Per the notice below, the United States Office for Civil Rights (OCR) has taken another action under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) against a health care provider stemming from a ransomware incident.

HHS Office for Civil Rights Imposes a $240,000 Civil Monetary Penalty Against Providence Medical Institute in HIPAA Ransomware Cybersecurity Investigation

Civil Monetary Penalty marks OCR’s fifth ransomware enforcement action amid a 264% increase in large ransomware breaches since 2018

The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $240,000 civil monetary penalty against Providence Medical Institute in Southern California, concerning potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule, following a ransomware attack breach report investigation by OCR.  Ransomware and hacking are the primary cyber-threats in health care.  There has been a 264% increase in large breaches reported to OCR involving ransomware attacks since 2018.

“Failures to fully implement all of the HIPAA Security Rule requirements leaves HIPAA covered entities and business associates vulnerable to cyberattacks at the expense of the privacy and security of patients’ health information,” said OCR Director Melanie Fontes Rainer.  “The health care sector needs to get serious about cybersecurity and complying with HIPAA.  OCR will continue to stand up for patient privacy and work to ensure the security of health information of every person.  On behalf of OCR, I urge all health care entities to always stay alert and take every precaution and steps to keep their systems safe from cyberattacks.”

OCR enforces the HIPAA Privacy, Security, and Breach Notification Rules, which sets forth the requirements that covered entities (health plans, health care clearinghouses, and most health care providers), and business associates must follow to protect the privacy and security of protected health information.  The HIPAA Security Rule establishes national standards to protect individuals' electronic personal health information that is created, received, used, or maintained by a covered entity.  It also requires appropriate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information.  The Civil Money Penalty resolves OCR’s investigation concerning Providence Medical Institute’s compliance with the HIPAA Security Rule.  OCR initiated an investigation following the receipt of a breach report filed by Providence Medical Institute in April 2018, which reported that its systems were impacted by a series of ransomware attacks that affected the electronic protected health information (ePHI) of 85,000 individuals between February and March 2018.  OCR’s investigation determined that servers containing ePHI were encrypted with ransomware three times.  OCR found two potential violations of the HIPAA Security Rule, including failure to have a business associate agreement in place and failure to implement policies and procedures to allow only authorized persons or software programs access to ePHI.  In March 2024, OCR issued a Notice of Proposed Determination seeking to impose a civil money penalty.  Providence Medical Institute waived its right to a hearing and did not contest OCR’s findings.  Accordingly, OCR imposed a civil money penalty of $240,000.

The Notice of Proposed Determination may be found at: https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/pmi-npd/index.html.

The Notice of Final Determination may be found at: https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/pmi-nfd/index.html.

OCR recommends that health care providers, health plans, clearinghouses, and business associates that are covered by HIPAA take the following steps to mitigate or prevent cyber-threats:

• Review all vendor and contractor relationships to ensure business associate agreements are in place as appropriate and address breach/security incident obligations.
• Integrate risk analysis and risk management into business processes; conducted regularly and when new technologies and business operations are planned.
• Ensure audit controls are in place to record and examine information system activity.
• Implement regular review of information system activity.
• Utilize multi-factor authentication to ensure only authorized users are accessing ePHI.
• Encrypt ePHI to guard against unauthorized access to ePHI.
• Incorporate lessons learned from incidents into the overall security management process.
• Provide training specific to organization and job responsibilities and on regular basis; reinforce workforce members’ critical role in protecting privacy and security.

The HHS Breach Portal: Notice to the Secretary of HHS Breach of Unsecured Protected Health Information may be found at: https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf.  OCR is committed to enforcing the HIPAA Rules that protect the privacy and security of peoples’ health information.  Guidance about the Privacy Rule, Security Rule, and Breach Notification Rules can also be found on OCR’s website.  If you believe that your or another person’s health information privacy or civil rights have been violated, you can file a complaint with OCR at: https://www.hhs.gov/ocr/complaints/index.html.