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The HIPAA Security Rule is Changing: Is Your Practice Ready?

January 23, 2025

The HIPAA Security Rule went into effect in 2003, and it’s an understatement to say that technology has changed quite a bit since then. 

The Office for Civil Rights has released proposed updates for the HIPAA Security Rule. After a historic year of breaches, this legislation comprehensively strengthens the current Rule. This is the first update of the legislation in a decade. Many of the new requirements simply reinforce existing recommendations within the Security Rule, which now makes best practices mandatory.

This legislation is the result of the significant rise in cyber attacks and the OCR’s continuous noncompliant findings when investigating Covered Entities and Business Associates. 

Although the proposed rule has not yet been finalized, legislation will likely be enacted within the next year, given bipartisan support for protecting patient data.

What is the HIPAA Security Rule?

The Security Rule, a critical component of HIPAA, centers on stringent guidelines for managing electronic Protected Health Information (ePHI). These guidelines encompass a wide range of safeguards—including physical, administrative, and technical—all designed to ensure the protection of sensitive patient data.

One of the most significant components of the Security Rule is completing a Security Risk Analysis (SRA). The SRA sets a benchmark for your practice and assesses what your practice currently does to protect patient data. This analysis includes safeguards ranging from physical measures, like door alarms, to technical precautions, like properly encrypting files. 

This analysis is a yearly procedure for the OCR and continues to be emphasized in this proposal. In this new proposal, the OCR strictly defines the SRA as a yearly requirement with more guidelines on specific questions. The OCR has introduced eight implementation specifications for risk analysis. This also includes a thorough analysis of potential natural disasters and the consequences if a Business Associate was breached. 

In fact, the government has introduced a Risk Analysis Initiative, fining practices and businesses that do not complete this analysis. 

While this assessment is a major component of this rule, once vulnerabilities are identified, it’s up to your practice to implement these safeguards to protect your patients. 

What’s Changing? 

This proposed rule mandates that Covered Entities and their Business Associates implement certain proactive measures that were previously only strongly recommended, such as multi-factor authentication.

As technology has greatly advanced since the introduction of this rule, there are also more requirements focused on system management, including required anti-malware protection, disabling unused network ports, and a network map, highlighting what devices are connected to specific networks in an organization. Network segmentation is another advancement of the rule, requiring practices to use different networks based on access to specific information. 

New policies and procedures will also be required if this proposal goes into effect. For instance, contingency plans will be required, showing what a practice or business plans to do if it is breached within 72 hours. Additionally, practices need to have a transition plan when staff leaves, and they need to notify other regulated entities when a staff member’s access to ePHI is changed or terminated. 

Business Associates (BAs) will also face stricter requirements when working with Covered Entities. If breached, BAs must notify their Covered Entities within 24 hours. BAs will also now have to have their compliance program certified by a Subject Matter Expert in cybersecurity on a yearly basis, ensuring that the business is taking the right steps to protect patient data. 

What Can I Do? 

While this rule is still within its comment period until early March, it could be enacted this year. Being aware of upcoming HIPAA legislation and preparing your practice is vital. 

Working with a smart compliance solution can take the pressure off, with compliance experts updating their systems to ensure their users will be compliant with new laws. 

Looking to understand HIPAA compliance for your practice before new laws take effect? Schedule a consultation with one of our experts today.

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$700K HIPAA Settlement: What the Ambry Genetics Phishing Breach Teaches Every Practice

September 21, 2026 Penelope Schweitzer No comments yet

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Right of Access Enforcement Hits Eye Care: Inside the Azul Vision Settlement

