HIPAA Security Rule

HHS and American Hospital Association Alert Providers to Act Now on “Citrix Bleed” Vulnerability

Kathie McDonald-McClure Cyber Security and Cyber Crime, Data Privacy & Security, Health Information Technology , , , , , , , ,

The United States Health & Human Services Department (HHS) Health Sector Cybersecurity Coordination Center (HH3) issued an HH3 Sector Alert for a software vulnerability dubbed the “Citrix Bleed“. The HH3 Alert advises on a Citrix security advisory regarding a zero-day vulnerability that impacts the NetScaler ADC (formerly Citrix ADC) and NetScaler Gateway (fomerly Citrix Gateway). The HH3 Alert, issued on November 30, 2023, urges healthcare organizations to upgrade their devices to prevent damage to the health sector from cyber attacks, including ransomware.

Per the HH3 Alert, even if the patch that Citrix released for this vulnerability was implemented, Citrix warns that compromised sessions will still be active after the patch is implemented. Organizations should follow the Citrix guidance to upgrade devices and remove any active or persistent sessions with the commands listed in the Alert.

On December 1, 2023, the American Hospital Association (AHA) similarly alerted its members about the Citrix Bleed issuing its own alert titled, “Urgent: Hospital Action Needed to Protect Against ‘Citrix Bleed’ Threat.” AHA also published the following article the same day: “HHS-HC3 calls for immediate hospital action to protect against ‘Citrix Bleed’ vulnerability and ransomware threat.”

In its weekly Medicare MLN Connects news on December 7, 2023, the Centers for Medicare and Medicaid Services (CMS) asks providers to make sure their IT department reads the information and takes necessary action. Providers also should share the HH3 Alert with their network clearinghouse and vendors.

Relatedly, on December 6, 2023, CNN reported that HHS shared exclusively with CNN a plan focused on getting more money and training to small and rural health care providers who lack dedicated cybersecurity staff. CNN reported that Biden administration officials “have long been concerned that software providers continue to sell insecure products that hackers are too easily able to exploit.” Click here to read the full CNN article, titled “US health officials call for surge in funding and support for hospitals in wake of cyberattacks that diverted ambulances,” by Sean Lyngass.

Looking for assistance with your organization’s data security policies? We work with clients and their IT team in the preparation and updating of information security policies and procedures to comply with the HIPAA Security Rule, FTC Safeguards Rule, and more.  Such policies are essential in today’s cyber threats environment to meet the expectations of regulatory enforcement agencies such as the HHS Office for Civil Right and FTC. Information security policies also aide organizations in meeting other legal requirements and expections, e.g., contractual, cyber insurance underwriting, consumer, and other third-parties. If you are looking for assistance in this area, and to learn more about Wyatt’s data privacy and cyber security practice, visit the Wyatt Data Privacy & Cyber Security webpage.

If you need additional information, contact: Kathie McDonald-McClure, kmcclure@wyattfirm.com, at 502.562.7526

HITECH Act Amendment: Using “Recognized Security Practices” May Lead to More Favorable HHS Review and Reduced Fines After Data Breach

Kathie McDonald-McClure Data Privacy & Security, HIPAA, HITECH Law , , , , ,

by Margaret Young Levi and Kathie McDonald-McClure

Congress amended the Health Information Technology for Economic and Clinical Health Act (HITECH Act) on January 5, 2021.  This Amendment requires the U.S. Department of Health and Human Services (HHS) to favorably consider whether covered entities and business associates have implemented specific security measures when making decisions regarding penalties and audits under the Health Insurance Portability and Accountability Act (HIPAA). 

Specifically, the Amendment mandates HHS to “consider whether the covered entity or business associate has adequately demonstrated that it had, for not less than the previous 12 months, recognized security practices in place” when HHS is making decisions to (1) decrease fines, (2) decrease the length and extent of an audit or terminate an audit, and (3) mitigate other remedies with respect to resolving potential violations of the HIPAA Security Rule. 

