This document discusses medical identity theft and data protection. It begins by outlining statistics on healthcare data breaches in the US, including their high costs and common causes. It then details types of medical identity theft and consequences for victims. The document also covers updates to HIPAA regulations and provides recommendations for securing patient data, including following security best practices, conducting risk assessments, and documenting policies and processes.

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robertGrupe, CISSP, CSSLP, PE, PMP
tags :|: medical identity, patient data, data protection
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PATIENT
MEDICAL IDENTITY &
DATA PROTECTION
SECURITY

2. • US Medical Identity Theft and Data Breaches
• HIPAA 2013 Omnibus Final Rule Updates
• Recommendations
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Agenda

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US MEDICAL IDENTITY THEFT
AND DATA BREACHES

4. • Top Industries Cost
• 1. Healthcare $233 per person
• 2. Finance $215
• 3. Pharmaceutical $207
• Top Causes
• 41% Malicious attack
• 33% Human Factor
• 26% System glitch
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US Data Breaches
2013 Cost of Data Breach Study: Global Analysis, Ponemon Institute
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5. • 94% health-care organizations have been hit by at least
one data breach,
• 45% more than five breaches in the past two years
• $2.4 million estimated average cost over 2 years
• $10,000 - $1+ million per incident
• 2,796 average number of records lost per breach
• 47% detected by employees
• 52% breaches discovered by audits
• Black Market Data Value
• $50 per medical record (SSNs go for about $1 each)
• Criminal Mis-Use
• Overseas call centers ordering medical equipment and drugs
Ponemon Institute’s Third Annual Benchmark Study on Patient Privacy & Data Security. Dec 2012
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US Healthcare Data Breaches

6. • $1.8 million, 19%+ over 2012
• Causes
• 30% Member shared identification with a friend/family member
• 28% Acquaintance or family member stole
• 8% provided in phishing
• 7% provider/insurer due to data breach
• 5% healthcare worker
• Criminal mis-uses
• 63% treatments
• 60% prescriptions and equipment
• 51% obtain government benefits
• 12% credit card account applications
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US Medical Identity Theft
• Difficulties detecting
• 56% Patients don’t check their records for accuracies
2013 Survey on Medical Identity Theft, Ponemon Institute
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7. • “Medical Identity theft is being called the fastest growing
type of fraud.
• This contributes to rising cost in health care.”
• Unlike financial identity theft, medical identity theft holds
life threatening impacts.
• For example if you are rushed to the ER with appendicitis but your
records already show your appendicitis removed, the
consequences can be dangerous.”
• Medical Identity Fraud Alliance, Development Coordinator Robin Slade
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Consequences

8. • 50% of victims unaware creates inaccuracies in their records
• 15% misdiagnosis
• 14% treatment delays
• 13% mistreatment
• 11% wrong prescription
• 23% credit rating
• 20% financial identity theft (credit card, banking)
• 17% legal fees
• Loss of coverage, cost to restore, out-of-pocket costs, increased
premiums
• 6% employment difficulties
• 58% victims lost trust in providers
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Patient Harm

9. • Member, client, provider communications
• Member online security monitoring and restoration
services
• Response and reputation crisis management
• Loss of business
• Law suites: members, customers, investors
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Enterprise Consequences

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HIPAA Breach Notifications

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HIPAA 2013 OMNIBUS
FINAL RULE UPDATES

12. • Defines Business Associates of Covered Entities directly liable for
•
•
•
•
compliance with certain of the HIPAA Privacy and Security Rules'
requirements.
Require modifications to, and redistribution of, a Covered Entity's
notice of privacy practices.
Final rule adopting changes to the HIPAA Enforcement Rule to
incorporate the increased and tiered civil money penalty structure
provided by the HITECH Act.
Final rule on Breach Notification for Unsecured Protected Health
Information under the HITECH Act, which replaces the breach
notification rule's "harm" threshold
Violation Penalties
•
•
•
•
(A) Did Not Know (with reasonable diligence) $100+
(B) Reasonable Cause $1,000+
(C)(i) Willful Neglect-Corrected $10,000+
(C)(ii) Willful Neglect-Not Corrected $50,000
HHS Omnibus http://www.hhs.gov/ocr/privacy/hipaa/administrative/omnibus/index.html
http://www.hipaasurvivalguide.com/hipaa-omnibus-rule.php
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HIPAA 2013 Omnibus Final Rule Updates

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RECOMMENDATIONS

14. • Last patched software maintenance
• Install anti-virus and application IDS everywhere
• (Yes: Mac OS, iOS, Linux, and Android too)
• Strong Credential Management
• Strong Passwords and management policies
• Network Mapping
• Sites, gateways, routers, devices,
• then directory details for all devices
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Master the Basics

15. • What security laws and regulations effect your
organization
• Heath Care: HIPAA, states
• Financial: PCI, etc.
• Personal: States, EU
• Other
• Map your external app’s PHI flows
• Workflows
• Reference lookups
• Data backups
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Risk Assessment

16. If it isn’t documented, it doesn’t exist
• Use an industry recognized framework
• E.g. ISO/IEC 27001:2005
• Living Document: Continual detailing and updating
• Don’t use all at once, keep section numbers but only draft and publish active sections
• Identify information security best practices
• Reference for Minimum acceptable security
• Industry (e.g. HIPAA, HITRUST, ARRA) state (Mass.), third party (e.g., PCI and
COBIT), government (e.g., NIST, FTC and CMS), appdev (e.g. OWASP)
• Application regression test scripts for all policy rules validation
• Responsible Program Manager to
• prioritize critical success factors and initiatives
• ensure document maintenance
• champion process improvements
• oversee system/application/services updates
• ensure compliance validation
• provide status reporting
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Document Your Policies & Processes

17. • Don’t Procrastinate - Start Right Now!
• With quick list brainstorm
• Continuous Process Improvement
• What doesn’t get measured, doesn’t get done
• Regular Privacy controls and processes Risk Assessment
• Security Technology isn’t the (whole) solution
• Vulnerability assessment utilities to detect security policy & process
vulnerabilities
• E.g. Social engineering vulnerabilities
• Insider data access
• User validation
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Well Begun, Is Half Done

18. • This Presentation & Further Resources
• www.red7managementsolutions.com
• Questions, suggestions, & requests
• Robert Grupe, CISSP, CSSLP, PE, PMP
• robert.grupe@red7managementsolutions.com
• +1.314.278.7901
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Finis