INTRODUCTION
PRIVACY, HIPAA, SECURITY AND GDPR
The introduction and spread of COVID-19 to communities across the globe has created numerous privacy and security compliance questions and challenges. Below, we address several frequently asked privacy and security questions, including those related to: (1) health care providers, health plans and health care clearinghouses in the United States (“Covered Entities”) and their services providers (“Business Associates”) that are subject to HIPAA; (2) businesses that are not subject to HIPAA, but who collect information that could be useful in reducing the spread of COVID-19; (3) cybersecurity considerations; and (4) businesses that process data concerning individuals in the European Economic Area (EEA) and are subject to the General Data Protection Regulation (GDPR).
Click the linked questions below to see their answers:
HIPAA FAQs (For Covered Entities and Business Associates)
- Are there any information security risks that we should be addressing in our response to COVID-19?
- What types of disclosures are we permitted under HIPAA to make to local, state, federal and international public health agencies?
- May we disclose information about a patient or plan member’s COVID-19 diagnosis to other persons who may have been in contact with the patient or plan member?
- May we share a patient or plan member’s COVID-19 diagnosis with the patient or plan member’s employer in order to allow the employer to take precautions against further infection?
- How do we respond to requests from the news media about the COVID-19 cases we are treating?
- As a Business Associate of multiple Covered Entities, we hold health data that we could analyze to provide insight on COVID-19 exposure, spread patterns and mortality. Does HIPAA allow us to leverage health data in this manner?
Personal Information FAQs (For All Businesses)
- If we intend to collect personal information likely to be of interest to others, including government agencies or the media, in our response to COVID-19, such as information related to employee, guest or customer travel or geolocation, what do we need to consider before collecting, using or sharing this information?
- What if our privacy policy sufficiently describes the types of personal information we are collecting, but our intended use or sharing of the personal information in response to COVID-19, including with government agencies, will be novel or unexpected to our guests or consumers?
- If we learn that an employee, guest or customer has tested positive for COVID-19, what information may we disclose?
- If a government agency requests information about our employees, guests or customers, what do we need to consider from a privacy perspective in complying with such a request?
- If we disclose information to a government agency about our employees, guests or customers in relation to COVID-19, do we need to inform the individuals that we shared this information?
Cybersecurity Considerations and FAQs (For All Businesses)
- How can companies prepare their employees, contractors and others to identify and avoid the unique cybersecurity threats related to online communications about COVID-19?
- What are the cybersecurity issues or risks in increasing remote work?
- What additional cybersecurity concerns or risks should companies be aware of in these circumstances?
GDPR FAQs (For Businesses Subject to the EU General Data Protection Regulation)
- Are there GDPR considerations when dealing with the COVID-19 crisis?
- Are there special rules in the GDPR about how to handle information about COVID-19?
- Are there any special rules to consider when transferring sensitive personal data to a controller outside of the EEA?
HIPAA FAQS (FOR COVERED ENTITIES AND BUSINESS ASSOCIATES)
WHAT TYPES OF DISCLOSURES ARE WE PERMITTED UNDER HIPAA TO MAKE TO LOCAL, STATE, FEDERAL AND INTERNATIONAL PUBLIC HEALTH AGENCIES?
The Office for Civil Rights of the US Department of Health and Human Services, which enforces HIPAA, has released helpful guidance on COVID-19-related uses and disclosures, and our responses are reflective of this guidance.
Under HIPAA, Covered Entity health care providers may disclose PHI about individuals who are suspected of having contracted COVID-19 to public health authorities that are authorized by law to receive such information for preventing or controlling the spread of disease. “Public health authorities” include agencies or authorities of the United States government, a State, a territory, a political subdivision of a State or territory, or Indian tribe that is responsible for public health matters as part of its official mandate, as well as a person or entity acting under a grant of authority from, or under a contract with, a public health agency.
Under HIPAA, health care providers may also, at the direction of a public health authority, disclose PHI to a foreign government agency. Some states have mandatory legal requirements to report infectious disease cases, such as COVID-19, to state or local public health authorities.
