Addressing Gaps in Cybersecurity: OCR Releases Crosswalk Between HIPAA Security Rule and NIST Cybersecurity Framework

The sensitive health information maintained by health care providers and health plans has become an increasingly attractive target for cyberattacks. The need for health care organizations to up their game on health data security has never been greater.

To help health care organizations covered by the Health Insurance Portability and Accountability Act (HIPAA) to bolster their security posture, the Office for Civil Rights (OCR) today has released a crosswalk developed with the National Institute of Standards and Technology (NIST) and the Office of the National Coordinator for Health IT (ONC), that identifies “mappings” between the NIST Framework for Improving Critical Infrastructure Cybersecurity (the Cybersecurity Framework) and the HIPAA Security Rule.  The crosswalk also includes mappings to other commonly used security frameworks.

In addressing security, many entities both within and outside of the healthcare sector have voluntarily relied on detailed security guidance and specific standards issued by NIST. In February 2014, NIST released the Cybersecurity Framework to help organizations in any industry to understand, communicate and manage cybersecurity risks.

Entities covered by HIPAA must implement strong data security safeguards in their environments, and in particular, comply with the HIPAA Security Rule to ensure the confidentiality, integrity, and availability of all of the electronic protected health information (ePHI) they create, receive, maintain or transmit. We hear frequently from covered entities and business associates who say they are working hard in an increasingly challenging atmosphere to assure their PHI is adequately protected. We also know from our HIPAA enforcement work that far too frequently entities are leaving PHI vulnerable to breach and access by unauthorized persons. According to a report in USA Today, the healthcare industry has accounted for over 40 percent of data breaches over the last three years, and 91 percent of all health organizations have reported a breach over the last two years.

Organizations that have already aligned their security programs to either the NIST Cybersecurity Framework or the HIPAA Security Rule may find this crosswalk helpful in identifying potential gaps in their programs. Taking specific action to address these gaps can bolster compliance with the Security Rule and improve an entity’s ability to secure ePHI from a broad range of threats. The HIPAA Security Rule is designed to be flexible, scalable, and technology-neutral, which enables it to accommodate integration with more detailed frameworks such as the NIST Cybersecurity Framework. Although the Security Rule does not require use of the NIST Cybersecurity Framework, and use of the Framework does not guarantee HIPAA compliance, the crosswalk provides an informative tool for entities to use to help them more comprehensively manage security risks in their environments.

In addition, Congress, in both the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) as well as the Cybersecurity Information Sharing Act of 2015 (CISA), called for guidance on implementation of NIST frameworks. In response, this crosswalk provides a helpful roadmap for HIPAA covered entities and their business associates to understand the overlap between the NIST Cybersecurity Framework, the HIPAA Security Rule, and other security frameworks that can help entities safeguard health data in a time of increasing risks. The crosswalk also supports the President’s Cybersecurity National Action Plan (CNAP) by encouraging HIPAA covered entities and their business associates to enhance their security programs, increase cybersecurity awareness, and implement appropriate security measures to protect ePHI.

Entities can also find additional resources on the HIPAA Security Rule at

Content created by Office for Civil Rights (OCR)
Content last reviewed on February 23, 2016