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FBI Issues New COVID-19 Cyber Alert for Healthcare Providers on April 21, 2020

Kathie McDonald-McClure Cyber Security and Cyber Crime , , , , , ,

On April 21, 2020, the American Hospital Association alerted its members that the Federal Bureau of Investigations (FBI) had issued an FBI Flash to update healthcare providers on additional cyber activity* that continues to exploit fears related to the COVID-19 pandemic. The FBI stated that it had been notified of targeted email phishing attempts against US-based medical providers. The phishing attempts use subject lines and content related to COVID-19 and distribute malicious attachments. Individuals or companies receiving email with unsolicited attachments that may be a phishing attempt should NOT open the email or email attachment if the individual or the company does not have the capability to examine the attachment in a controlled and safe manner.

FBI Alert provides technical details. The FBI Flash provides technical details about the phishing campaign to assist individuals and company IT personnel in identifying the malicious emails. The technical details include a list of email senders, email subject lines, attachment file names and hashes related to the phishing attempts.

The FBI Requests Assistance to Respond to the Threat. To assist in the FBI’s response to the COVID-19 phishing campaign, the targeted individual, or his or her company, is being asked to:

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HHS Office for Civil Rights Issues Telehealth HIPAA Guidance during COVID-19 Emergency

Kathie McDonald-McClure Health Information Technology, HIPAA , , ,

On March 17, 2020, the Office for Civil Rights (“OCR”), the agency within the Department of the United States Health & Human Services (“HHS”) responsible for enforcement of HIPAA, issued the following guidance: “Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency.” Pursuant to Telehealth regulatory waivers issued by the HHS Centers for Medicare & Medicaid Services (“CMS”) effective during the COVID-19 Public Health Emergency (“PHE”), providers can use telehealth at any location including in a patient’s home. As more fully explained in its Telehealth Fact Sheet March 17, 2020, HHS stated:

“The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home. …  It is imperative during this public health emergency that patients avoid travel, when possible, to physicians’ offices, clinics, hospitals, or other health care facilities where they could risk their own or others’ exposure to further illness.” Continue reading →

Healthcare CIOs Face Cyber Risk: Internet Explorer Gives Hackers Total Access (Microsoft Issues Patch)

Kathie McDonald-McClure Electronic Health Records, Federal Law Resources, Health Information Technology , , ,

Microsoft's IE browser allows hackers to get keys for total access to otherwise secured data

Updated May 1, 2014 at 5:30 pm

The old weather proverb about March, in like a lion and out like a lamb, hit April in the reverse in the world of cyber security.  While the first six days of April seemed relatively calm in the cyber world, on Monday, April 7, 2014, the Heartbleed flaw in encryption security was announced (see our previous post here).  As of April 26, 2014, the month was still roaring like a lion with yet another newly discovered cyber security threat to Internet Explorer (IE), first announced by FireEye Research Labs.  Microsoft quickly confirmed the flaw on its Security TechCenter webpage.   Today, May 1, 2014, Microsoft released a critical security update announcing a patch for all versions of Microsoft IE, including XP, which have the vulnerable flaw.  This patch, which fixes the vulnerability discussed further in this article, should be immediately installed.

IE’s Vulnerability Dubbed “Operation Clandestine Fox.”  FireEye named the flaw “Operation Clandestine Fox” for a couple of reasons.  One is that hackers are already exploiting the vulnerability in an active “campaign.”  Further, FireEye said the exploits are “clandestine” because the hackers lure computer users to malicious web code, like a “fox” who lures prey to a watering hole and then moves in for the kill.

With the IE vulnerability, the hacker can use Adobe Flash content, a popular website or an email to bait the computer user to click on malicious HTML code.  This allows the hacker to download the malicious software to the user’s computer.  Once downloaded, the hacker gains access to the user’s computer and can then gather the information needed to access other programs and networks accessed by the user.  Such access can include otherwise secure servers, databases and networks.  The risk has been perceived as sufficiently significant to prompt the U.S. Department of Homeland Security to issue a security advisory to its CERT Vulnerability Alerts Database webpage.  Microsoft and Homeland Security are updating their advisories almost daily, requiring daily, if not hourly, vigilance on the part of Chief Information Officers (CIOs) in developing a responsive action plan.

HIPAA Security Rule Compliance: Develop An Action Plan. CIOs should immediately assess newly identified cyber security vulnerabilities posed to its networks and develop an action plan to address them.  The risk assessment should include an evaluation of how confidential electronic data is accessed by others such as employees, medical staff, patients, and third-party vendors.  Ensuring security is especially critical for those who can remotely access your organization’s electronic health record system. Continue reading →