Health care providers may report COVID-19 cases to federal, state and local public health authorities that are tasked with tracking COVID-19 case and performing COVID-19 testing. Such disclosures should be limited to the “minimum necessary” information needed by the public health authority to conduct activities to control the spread of COVID-19. In addition, Covered Entity health care providers must keep records of disclosures made to public health authorities in order to be able to accommodate requests from individuals for an accounting of disclosures.
MAY WE SHARE A PATIENT OR PLAN MEMBER’S COVID-19 DIAGNOSIS WITH THE PATIENT OR PLAN MEMBER’S EMPLOYER IN ORDER TO ALLOW THE EMPLOYER TO TAKE PRECAUTIONS AGAINST FURTHER INFECTION?
HIPAA generally does not permit Covered Entities to disclose PHI to a patient’s employer without the patient’s written authorization. The potential presence of COVID-19 at a patient or plan member’s workplace does not in itself provide an exception for the health care provider or health plan to notify the patient’s employer. Covered Entities may communicate concerns about potential workplace spread to public health authorities, identifying the employer. Public health authorities may then work with the patient’s employer to react appropriately to limit the spread of the virus. As noted above, health care providers may in some states notify individual employees of potential exposure to a patient with COVID-19.
To the extent that an employer conducts workplace surveillance of COVID-19 exposure (e.g., testing all or a portion of employees for disease status) as a result of federal, state or local workplace safety requirements, health care providers or labs working with the employer to conduct testing would be permitted under HIPAA to reveal test results directly to the employer who has requested the testing.
Please see our FAQs for US and Multi-National Employers for additional employer-focused resources.
AS A BUSINESS ASSOCIATE OF MULTIPLE COVERED ENTITIES, WE HOLD HEALTH DATA THAT WE COULD ANALYZE TO PROVIDE INSIGHT ON COVID-19 EXPOSURE, SPREAD PATTERNS AND MORTALITY. DOES HIPAA ALLOW US TO LEVERAGE HEALTH DATA IN THIS MANNER?
Many companies in the healthcare industry are looking to do whatever they can to combat the spread of the virus and identify disease trends. In particular, companies that have access to large data stores may be considering different analytical products they could create to provide additional insight on exposure and spread patterns, and trends in disease morbidity and mortality.
Companies seeking to perform such data analytics on PHI or to de-identify PHI in their possession to perform analytics must consider the following before doing so:
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To the extent the company needs to perform such analytics on PHI, the company must evaluate whether the activity would be considered “research” under HIPAA; and
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Regardless of whether the data is PHI or de-identified, the company must ensure that it has permission from the Covered Entities that provided the data to use the data for such analytics.
Under HIPAA, “research” means a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge. To the extent that analytics will be performed on PHI, the company will need to evaluate in coordination with its Covered Entity customers whether the results of the analysis will be used to inform the public at large about conclusions related to COVID-19. If yes, the company may first need to seek a waiver of the HIPAA authorization requirement from an institutional review board before conducting the analysis.
Even if the data is de-identified and not subject to HIPAA authorization requirements, the company would need to ensure that it has obtained adequate permissions in its agreements with Covered Entities to create de-identified data from PHI, and use the de-identified data to conduct the analyses.
Companies should consult legal counsel and review their agreements with Covered Entities before using their access to PHI to conduct COVID-19-related analytics.
PERSONAL INFORMATION FAQS (FOR ALL BUSINESSES)
IF A GOVERNMENT AGENCY REQUESTS INFORMATION ABOUT OUR EMPLOYEES, GUESTS OR CUSTOMERS, WHAT DO WE NEED TO CONSIDER FROM A PRIVACY PERSPECTIVE IN COMPLYING WITH SUCH A REQUEST?
