How firewalls support HIPAA compliance: best practices for healthcare providers

Healthcare providers and insurers handle more valuable personal data than any other organizations. Losing this data puts millions of patients at risk, which is why healthcare is also one of the most highly regulated sectors.

Regulations like the Health Insurance Portability and Accountability Act (HIPAA) protect our privacy from an army of cyber attackers. HIPAA recommends administrative and technical solutions to lock down patient data.

There are many HIPAA requirements, ranging from preventing PHI disclosure to making health information available. Firewall barriers help meet requirements for access control policies and role-based access.

That’s because firewall tools allow for the implementation of granular network access controls, which helps protect sensitive medical records and data from unauthorized access. Firewalls enable healthcare companies to benefit from digital environments and remote access while securing data and avoiding HIPAA penalties.

This article will explore what role firewalls play in achieving HIPAA compliance and suggest some best practices for firewall configuration. We will look at firewall risk assessments and help you lock down medical data.

What is HIPAA compliance?

HIPAA compliance involves following security and privacy rules under the Health Insurance Portability and Accountability Act (HIPAA). This act is a body of regulations covering the healthcare sector in the United States, and non-compliance can result in significant penalties.

HIPAA is a complex set of acts and regulations, but core aspects include:

• Privacy. Organizations must safeguard the confidentiality of Protected Health Information (PHI) relating to patient identities and healthcare histories.
• Security. Organizations must protect against data breaches and implement appropriate data protection and cybersecurity measures.
• Assessment. Companies must allow access to patient records.
• Portability. Patients must be able to change providers if desired.

Compliance requirements extend to covered entities and business associates. Covered entities include direct healthcare organizations and insurers. Business associates are third parties with access to medical records. Examples include cloud storage providers or IT support companies.

Key takeaway: HIPAA compliance is essential if your company handles or stores PHI.

The importance of firewalls in HIPAA compliance

Data protection is one of the core HIPAA requirements. Although HIPAA does not set out precise technical requirements, organizations can use any technical means to protect patient data.

However, Firewalls usually play a critical role by blocking unauthorized access and filtering data passing to and from network assets.

A robust firewall enables healthcare organizations to regulate who accesses digital PHI (ePHI). Cloud-based firewalls also secure hybrid environments that host patient information or web assets.

Firewalls are not the only tools required to comply with the HIPAA Security Rule, but they are compliance essentials.

Features of a HIPAA-compliant cloud firewall

Every business should use firewalls in their security infrastructure, but not all firewalls suit healthcare organizations. Firewalls that contribute to HIPAA compliance must meet regulatory standards in various ways. Knowing where you stand is vital.

Features of a suitable firewall include:

• Data encryption for patient information (at rest and in transit)
• Access controls and identity management to block unauthorized access to medical records
• In-depth traffic analysis via Deep Packet Inspection (DPI) and Stateful Packet Inspection (SPI)
• Real-time activity monitoring (inbound and outbound traffic)
• Blocking viruses and malicious software
• Virtual private network (VPN) coverage
• Network segmentation for confidential data
• Flexibility and the ability to scale safely

Best practices for using firewalls to achieve HIPAA compliance

Given the requirements above, what is the best way to set up a firewall that helps you meet HIPAA regulations?

Implementations vary depending on the type and amount of PHI you handle. The best practices below apply to most HIPAA compliance situations and provide a solid foundation.

• Secure inbound connections. Securing remote access or third-party network connections is a common pain point. Set inbound firewall rules to allow access to legitimate users. Add VPN protection for remote connections to shield traffic from external view.
• Manage outbound connections. Configure outbound firewall rules to prevent unauthorized extraction of PHI.
• Manage third parties securely. Many covered entities use business associates to process, store, or analyze data. Carry out risk assessments for all third-party access. Consider time-limiting third-party providers to minimize their contact with PHI.
• Strategically position your firewall. Firewall rules should manage traffic to and from locations where you store or handle PHI. Assess PHI processing operations and position your firewall to filter inbound and outbound traffic.
• Control access to firewall settings. Only approved administrators should have access to firewall controls. Be careful when assigning admin privileges. Apply brief escalation windows to scale back permissions if needed.
• Protect PHI inside a secure zone. Secure zones are network segments containing HIPAA-covered health data. Configure firewall rules to filter traffic to and from these zones.
• Implement threat responses. Plan how you respond to suspected data breaches or security gaps. Document firewall breaches and actions taken in response. Constantly update firewall rules to meet evolving cyber threats.
• Create HIPAA firewall policies. Policies document firewall rules and how your firewall meets HIPAA obligations. Revisit policies annually to assess their effectiveness and make changes if needed.
• Backup firewall rules and configurations. Create a secure storage zone for firewall configurations. Regular and secure backups allow you to restore security infrastructure following cyber attacks.
• Maintain and review audit logs. Configure firewall logs to record access patterns. Retain logs for at least one year, according to HIPAA guidelines. Store logs in an accessible format and consult logs daily to detect incoming cyber attacks.
• Schedule third-party HIPAA audits. Covered entities and business associates should arrange external audits to ensure HIPAA compliance. Audits should include robust firewall assessments. Implement recommendations promptly to resolve vulnerabilities.
• Scan systems to detect weaknesses. Scan networks regularly using qualified internal resources or third-party services. Include firewall integrity in vulnerability scans, focusing on access to sensitive data.
• Update firewall appliances and software regularly. Implement vendor-supplied updates as soon as they are available. Upgrade or replace software tools if vendors no longer support them. Audit tools annually to detect unsupported firewalls. Vendors may not inform users when products change.
• Train staff to use firewalls. HIPAA compliance requires employee training. Programs should focus on handling patient data and preventing cyber threats. Firewall usage is a core component. Ensure staff understand cloud security protocols and tools and test knowledge and behavior annually.
• Consider a managed firewall to cut costs. Smaller covered entities under HIPAA may struggle to protect patient information themselves. While firewalls—whether hardware or software—are typically provided by third-party vendors, choosing a managed firewall service adds an extra layer of support. For example, instead of setting up NordLayer’s firewall directly and handling all configurations yourself, you could choose an MSP (Managed Service Provider). MSPs handle all firewall configurations and maintenance, which is ideal for organizations without the internal expertise or confidence to manage these technical safeguards.