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September 1, 2026   The Office for Civil Rights (OCR) announced its 55th settlement under the HIPAA Right of Access Initiative, and this one is a good reminder that “we’ll get to it” is an easy shortcut to a massive financial penalty.   What happened Azul Vision, Inc., a California optometry enterprise healthcare provider, took nearly two years to provide a patient her healthcare records failed to give a patient timely access to her health records. She requested her records in January 2023. She didn’t actually receive them until January 2025, or two years later, and only after OCR opened an investigation following her complaint in April 2023.   The importance of Right of Access The HIPAA Privacy Rule’s Right of Access is straightforward: patients are entitled to their healthcare records within 30 days of a request, with one possible 30-day extension if needed.    The cost Azul Vision agreed to a two-year, OCR-monitored corrective action plan and paid $50,000. The corrective action plan requires the practice to: Review and revise its written policies and procedures for Privacy Rule compliance.  Regularly report to HHS a log of every PHI access request it receives, including when it came in and when it was resolved, Train all workforce members on right of access requirements and the practice’s own procedures.   Practical takeaways Have a documented, assigned process for access requests: not an informal “someone will handle it” arrangement. Track every request against the 30-day (or extended 60-day) clock: If nothing is timestamping requests, nothing is catching the ones that slip. Train staff specifically on right of access: this is a distinct Privacy Rule obligation from general HIPAA awareness, and it’s clearly one OCR is actively enforcing.   The bottom line A single records request that went unanswered turned into a $50,000 penalty, two years of federal monitoring, and a detrimental hit to the organization’s reputation. That’s a steep price for what really comes down to a missing process. If your team can’t answer “what happens the moment a patient asks for their records?” right now, that’s the gap to close before your practice ends up as OCR’s next enforcement case. Want a streamlined way to close your compliance gaps? Meet with an Abyde expert today!

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August 5, 2026 The latest HIPAA fine is another clear reminder that ransomware attacks are, unfortunately, here to stay in the healthcare industry. A settlement involving the OSF Healthcare System was recently announced by the Office for Civil Rights (OCR). As an enterprise healthcare provider in the midwest, the organization serves 174 locations, including 16 hospitals – a prime target for a ransomware attack.    So, what happened?  In April 2021, OSF discovered that they joined the unlucky club of ransomware victims when a malicious actor deployed Nephilim, a ransomware strain made to target larger organizations. Once the ransomware infected OSF systems, the hacker demanded payment or patient Protected Health Information (PHI) would be leaked online. In this attack, sensitive information like financial account information, driver’s license numbers, medical record numbers, and more, were all exposed. Over 53,000 patient records were exposed in this attack.  When ransomware attacks in healthcare have soared 278% in recent years, it’s more of a when then an if your organization doesn’t have the right safeguards in place.  While the breach was discovered in April, OSF healthcare reported the breach to the OCR in October. The OCR took it from there, digging into what precautions (or lack thereof) let this happen.  What did the OCR discover? If you’ve read any of our other fine breakdowns, you already know where this is going: another missing Security Risk Analysis (SRA).  The SRA is a required document every HIPAA-regulated entity (ie: every practice and their Business Associates that handle patient information) needs to complete. The SRA is a thorough review of the physical, technical, and administrative safeguards in place to prevent PHI ending up in the wrong hands. While the OCR didn’t specify exactly how the ransomware got into OSF’s system, a technical safeguard vulnerability was very likely the entry point. A proactive SRA could have flagged that gap before it turned into a major breach. In addition to missing this required documentation, OSF also took too long to report the breach to the OCR and notify affected patients. This is a direct violation of the Breach Notification Rule, which requires organizations to notify patients within 60 days of a discovered breach. Moreover, since the breach impacted more than 500 patients, OSF was also required to report this breach to the OCR within 2 months as well. Time is of the essence in every component of a breach, from securing systems to ensuring affected parties are aware to protect themselves and an over five month delay was unacceptable in the eyes of the OCR.    What was the result?  OSF’s settlement tops the list as the largest fine of the year, coming in at $552,250, plus government monitoring for the next two years.  It’s very important to note that this breach occurred in 2021, meaning that over five years were spent from the initial breach, to investigations, to the public press releases. Also, the average cost of a healthcare breach is over 7 million dollars –  from implementing secure systems, notifying patients, legal fees, and more. The Takeaway While the settlement payment and Corrective Action Plan (CAP) are just the cherries on top, this experience was a tremendous cost of time, money, and resources, highlighting the importance of making sure everything is secure before a situation occurs.  So, when was the last time you looked at your SRA? It’s time to seriously analyze your current compliance posture. Ransomware groups don’t check whether you’re a small dental office or a 16-hospital health system before they attack, they check whether the door was left open. Time and again, OCR’s findings come back to the same root cause: organizations can’t secure what they haven’t even identified as a problem. Looking to review your current compliance standings? Meet with our team of experts for a complimentary educational consultation. 

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