical devices themselves are based on outdated Windows versions, and cannot be updated without complete remodeling,” said Armis VP of research, Ben Seri.

Searches on the Shodan search engine showed around 1.7 million devices are still vulnerable to attack, even though patches were released by Microsoft more than 2 years ago. Those devices are being attacked at an alarming rate.

According to Armis, attacks are taking place in 103 countries at a rate of around 3,500 devices per hour. Seri determined that around 145,000 devices are currently compromised.

Thanks to the identification and activation of a kill switch in May 2017, it was possible to prevent encryption, even on devices that had been compromised. While that prevented many organizations from having to pay the ransom, it did not mean the threat had been neutralized entirely. Several variants of the ransomware are now in use, some of which lack the kill switch.

In Q3, 2018, 30% of all ransomware attacks involved WannaCry and the United States has the highest number of attacks. In the United States there are around 130,000 new attacks conducted every week.

All it takes is for one device to be infected with WannaCry. That device can then be used to move laterally and infect many other vulnerable devices on the network through the use of the DoublePulsar exploit.

The failure to apply patches due to having to rebuild systems is not the only problem. Seri explained that healthcare organizations often have a large number of unmanaged devices. Security agents have been turned off or uninstalled out of frustration, unsanctioned devices are connected to the network, and many IoT devices are allowed to connect to the network, even though they cannot have security agents installed. This creates a major blind spot for IT teams who are unable to monitor those devices and, in many cases, they have zero visibility into their existence.

Preventing attacks is straightforward in theory, but time consuming and complicated in practice. Patches must be applied, even though that process is difficult and time consuming. It is essential for IT teams to maintain an asset inventory of all devices that connect to the network and to monitor those devices and monitor networks for other unknown, suspicious, or misplaced devices.

Solutions also need to be implemented that monitor and protect unmanaged devices that lack security controls. “Healthcare and manufacturing environments are rampant with such devices from MRIs to infusion pumps to ventilators to industrial control devices, robotic arms, HMIs, PLCs, etc. Without such solutions, these devices, and consequently your entire network, are sitting ducks for any hacker,” explained Seri.

According to Seri, 70% of devices in healthcare are running old operating systems such as Windows 7. Seri points out that Windows 7 will reach end of life in 2020 and will no longer be supported, which will leave the healthcare industry even more vulnerable to attack.

The latest patch for the flaw in RDS is also not being applied, even though the flaw can be exploited remotely with no user interaction required in a WannaCry-style attack. As Seri explained, many organizations will not consider patching until an exploit is developed and attacks commence. Of course, by then, it may be too late.

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Almost 1 Million Windows Devices Still Vulnerable to Microsoft BlueKeep RDS Flaw

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More than two weeks after Microsoft issued a patch for a critical, wormable flaw in Remote Desktop Services, nearly 1 million devices have yet to have the patch applied and remain vulnerable. Those devices have also not had the recommended mitigations implemented to reduce the potential for exploitation of the flaw.

The vulnerability – CVE-2019-0708 – can be exploited remotely with no user interaction required and could allow a threat actor to execute arbitrary code on a vulnerable device, view, change, or delete data, install programs, create admin accounts, and take full control of the device. It would also be possible to then move laterally and compromise other devices on the network. Microsoft has warned that the vulnerability could be exploited via RDP and could potentially be used in another WannaCry-style attack.

Microsoft released patches for the vulnerability on May 14 and, due to the seriousness of the flaw, the decision was taken to also release patches for unsupported Windows versions. The flaw affects Windows XP, Windows 7, Windows 2003, Windows Server 2008, and Windows Server 2008 R2. Patches are available for all vulnerable systems.

Microsoft also detailed mitigations that could be implemented if the patch could not be promptly applied.

  • Disable RDP from outside the organization and limit its use internally
  • Block TCP port 3389 at the firewall
  • Implement Network Level Authentication (NLA)

Due to the seriousness of the flaw, Robert Graham of Errata Security conducted a scan to determine how many devices had not yet been patched. Graham used a masscan port scanner and an additional scanning tool to scan the internet to identify systems that were still vulnerable to the BlueKeep vulnerability. 7 million systems were identified that had port 3389 open and 950,000 of those systems had not had the patch applied. All of those systems are vulnerable to attack and if a worm-like exploit is developed, every one could be compromised.

