The Department of Health and Human Services’ Office for Civil Rights (OCR) breach portal shows a 12% month-over-month reduction in the number of healthcare data breaches of 500 or more records. In June, HIPAA-regulated entities reported 66 breaches, and while this was an improvement on the 73 breaches reported in June 2022, the month’s total is still well above the 12-month average of 58 data breaches a month.

May was a particularly bad month for data breaches with more than 19 million individuals having their protected health information exposed or impermissibly disclosed, so while there was a 73.67% month-over-month reduction in breached records in June, the previous month’s total was unnaturally high. June’s total of 5,015,083 breached records was below the 12-month average of 6 million records a month and less than the 6,258,833 records breached in June 2022, but that is still more than 167,000 breached healthcare records a day – 17.6% more than the daily average in 2022.

In H1 2023, 41,452,622 healthcare records were exposed or impermissibly disclosed. That’s just a few thousand records short of the total for all of 2019 and just 10 million below the total for all of 2022.

Largest Healthcare Data Breaches in June 2023

In June, 25 data breaches of 500 or more records were reported to OCR, all but two of which were hacking/IT incidents. The largest breach of the month by some distance was a ransomware attack and data theft incident at the biotech and diagnostics company, Enzo Clinical Labs (Enzo Biochem).  Murfreesboro Medical Clinic & SurgiCenter also suffered a major breach where sensitive data was stolen and a ransom demand was issued to prevent a data leak, as did Intellihartx. Intellihartx was one of several companies that had sensitive data stolen by the Cl0p ransomware group, which mass exploited a zero day vulnerability in Fortra’s GoAnywhere MFT file transfer solution in late January.

As the table below indicates, it is becoming increasingly common for HIPAA-regulated entities to only disclose limited information in their notification letters. Data breaches are often reported as “unauthorized individuals accessed the network and may have accessed or removed patient information,” even when data theft has been confirmed and the stolen data has been uploaded to the data leak sites of ransomware groups. The lack of information can make it difficult for victims of data breaches to assess the level of risk they face.

Healthcare Data Breaches of 10,000 or More Records

Causes of June 2023 Healthcare Data Breaches

Hacking incidents once again dominated the breach reports, accounting for more than 77% of the month’s data breaches and more than 96% of the month’s breached records. The average breach size was 94,480 records and the median breach size was 5,973 records. 4,818,457 records were exposed or compromised in hacking incidents. There were 14 unauthorized access/disclosure incidents reported, which cover a range of different incidents including unauthorized medical record access, unsecured paper records, mismailing incidents, and misdirected emails. Across those incidents, 196,026 records were impermissibly accessed or disclosed. The average breach size was 14,002 records and the median breach size was 2,567 records. There was one incident involving the improper disposal of 600 paper records and no reported loss or theft incidents.

As the chart below shows the most common location of breached protected health information was network servers, with email accounts the second most common location of breached data.

Where Did the Breaches Occur?

The raw data from the OCR breach portal shows data breaches by reporting entity; however, that does not mean that is where the breach occurred. When data breaches occur at business associates, the business associate may report the breach, or the covered entities affected, or a combination of the two. The raw data shows 44 breaches at healthcare providers, 12 at business associates, and 10 at health plans.

The charts below are based on adjusted figures and show where the data breach occurred rather than the entity reporting the breach as this better reflects the number of data breaches that occurred at business associates of HIPAA-regulated entities.

Geographical Distribution of Healthcare Data Breaches

Data breaches of 500 or more records were reported by HIPAA-regulated entities in 31 states in June 2023. Pennsylvania was the worst affected state, with 11 data breaches reported. The high total is partly due to 6 of the breaches relating to two incidents that were reported separately for each company affected. Even taking this into account, Pennsylvania was the worst affected state.

HIPAA Enforcement Activity in June 2023

The Office for Civil Rights announced three enforcement actions in June to resolve potential violations of the HIPAA Rules. Yakima Valley Memorial Hospital was investigated by OCR after a report was received about a HIPAA breach involving 23 security guards who had been accessing patient records without authorization. OCR determined that the hospital had failed to implement reasonable and appropriate policies and procedures to comply with the standards, implementation specifications, or other requirements of the Security Rule. The case was settled and the hospital agreed to pay a $240,000 penalty.

Manasa Health Center was investigated after complaints were filed with OCR about impermissible disclosures of PHI in response to negative online reviews left by four patients. The case was settled with OCR and Manasa Health Center agreed to pay a $30,000 penalty. This was OCR’s third enforcement action in the past year to see a financial penalty for disclosures of PHI in response to negative patient reviews. No company likes to receive bad reviews and negative customer comments may be unjustified, but PHI must never be disclosed online in response to reviews.

iHealth Solutions, which does business as Advantum Health, was investigated over a relatively small data breach involving the exposure of the ePHI of 267 patients. Patient information was stored on a server that had not been properly secured, allowing protected health information to be accessed over the Internet. OCR determined that iHealth Solutions had failed to conduct an accurate, thorough, organization-wide risk analysis to identify all risks and vulnerabilities to the confidentiality, integrity, and availability of ePHI. The case was settled and iHealth Solutions agreed to pay a $75,000 penalty.

OCR has now imposed 8 financial penalties on HIPAA-regulated entities so far this year to resolve alleged violations of the HIPAA Rules with the penalties totaling $1,976,500. OCR has already exceeded last year’s total of $1,124,640 in fines that were collected from HIPAA-regulated entities in 17 enforcement actions.

State attorneys general can also impose financial penalties for HIPAA violations, although the fines are often imposed for equivalent violations of state laws, as was the case in California in June. In 2019, Kaiser Permanente sent mailings to its plan members, but an error resulted in letters being sent to old addresses, resulting in an impermissible disclosure of members’ protected health information. While this was a HIPAA violation, California imposed a financial penalty for violations of the California Confidentiality of Medical Information Act (CMIA) – an impermissible disclosure of the personal information of up to 175,000 individuals and the negligent maintenance and/or disposal of medical information. The case was settled for $450,000.

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