Breach Notification Requirements

Following a breach of unsecured protected health information, covered entities must provide notification of the breach to affected individuals, the Secretary, and, in certain circumstances, to the media. In addition, business associates must notify covered entities if a breach occurs at or by the business associate.

Individual Notice

Covered entities must notify affected individuals following the discovery of a breach of unsecured protected health information. Covered entities must provide this individual notice in written form by first-class mail, or alternatively, by e-mail if the affected individual has agreed to receive such notices electronically. If the covered entity has insufficient or out-of-date contact information for 10 or more individuals, the covered entity must provide substitute individual notice by either posting the notice on the home page of its web site for at least 90 days or by providing the notice in major print or broadcast media where the affected individuals likely reside. The covered entity must include a toll-free phone number that remains active for at least 90 days where individuals can learn if their information was involved in the breach. If the covered entity has insufficient or out-of-date contact information for fewer than 10 individuals, the covered entity may provide substitute notice by an alternative form of written notice, by telephone, or other means.  

These individual notifications must be provided without unreasonable delay and in no case later than 60 days following the discovery of a breach and must include, to the extent possible, a brief description of the breach, a description of the types of information that were involved in the breach, the steps affected individuals should take to protect themselves from potential harm, a brief description of what the covered entity is doing to investigate the breach, mitigate the harm, and prevent further breaches, as well as contact information for the covered entity (or business associate, as applicable).

With respect to a breach at or by a business associate, while the covered entity is ultimately responsible for ensuring individuals are notified, the covered entity may delegate the responsibility of providing individual notices to the business associate.  Covered entities and business associates should consider which entity is in the best position to provide notice to the individual, which may depend on various circumstances, such as the functions the business associate performs on behalf of the covered entity and which entity has the relationship with the individual.  

Media Notice

Covered entities that experience a breach affecting more than 500 residents of a State or jurisdiction are, in addition to notifying the affected individuals, required to provide notice to prominent media outlets serving the State or jurisdiction.  Covered entities will likely provide this notification in the form of a press release to appropriate media outlets serving the affected area.  Like individual notice, this media notification must be provided without unreasonable delay and in no case later than 60 days following the discovery of a breach and must include the same information required for the individual notice.

Notice to the Secretary

In addition to notifying affected individuals and the media (where appropriate), covered entities must notify the Secretary of breaches of unsecured protected health information. Covered entities will notify the Secretary by visiting the HHS web site and filling out and electronically submitting a breach report form. If a breach affects 500 or more individuals, covered entities must notify the Secretary without unreasonable delay and in no case later than 60 days following a breach. If, however, a breach affects fewer than 500 individuals, the covered entity may notify the Secretary of such breaches on an annual basis. Reports of breaches affecting fewer than 500 individuals are due to the Secretary no later than 60 days after the end of the calendar year in which the breaches are discovered.



In today's interconnected world, data breaches are an unfortunate reality. Whether it's a sophisticated cyberattack or a simple human error, the unauthorized access to sensitive information can have devastating consequences for individuals and organizations alike. While prevention is paramount, knowing how to respond effectively in the aftermath of a breach is equally critical. A key aspect of that response is data breach reporting. Why is Data Breach Reporting So Important? Data breach reporting is the process of notifying relevant authorities and affected parties about a security incident that has compromised personal or sensitive data. It's more than just an administrative formality; it's a legal obligation in many jurisdictions and has a profound impact on: Protecting Individuals: Prompt reporting allows affected individuals to take necessary steps to mitigate potential harm, such as changing passwords, monitoring their credit reports, and being vigilant against identity theft.Legal Compliance: Numerous laws and regulations, like ...read more



If a breach of unsecured protected health information occurs at or by a business associate, the business associate must notify the covered entity following the discovery of the breach.  A business associate must provide notice to the covered entity without unreasonable delay and no later than 60 days from the discovery of the breach.  To the extent possible, the business associate should provide the covered entity with the identification of each individual affected by the breach as well as any other available information required to be provided by the covered entity in its notification to affected individuals. ...read more



Protected health information (PHI) is rendered unusable, unreadable, or indecipherable to unauthorized individuals if one or more of the following applies: Electronic PHI has been encrypted as specified in the HIPAA Security Rule by “the use of an algorithmic process to transform data into a form in which there is a low probability of assigning meaning without use of a confidential process or key” (45 CFR 164.304 definition of encryption) and such confidential process or key that might enable decryption has not been breached.  To avoid a breach of the confidential process or key, these decryption tools should be stored on a device or at a location separate from the data they are used to encrypt or decrypt.  The encryption processes identified below have been tested by the National Institute of Standards and Technology (NIST) and judged to meet this standard. Valid encryption processes for data at rest are ...read more



In today's interconnected world, data breaches are an unfortunate reality. Whether it's a sophisticated cyberattack or a simple human error, the unauthorized access to sensitive information can have devastating consequences for individuals and organizations alike. While prevention is paramount, knowing how to respond effectively in the aftermath of a breach is equally critical. A key aspect of that response is data breach reporting. Why is Data Breach Reporting So Important? Data breach reporting is the process of notifying relevant authorities and affected parties about a security incident that has compromised personal or sensitive data. It's more than just an administrative formality; it's a legal obligation in many jurisdictions and has a profound impact on: Protecting Individuals: Prompt reporting allows affected individuals to take necessary steps to mitigate potential harm, such as changing passwords, monitoring their credit reports, and being vigilant against identity theft.Legal Compliance: Numerous laws and regulations, like ...read more

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