Breach Notification Rules Were Designed for Disclosure Not Protection

The Health Insurance Portability and Accountability Act (HIPAA) requires covered entities and business associates to notify affected individuals when protected health information (PHI) is breached. This rule, established to promote transparency and accountability, now serves as the healthcare sector’s primary line of defense against public fallout after cyber incidents. But that purpose is increasingly out of step with modern threats.

In today’s environment, breach notification is less a patient protection mechanism and more a damage control tactic. It offers no real-time defense, no system restoration, and no operational recourse. As ransomware and supply chain compromises grow more disruptive, the inadequacy of disclosure-centric policy becomes harder to ignore.

Breach Notification Is a Retrospective Tool

The timeline of most breach notifications illustrates the gap between detection and disclosure. Under HIPAA, entities have up to 60 days to notify affected individuals after discovering a breach. But investigations often take weeks, and notifications may be delayed further by legal reviews, law enforcement coordination, or incomplete forensic evidence.

By the time letters arrive in mailboxes, systems may still be offline, attackers may have already sold or leaked the data, and patients have limited ability to respond. For example, when PharMerica disclosed a breach in 2023 that exposed data from over 5.8 million individuals, the notice came months after the incident and offered little detail on how patients could protect themselves.

This delay creates a vacuum in which disinformation, confusion, and reputational damage thrive. Worse, it undermines trust. Patients are asked to take action based on minimal information, often long after the harm is done.

Notification Without Intervention Leaves Patients Exposed

The HIPAA Breach Notification Rule emphasizes transparency, but it does not require mitigation. Entities are not obligated to offer identity protection, credit monitoring, or ongoing risk updates unless the breach involves specific categories of data. There is also no mandate for system hardening or patient re-engagement following a disclosure.

This leaves individuals not only uninformed, but unsupported. In sectors such as finance, affected consumers may receive fraud alerts, account freezes, and institution-driven remediation. In healthcare, breach notifications frequently conclude with vague advice to “monitor your accounts” and a general offer of credit protection that may not be sufficient to counter medical identity theft.

Ransomware Is Exposing the Rule’s Limitations

The rise of ransomware has further strained the breach notification framework. In many cases, the exfiltration of PHI is only one part of the damage. Operational outages, care delays, and supply chain disruptions have become core features of modern cyberattacks.

However, HIPAA’s definition of a breach focuses narrowly on unauthorized access to data. If a ransomware event encrypts systems but does not involve confirmed data exfiltration, notification requirements may not be triggered. This creates a blind spot in which patients are left unaware that their care or records were impacted until services are disrupted.

Additionally, many third-party vendors argue that they are not responsible for notification even when they are the source of the breach, placing the burden on providers who may not control the forensic timeline or scope of impact. This further fragments communication and delays response.

What Policymakers and Providers Must Reconsider

Breach notification rules need modernization to reflect the scale and complexity of today’s cyber threats. Regulatory bodies should consider:

• Shortening notification windows to limit the exposure gap.
• Requiring minimum mitigation steps for all major breaches, including identity protection.
• Expanding the definition of a breach to include operational outages and confirmed system compromise.
• Clarifying the chain of responsibility when business associates are involved.

Health systems and vendors can also lead in closing the protection gap:

• Develop patient-facing response plans that go beyond letters.
• Offer proactive support such as helplines, medical record audits, and care coordination for impacted individuals.
• Increase transparency about the scope, nature, and ongoing impact of breaches.

The Letter Is Not the Fix

Transparency remains essential. But when breach notification becomes the final step in a failure rather than part of a coordinated response, it loses its protective value. Patients deserve more than delayed awareness. They need timely support, actionable information, and assurance that systems will be better defended next time.

Until breach notification rules are updated, the burden will continue to fall on those least able to respond. The current framework assumes that disclosure is enough. But in an era of systemic cyber risk, protection, not just awareness, must be the standard.