HHS Settles with Bryan County Ambulance Authority Over HIPAA Violations Stemming from Ransomware Attack

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WASHINGTON, D.C. — The U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), has reached a settlement with Bryan County Ambulance Authority (BCAA) in Oklahoma regarding potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule. This resolution follows an OCR investigation into a ransomware incident that compromised the security of electronic protected health information (ePHI) under BCAA’s management.

Ransomware attacks, a significant cyber threat to the healthcare sector, have seen a dramatic increase of 264% in reported large breaches since 2018. In a ransomware attack, malicious software encrypts a user’s data, typically demanding payment for decryption. The breach at BCAA, reported to OCR in May 2022, resulted in the encryption of files containing the ePHI of 14,273 patients. OCR’s investigation revealed that BCAA had not conducted a compliant risk analysis to identify potential risks and vulnerabilities to ePHI in its systems, a fundamental requirement under the HIPAA Security Rule.

This settlement marks a pivotal enforcement action under OCR’s Risk Analysis Initiative, an effort designed to emphasize the necessity of rigorous risk analysis as a cornerstone of effective cybersecurity and HIPAA compliance. OCR Director Melanie Fontes Rainer highlighted the importance of knowing where ePHI is stored and the security measures in place to protect it, underscoring that neglecting these critical steps leaves healthcare entities vulnerable to cyberattacks.

Under the terms of the resolution agreement, BCAA has agreed to pay $90,000 and adopt a corrective action plan, which will be monitored by OCR over the next three years. The corrective actions include conducting a thorough risk analysis to assess potential threats to ePHI, implementing a robust risk management plan to address identified vulnerabilities, and developing comprehensive HIPAA-compliant policies and procedures. Additionally, BCAA is required to train its workforce on these policies to ensure adherence to HIPAA rules.

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OCR also advises other healthcare entities and their associates to take proactive measures against cyber-threats. These include regular integration of risk analysis and management into business processes, establishing audit controls to monitor information system activities, and employing multi-factor authentication to safeguard ePHI access. Encrypting ePHI and drawing lessons from past incidents to refine security management are also recommended practices.

This settlement spotlights the critical importance of compliance with the HIPAA Security Rule to protect sensitive patient information and to fortify defenses against the ever-evolving landscape of cyber threats in healthcare.

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