Responding to a request from a governmental agency for personal information about an employee, guest or customer will implicate a number of privacy considerations:
Geography
Because COVID-19 is spreading to countries around the globe, multinational companies need to be cognizant of their privacy obligations under federal, state and international data protection laws, which can vary widely. Information that can—or must—be freely shared in one jurisdiction may be subject to a stricter regulation in another. Absent a legal requirement (as discussed below), companies should be careful about providing personal information about the individuals with whom they interact to governmental entities in response to informal requests, particularly where the mere fact that an individual is a customer of, or otherwise associated with, a company could disclose personal information about the individual. Even where a legal obligation exists, companies need to be thoughtful in their responses to governmental requests to minimize potential harm to employees, guests or customers. Information that may be relevant to fighting the spread of COVID-19—such as precise geolocation data, travel data and information about contacts—may also be of interest to government entities for other purposes. Please see our GDPR FAQs for more information about relevant privacy obligations in the European Economic Area.
Valid Process/Legal Obligation
If applicable law requires companies to provide certain personal information to a governmental entity, many of the questions companies may have about disclosure will be resolved. Even in these instances, however, companies should be mindful while complying with lawful requests to ascertain the appropriate scope of the request; minimize any unnecessary harm to employees, guests or customers; and only provide information that is required. Where the government agency makes only an informal request for information, without providing legal process, companies should consider requesting an explanation of the legal basis for the request, or if necessary, legal process such as an order, subpoena or warrant prior to providing personal information. Factors that may weigh into this calculus include the nature of a company’s business, the jurisdiction of the government requesting the information and public relations considerations (discussed below).
Reputational Issues
If a company chooses initially not to comply with an informal request from the government to provide personal information of its employees, guests or customers, it could face objections or even a public relations backlash if the government then paints it as uncooperative in stopping the spread of COVID-19. However, companies that have built their brands and reputations around protecting privacy may need to insist on their rights to obtain legal process before complying, and weigh the short-term public relations response against the long-term impact on guest or customer trust.
CYBERSECURITY CONSIDERATIONS AND FAQS (FOR ALL BUSINESSES)
WHAT ARE THE CYBERSECURITY ISSUES OR RISKS IN INCREASING REMOTE WORK?
As companies begin encouraging more of their employees to work remotely, their businesses may experience bandwidth issues, increased exfiltration of data to employees’ personal devices, and greater security exposure due to larger numbers of remote workers, including new or inexperienced ones.
Companies may need to test (including load testing) their remote connectivity capacity—whether VPN, virtual desktop infrastructure (VDI) interfaces, or other remote facilities—to ensure that they can support the expected increase of remote logins, especially if offices are partially or completely closed.
This will differ depending on the remote access solution a company uses. For example, some companies may only need to verify the bandwidth and processing power connected to the VPN concentrator.
Other companies with VDI solutions may need to check server capacity and concurrent license requirements to accommodate an increased remote workforce. Additionally, prompt, continuous and up-to-date security patches on remote access components and devices is critical.
Companies should pay special attention to workers with no or limited history of remote work. These workers may not adequately understand the security necessary to safely work remotely, and may benefit from additional training on these topics. They may also need to be issued multi-factor devices, or have the appropriate software or certificates installed on their work or personal devices.
Although the majority of employees will heed the public concern and work from home, companies may consider cautioning its employees about the risks of connecting to unsecure networks in public locations (i.e., public libraries, cafes or even airports, for those determined to travel). Security awareness messages emphasizing current remote work security protocol should also be reiterated to the workforce generally.
Companies should be clear about the requirements and expectations of their remote access policy and acceptable use policy, including potential disciplinary actions to be taken if either policy is violated. Companies should clearly indicate whether company data is allowed on personal devices. Companies may consider attaching these policies to emails as a reminder, including when announcing office closures. Companies may also consider emphasizing the appropriate security hygiene employees should follow when working remotely, such as avoiding co-mingling company data with personal emails or avoiding “split tunneling,” which is when the device communicates with a secure network, like the company’s VPN, and an insecure network at the same time.
WHAT ADDITIONAL CYBERSECURITY CONCERNS OR RISKS SHOULD COMPANIES BE AWARE OF IN THESE CIRCUMSTANCES?
