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07.16.21

HHS OIG review calls out CMS’s lack of cybersecurity oversight

BY Julia E. Cassidy

The Office of the Inspector General (OIG) in the Department of Health and Human Services (HHS) recently conducted a review of the Centers for Medicare and Medicaid Services' (CMS’s) survey standards for hospital cybersecurity and determined that CMS lacks consistent oversight of networked-devices cybersecurity in hospitals. This lack of oversight is especially concerning in light of the many cybersecurity threats that hospitals have faced (and continue to face) and the recent increase in attacks against health care organizations.

 The OIG looked specifically at networked medical devices, or networked devices, which they defined as devices designed to connect to the internet, hospital networks, and other medical devices, providing features that improve health care and increase the ability of health providers to treat patients. These include systems that obtain, archive, and communicate pictures on networks within health care facilities (such as ultrasounds, MRIs, and nuclear medicine) and systems that monitor patient activity (such as electrocardiographic systems). The OIG noted that some of these networked devices also connect to the hospital’s electronic health record (EHR) system. As a result, networked devices lacking proper cybersecurity protection can potentially have significant vulnerabilities, which could lead to widespread data exposure and damaging cyberattacks.

Approximately, every three years, CMS uses both state survey agencies and Medicare accreditation organizations (AOs) to inspect Medicare-participating hospitals through on-site surveys. When state agencies conduct such surveys, they follow CMS’s survey protocol, which does not require hospitals to have any cybersecurity protections for networked devices. AOs follow their own survey protocols, which are required by the Social Security Act to be equivalent to or more stringent than those of CMS. CMS reviews the AO survey protocols and conducts complaint investigations and random surveys of hospitals AOs have surveyed. However, due to the fact that CMS’s survey protocols do not include any requirements for the cybersecurity of networked devices, AOs are under no obligation to do so. Consequently, it is unlikely that CMS or an AO will ask hospitals how they protect networked devices from cybersecurity attacks.

The OIG noted that neither CMS nor AOs have plans to update their oversight of hospital cybersecurity in general or of networked devices and recommended that CMS identify and implement an appropriate way to address the cybersecurity of networked devices in its oversight of hospitals. CMS’s lack of attention to cybersecurity is harmful for hospitals and health care providers, as the frequency of cybersecurity attacks is only increasing, and failure to properly secure hospital devices will only make such attacks easier and more frequent. The OIG noted that it awaits further detail on CMS’s cybersecurity plan.

Despite CMS’s lack of oversight on cybersecurity matters, hospitals and health care systems should continue heightened scrutiny of their cybersecurity practices in order to protect their patients and systems against these harmful threats and vulnerabilities. 

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Julia E. Cassidy

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