November was a relatively quiet month for healthcare data breaches with 31% fewer breaches reported than the previous month. November’s total of 49 breaches of 500 or more records was also well below the 12-month average of 58 breaches a month. 643 healthcare data breaches have been reported to the HHS’ Office for Civil Rights so far in 2022, which makes this year the second worst year to date for healthcare data breaches.

Despite the fall in reported breaches, the number of breached records increased by 10% from October. November was the worst month of 2022 in terms of the number of breached healthcare records, with 6,904,441 records exposed or impermissibly disclosed – Well above the 12-month average of 3.99 million records a month. So far in 2022, 44,852,648 healthcare records have been breached.

Largest Healthcare Data Breaches in November

17 breaches of 10,000 or more records were reported to OCR in November, five of which involved more than half a million records and three incidents involved the impermissible disclosure of more than 1 million records. The largest data breach was a hacked network server at the Pennsylvania-based business associate Connexin Software – A provider of electronic medical records to pediatric practices. An unauthorized individual gained access to an offline set of patient data that was used for data conversion and troubleshooting. The records of 2,216,365 patients were exposed and potentially stolen.

The Indiana-based healthcare provider, Community Health Network, reported an impermissible disclosure of the protected health information of up to 1.5 million patients. Tracking code had been added to its website that resulted in patient information being transferred to third parties such as Meta and Google, without obtaining consent from patients or having a business associate agreement in place. Several healthcare providers have reported similar breaches this year, prompting OCR to issue a warning to HIPAA-regulated entities this month over the use of tracking technologies on websites and mobile applications.

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Doctors’ Center Hospital in Puerto Rico suffered a ransomware attack that exposed the protected health information of up to 1,195,220 patients. Major ransomware attacks were also reported by the Michigan-based prosthetics and orthotics provider, Wright & Filippis, and Health Care Management Solutions in West Virginia.

Name of Covered Entity State Covered Entity Type Individuals Affected Type of Breach Cause of Data Breach
Connexin Software, Inc. PA Business Associate 2,216,365 Hacking/IT Incident Hacking of network server
Community Health Network, Inc. as an Affiliated Covered Entity IN Healthcare Provider 1,500,000 Unauthorized Access/Disclosure Website tracking code transmitted PHI to third parties
Doctors’ Center Hospital PR Healthcare Provider 1,195,220 Hacking/IT Incident Ransomware attack
Wright & Filippis LLC MI Healthcare Provider 877,584 Hacking/IT Incident Ransomware attack
Health Care Management Solutions, LLC WV Business Associate 500,000 Hacking/IT Incident Ransomware attack on subcontractor of CMS business associate
Gateway Rehabilitation Center PA Healthcare Provider 130,000 Hacking/IT Incident Hacking of network server
Mena Regional Health System AR Healthcare Provider 84,814 Hacking/IT Incident Hacking of network server
Dallam Hartley Counties Hospital District TX Healthcare Provider 69,835 Hacking/IT Incident Hacking of network server (data theft confirmed)
Consumer Directed Services in Texas, Inc. TX Healthcare Provider 56,728 Hacking/IT Incident Hacking incident at a business associate
Stanley Street Treatment and Resources, Inc. MA Healthcare Provider 45,785 Hacking/IT Incident Hacking of network server (data theft confirmed)
South Walton Fire District FL Healthcare Provider 25,331 Hacking/IT Incident South Walton Fire District
Rosenfeld VanWirt, PC PA Business Associate 18,719 Hacking/IT Incident Hacking incident affecting multiple affiliates of the Lehigh Valley Health Network
CCA Health Plans of California, Inc d/b/a CCA Health CA CA Health Plan 14,631 Hacking/IT Incident Hacking of network server (data theft confirmed)
CareFirst Administrators MD Health Plan 14,538 Hacking/IT Incident Phishing attack on business associate
Work Health Solutions CA Healthcare Provider 13,157 Hacking/IT Incident Phishing attack
New York-Presbyterian Hospital NY Healthcare Provider 12,000 Hacking/IT Incident Hacking of network server
Epic Management LLC TN Healthcare Provider 10,862 Hacking/IT Incident Unauthorized email account access

Causes of November Data Breaches

All but one of the 17 data breaches of 10,000 or more records were due to hacking incidents, several of which were ransomware attacks. Many hacking incidents involve ransomware, although it is common for HIPAA-regulated entities not to disclose the exact nature of these attacks. It is therefore difficult to determine the extent to which ransomware is used in cyberattacks on the healthcare industry. 5,374,670 records were exposed or stolen in these hacking incidents – 77.8% of all records breached in November. The average breach size was 134,367 records and the median breach size was 7,158 records.

There were 8 unauthorized access/disclosure incidents reported that involved the records of 1,521,788 individuals. The majority of those records were impermissibly disclosed by one healthcare provider. The average breach size was 190,224 records and the median breach size was 2,275 records.  There was also one theft incident reported involving the records of 7,983 individuals. In the majority of reported incidents, the breached protected health information was located on network servers. There were also 7 incidents involving breaches of email data, and four incidents involving electronic health records.

HIPAA-Regulated Entities Affected by Data Breaches

Healthcare providers were the worst affected entities in November, with 26 reported breaches, one of which occurred at a business associate but was reported by the healthcare provider. 6 data breaches were reported by health plans, with one of those breaches occurring at a business associate. Business associates self-reported 17 breaches in November. The pie chart below shows the breakdown of data breaches based on where they occurred, rather than the entities reporting the data breaches.

Healthcare Data Breaches by State

Data breaches were reported by HIPAA-regulated entities in 18 states and Puerto Rico. Pennsylvania was the worst affected state with 12 breaches, which involved 34.8% of the month’s breached records. 10 of those breaches were due to a hacking incident involving healthcare providers that are part of the Lehigh Valley Health Network. HIPAA-regulated entities in California reported 6 breaches, but these were relatively minor, only involving the protected health information of 41,382 patients.

State Breaches
Pennsylvania 12
California 6
Florida & New York 4
Texas 3
Arkansas, Connecticut, Indiana, Maryland, Massachusetts & Tennessee 2
Georgia, Michigan, New Jersey, Nevada, Oregon, Washington, West Virginia, and Puerto Rico 1

HIPAA Enforcement Activity in November

No civil monetary penalties or settlements were announced by OCR in November. Even so, 2022 has seen more HIPAA enforcement actions than in any other year since OCR was given the authority to enforce HIPAA compliance. The majority of the financial penalties in 2022 have been imposed for violations of the HIPAA right of access, and 55% of the year’s enforcement actions over HIPAA violations were on small healthcare providers.

In November, the state of Massachusetts announced that Aveanna Healthcare had been fined $425,000 for a breach of the PHI of 166,000 individuals, 4,000 of whom were Massachusetts residents. Aveanna Healthcare had suffered a phishing attack, with the Massachusetts Attorney General discovering a lack of safeguards such as multi-factor authentication and security awareness training.


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