While an exploit for the vulnerability does not appear to be in use in the wild as of yet, it is only a matter of time before one is developed and used to attack vulnerable devices. Several security firms claim to have already developed a workable exploit for the vulnerability, although they have not released that exploit publicly.

Graham has predicted an exploit will be developed by a threat actor and used in real world attacks in the next couple of months, although attacks could take place much sooner. Some evidence has already been found which suggests hackers are already searching for vulnerable devices. GreyNoise Intelligence identified several dozen hosts that are being used to scan the internet for unpatched devices.

All it takes is for one device to remain vulnerable to give an attacker a foothold in the network, after which many more devices could be compromised even if they are not vulnerable to BlueKeep.

Any healthcare organization that has yet to apply the patch or implement the recommended mitigations should do so as soon as possible to prevent the vulnerability being exploited.

Opatch has also released a micropatch that can be applied to always-on servers which means they can be protected without having to reboot the servers.

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Siemens Healthineers Products Vulnerable to Microsoft BlueKeep Wormable Flaw

Posted by HIPAA Journal

Six security advisories have been issued covering Siemens Healthineers products. The flaws have been assigned a CVSS v3 score of 9.8 and concern the recently announced Microsoft BlueKeep RDS flaw – CVE-2019-0708.

CVE-2019-0708 is a remotely exploitable flaw that requires no user interaction to exploit. An attacker could exploit the flaw and gain full control of a vulnerable device by sending specially crafted requests to Remote Desktop Services on a vulnerable device via RDP.

The flaw is wormable and can be exploited to spread malware to all vulnerable devices on a network in a similar fashion to the WannaCry attacks of 2017. The severity of the vulnerability prompted Microsoft to issue patches for all vulnerable operating systems, including unsupported Windows versions which are still used in many healthcare and industrial facilities.

The flaw affects Windows 2003, Windows XP, Windows 7, Windows Server 2008 and Windows Server 2008 R2. If the patch cannot be applied, RDP should be disabled, port 3389 should be blocked at the firewall, and Network Level Authentication (NLA) should be enabled.

Following Microsoft’s announcement about the RDS flaw and the release of the patches, Siemens conducted an investigation to determine which Siemens Healthineers products were affected. 6 classes of product were found to be vulnerable.

The exploitability of the vulnerability on these products will depend on the specific configuration and deployment environment. The vulnerabilities can generally be addressed by applying the Microsoft patch, although compatibility of the patch with any devices beyond end-of-life cannot be guaranteed.

Customers with vulnerable devices can obtain patch and remediation advice from their local Siemens Healthineers customer service engineer, portal, or Regional Support Center.

Siemens Healthineers Software Products

MagicLinkA, MagicView (100W and 300), Medicalis (Clinical Decision Support, Intelligo, Referral Management, and Workflow Orchestrator), Screening Navigator, Syngo (Dynamics, Imaging, Plaza, Workflow MLR, Worlflow SLR, via, via View&Go, and via WebViewer), and Teamplay.

Users should install the Microsoft patch. Risk can be reduced by ensuring a secure deployment in accordance with Siemens recommendations and ensuring AV software is in use and is regularly updated.

Siemens Healthineers Advanced Therapy Products

System Acom, Sensis and VM SIS Virtual Server

Siemens recommends disabling RDP on Acom systems and following Microsoft’s workarounds and mitigations on Sensis and VM SIS Virtual Server until a patch is made available.

Siemens Healthineers Radiation Oncology Products

All versions of Lantis

Siemens recommends disabling RDP and closing TCP port 3389

Siemens Healthineers Laboratory Diagnostics Products

Most Laboratory Diagnostics products are unaffected by the vulnerability.