As the workforce shifts to more remote work, security monitoring solutions (SIEM) and other risk avoidance solutions may experience a higher number of false positives as workers who typically access the network from the office start to access it from home. Companies may need additional security operations personnel to handle alerts and filter the false positives from actual positives. Additionally, attackers may use the disruption in normal work patterns to hide intrusion activities, so additional caution is needed.
Companies can take precautions to ensure they are prepared to respond to a data security crisis with a potential skeleton crew. Now is a crucial time to take a fresh look at the company’s incident response plan, disaster recovery plan and other security monitoring plans to ensure the company is adept at responding to a data security incident while managing business interruption affecting personnel.
Regardless of the strength of these existing policies, companies may consider updating them for pandemic preparedness. The company may also want to consider holding a tabletop exercise to practice for a potential data security incident to simulate its response capabilities when multiple members of the incident response team or others are out of the office and working remotely. At a minimum, a training refresher in the form of a meeting with security personnel inside the company emphasizing current policies and plans for response should be considered. Also consider whether existing cyber insurance coverage is adequate to cover the risks that may be possible during the pandemic.
Companies should also ensure that they comply with relevant security rules and frameworks (such as the HIPAA or GLBA security rules, PCI DSS standards, and internal policy requirements, as applicable) regarding the transmission and storage of sensitive information concerning COVID-19 (such as PHI, consumer data or other company classified data).
The cybersecurity rules that were applicable prior to the COVID-19 are still in effect now. Cybersecurity laws, regulations and procedures have not been lessened as a result of this, and there is no indication that enforcement, at least in the United States, will be lax or suspended at this time. The appropriate response to the COVID-19 from a cybersecurity perspective is to continue to enforce basic good cyber hygiene.
Please see our FAQs for US and Multi-National Employers for additional employer-focused resources.
GDPR FAQS (FOR BUSINESSES SUBJECT TO THE EU GENERAL DATA PROTECTION REGULATION)
ARE THERE GDPR CONSIDERATIONS WHEN DEALING WITH THE COVID-19 CRISIS?
Yes. Any information about an individual resident in the EEA who has or is suspected to be infected with COVID-19 will be considered to be a “special category of personal data” (or “sensitive personal data”) under the GDPR and is subject to additional controls.
The practical impact for a company is that its GDPR data privacy notices, whether they are published on its website or provided internally to employees, should be checked to see that they cover this sort of personal data, and the way in which the company needs to use that information.
This is particularly the case where the company needs to provide COVID-19 information to additional third parties or government agencies.
Secondly, if a company or a subsidiary to it is subject to the GDPR, then it should be keeping “records of processing” of personal data (Art. 30).
These records of processing may need to be expanded to deal with any additional processing that is necessitated by dealing with COVID-19 information.
Thirdly, companies may start to receive data subject requests (DSRs) from employees, customers or contacts about COVID-19 concerns. For example, a passenger on a plane could ask the airline if any of the other passengers on that plane are infected, or are suspected to be infected, with COVID-19. Companies should check that they have a process in place to deal with these sorts of DSR requests.
Remember that the GDPR covers individuals whether or not they are named, and so if a company could identify the suspected individual with information in its possession or other publicly available information, the GDPR can apply.
ARE THERE ANY SPECIAL RULES TO CONSIDER WHEN TRANSFERRING SENSITIVE PERSONAL DATA TO A CONTROLLER OUTSIDE OF THE EEA?
Yes.
If using the standard contractual clauses, companies should check whether there are further restrictions in the clauses that relate to sensitive personal data.
For example, the standard contractual clauses contain a provision that requires that any onward transfer of the sensitive personal data is not permitted without the consent of the individual.
Care should be taken when transferring sensitive personal data received from Europe to any third parties that the terms and conditions of any standard contractual clauses are complied with.
For this reason, using the Privacy Shield self-certification or Binding Corporate Rules, if applicable, are often superior mechanisms to legitimize the international transfer of personal data.
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