Carrying out a firewall risk assessment

Risk assessments consider critical HIPAA compliance risks. They complement the best practices above by systematically assessing firewall setups according to HIPAA risks.

Never roll out firewall appliances without a thorough risk assessment. Risk assessments determine whether your firewall protects patient data while meeting operational needs and limiting costs.

HIPAA risk assessments for firewalls should include several critical elements:

• Scope and asset identification. Determine where patient data resides and how it moves around your network. Establish the scope for firewall protection, including any necessary network segments.
• Threat assessment. What kind of cyber threats should the firewall counter? Think about DDoS, data breaches, insider threats, and physical risks to firewall infrastructure.
• Assess vulnerabilities. Check configuration issues like vendor-supplied passwords, default settings, or compatibility problems. Ensure firmware is current. Look at policies and identify gaps that could impact firewall effectiveness.
• Prioritize risks. Identify risks based on vulnerabilities. Rank HIPAA risks based on impact and probability and create risk management plans for each vulnerability. Using a risk matrix makes it easy to visualize risks and keep track of progress.
• Risk mitigation. Test firewalls to ensure they protect HIPAA-covered data. Run simulations to test filtering, access control, and packet inspection features. Check training knowledge and admin controls. Verify firewalls are physically secure. If relevant, test remote access from employee workstations.
• Continuous monitoring. If you have not already done so, implement continuous firewall monitoring.
• Documentation. Create a risk assessment report documenting your findings. This document should explain how your firewall helps you meet HIPAA compliance requirements. It should list any additional mitigation actions and include sign-off from senior company officials.

What happens if your cloud firewall does not guard PHI?

Following best practices and carrying out a robust risk assessment may seem time-consuming. However, spending time on HIPAA risk mitigation is always worthwhile. Insecure firewalls eventually cause serious problems for healthcare companies and their customers.

Firewalls' most important role is preventing PHI data leaks, the number one cyber attack risk for healthcare organizations.

In 2023, the average data breach cost in the USA was $4.45 million, while the average in healthcare was $10.9 million—a massive difference. Firewalls cut data breach risks by blocking direct access to patient records.

According to HHS, this risk is even greater if companies rely on remote access. Telehealth services and medical practitioners use the public internet to send ePHI and access cloud storage. Firewalls and VPNs secure these connections while allowing innovation and flexibility.

Firewalls can also manage risks from insider attacks by locking ePHI inside secure zones. Only users with a legitimate reason have access to these zones, deterring other users with malicious intentions.

Just as importantly, firewalls achieve HIPAA compliance goals. This avoids some very damaging consequences.

Companies with solid access controls and data filtering systems are less likely to receive HIPAA penalties. Compliant organizations spend less on mitigation activities and avoid reputational damage when regulators detect problems.

How NordLayer can help you achieve HIPAA compliance

Access control policies are essential for HIPAA compliance, and firewalls are key tools for creating secure data environments that meet HIPAA requirements. Firewalls protect sensitive medical records and ensure that only authorized personnel can access critical resources. However, meeting compliance can challenge smaller and medium-sized enterprises.

NordLayer is the ideal HIPAA security partner for companies experiencing these challenges. Our cloud firewall protects today's hybrid network infrastructures with fine-grained access controls and traffic inspection. Administrators can also set role-based access controls, ensuring only authorized users access sensitive data.

That’s not all. NordLayer also offers VPN coverage, Deep Packet Inspection (DPI), Device Posture Security (DPS), and multi-factor authentication (MFA). Quantum-safe encryption of data in transit also meets HIPAA’s cryptography management requirements.

Together, NordLayer’s features address most of HIPAA’s technical and access control requirements. Applying security measures also makes life easier for users by integrating with business systems.

Our cloud firewall scales smoothly, allowing organizations to grow. IT admins can easily change rules to create groups or manage permissions. There's no hardware to maintain or update. Everything updates automatically, avoiding security gaps.

Ready to update your firewall and enhance your HIPAA compliance status? Contact the NordLayer team today.