Vulnerable products are:

Atellica Solution, Apto by Siemens, Aptio by Inpeco, Streamlab, CentraLink, Syngo Lab Process Manager, Viva E, and Viva Twin. Siemens Healthineers will provide customers with further information on the plan and details of activities to improve security.

For the following products, customers should use Microsoft’s workarounds and mitigations until Siemens makes a patch available on June 3, 2019.

Atellica COAG 360 (Windows 7), Atellica NEPH 630 (Windows 7), BCS XP (XP and Windows 7), BN ProSpec (XP and Windows 7),

The patch is currently under investigation for the following products. Microsoft’s workarounds and mitigations should be used in the interim.

CS 2000 (XP and Windows 7), CS 2100 (XP and Windows 7), CS 2500 (Windows 7), and CS 5100 (XP and Windows 7).

Siemens Healthineers Radiography and Mobile X-Ray Products

All versions of the following products with the Canon detector are vulnerable. Customers should contact their Siemens Regional Support Center for advice and, if possible, should block TCP port 3389.

Axiom (Multix M, Vertic MD Trauma, and Solitaire M), MobileTT XP Digital, Multix (Pro ACSS P, Pro P, PRO/PRO ACSS/PRO Navy, Swing, TOP, Top ACSS, and TOP P/TOP ACSS P), and Vertix Solitaire.

Siemens Healthineers Point of Care Diagnostics Products

AUWi, AUWi Pro, Rapid Point 500 (v2.2, 2.2.1, 2.2.2, 2.3, 2.3.1, and 2.3.2)

No immediate action is required as a patch will be made available in June 2019. In the meantime, Microsoft’s workaround and mitigations can be used for interim countermeasures.

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Multi-State Action Results in $900,000 Financial Penalty for Medical Informatics Engineering

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Medical Informatics Engineering (MIE) is required to pay a financial penalty of $900,000 to resolve a multi-state action over HIPAA violations related to a breach of 3.9 million records in 2015. The announcement comes just a few days after the HHS’ Office for Civil Rights settled its HIPAA violation case with MIE for $100,000.

MIE licenses a web-based electronic health record application called WebChart and its subsidiary, NoMoreClipboard (NMC), provides patient portal and personal health record services to healthcare providers that allow patients to access and manage their health information. By providing those services, MIE and NMC are business associates and are required to comply with HIPAA Rules.

Between May 7 and May 26 2015, hackers gained access to a server containing data related to its NMC service.  Names, addresses, usernames, passwords, and sensitive health information were potentially accessed and stolen.

A lawsuit was filed in December 2018 alleging MIE and NMC had violated state laws and several HIPAA provisions. 16 state attorneys general were named as plaintiffs in the lawsuit: Arizona, Arkansas, Connecticut, Florida, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Nebraska, North Carolina, Tennessee, West Virginia, and Wisconsin.

The plaintiffs’ investigation into the breach revealed hackers had exploited several vulnerabilities, MIE had poor password policies in place, and security management protocols had not been followed.

Under the terms of the consent judgement, in addition to the financial penalty, MIE must implement and maintain an information security program and deploy a security incident and event monitoring (SIEM) solution to allow it to detect and respond quickly to cyberattacks.

Data loss prevention technology must be deployed to prevent the unauthorized exfiltration of data, controls must be implemented to prevent SQL injection attacks, and activity logs must be maintained and regularly reviewed.

Password policies must be implemented that require the use of strong, complex passwords and multi-factor authentication and single sign-on must be used on all systems that store or are used to access ePHI.

Additional controls need to be implemented covering the creation of accounts that have access to ePHI. MIE must refrain from using generic accounts that can be accessed via the Internet and no generic accounts are allowed to have administrative privileges.

MIE is also required to comply with all the administrative and technical safeguards of the HIPAA Security Rule and states’ deceptive trade practices acts with respect to the collection, maintenance, and safeguarding of consumers’ protected health information. Reasonable security policies and procedures must be implemented and maintained to protect that information. MIE must also provide appropriate training to all employees regarding its information security policies and procedures at least annually.

In addition, MIE is required to engage a third-party professional to conduct an annual risk analysis to identify threats and vulnerabilities to ePHI each year for the next five years. A report of the findings of that risk analysis and the recommendations must be sent to the Indiana Attorney General within 180 days and annually thereafter.

The consent judgement has been agreed by all parties and resolves the alleged HIPAA violations and violations of state laws. The consent judgement now awaits court approval. The consent judgement can be found on the website of the Florida Office of the Attorney General – PDF.

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HHS Confirms When HIPAA Fines Can be Issued to Business Associates

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Since the Department of Health and Human Services implemented the requirements of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 in the 2013 Omnibus Final Rule, business associates of HIPAA covered entities can be directly fined for violations of HIPAA Rules.

On May 24, 2019, to clear up confusion about business associate liability for HIPAA violations, the HHS’ Office for Civil Rights clarified exactly what HIPAA violations could result in a financial penalty for a business associate.

Business associates of HIPAA Covered entities can only be held directly liable for the requirements and prohibitions of the HIPAA Rules detailed below. OCR does not have the authority to issue financial penalties to business associates for any aspect of HIPAA noncompliance not detailed on the list.

 

You can download the HHS Fact Sheet on direct liability of business associates on this link.

business associate liability for HIPAA violations

Penalties for HIPAA Violations by Business Associates

The HITECH Act called for an increase in financial penalties for noncompliance with HIPAA Rules. In 2009, the HHS determined that the language of the HITECH Act called for a maximum financial penalty of $1.5 million for violations of an identical provision in a single year. That maximum penalty amount was applied across the four penalty tiers, regardless of the level of culpability.

A re-examination of the text of the HITECH Act in 2019 saw the HHS interpret the penalty requirements differently. The $1.5 million maximum penalty was kept for the highest penalty tier, but each of the other penalty tiers had the maximum possible fine reduced to reflect the level of culpability.

Subject to further rulemaking, the HHS will be using the penalty structure detailed in the infographic below.

 

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Medical Informatics Engineering Settles HIPAA Breach Case for $100,000

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Medical Informatics Engineering, Inc (MIE) has settled its HIPAA violation case with the HHS’ Office for Civil Rights for $100,000.

MIE, an Indiana-based provider of electronic medical record software and services, experienced a major data breach in 2015 at its NoMoreClipboard subsidiary.

Hackers used a compromised username and password to gain access to a server that contained the protected health information (PHI) of 3.5 million individuals. The hackers had access to the server for 19 days between May 7 and May 26, 2015. 239 of its healthcare clients were impacted by the breach.

OCR was notified about the breach on July 23, 2015 and launched an investigation to determine whether it was the result of non-compliance with HIPAA Rules.

OCR discovered MIE had failed to conduct an accurate and through risk analysis to identify all potential risks to the confidentiality, integrity, and availability of PHI prior to the breach – A violation of the HIPAA Security Rule 45 C.F.R. § 164.308(a)(l)(ii)(A).

As a result of that failure, there was an impermissible disclosure of 3.5 million individual’s PHI, in violation of 45 C.F.R. § 164.502(a).

MIE chose to settle the case with OCR with no admission of liability. In addition to paying a financial penalty, MIE has agreed to adopt a corrective action plan that requires a comprehensive, organization-wide risk analysis to be conducted and a risk management plan to be developed to address all identified risks and reduce them to a reasonable and acceptable level.

“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.”

While the settlement releases MIE from further actions by OCR over the above violations of HIPAA Rules, MIE is not out of the woods yet. In December 2018, a multi-state lawsuit was filed against MIE by 12 state attorneys general over the breach.

The lawsuit alleged there was a failure to implement adequate security controls, that known vulnerabilities had not been corrected, encryption had not been used, security awareness training had not been provided to staff, and there were post-breach failures at MIE. That lawsuit has yet to be resolved. It could well result in a further financial penalty for MIE.

This is OCR’s second financial penalty of 2019. Earlier this month, a $3,000,000 settlement was agreed with Touchstone Medical Imaging to resolve multiple HIPAA violations, several of which were related to the delayed response to a data breach.

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