HIPAA Security Rule Enforcement in 2026: Proposed Changes, Current Expectations, and Risk Management
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What is the current state of HIPAA Security Rule enforcement and why are organizations in a holding pattern?
This episode of AHLA's Speaking of Health Law is sponsored by Clearwater. For more information, visit clearwatersecurity.com. Welcome to the American Health Law Association's Speaking of Health Law podcast. I'm John Hallett with Clearwater, and I'll be hosting today's discussion. Today, we're examining the current state of HIPAA security rule enforcement, including the pending security rule notice of proposed rulemaking, OCR's continued enforcement activity, and what healthcare organizations should be doing now while the regulatory picture remains unsettled. Joining me is Ileana Peters, attorney with Pulsinelli and former OCR deputy director, who brings deep experience in advising healthcare organizations on HIPAA, privacy, security, and regulatory compliance matters. Ileana, thanks for joining me.
It's great to speak with you again. Before we dive in, please share a little more about yourself and work you're doing with healthcare organizations in this space. Yeah, totally. Thanks, John, for having me. It's always nice to have a discussion with you and the folks at Clearwater.
I always like our in-depth discussions. Good stuff. As you mentioned, I'm a shareholder at Pulsinelli, which is almost an AMLA 50 law firm now. We have offices all across the country. I sit in the Washington, D.C. office because, as you also mentioned, until about eight years ago, I worked at HHS. I was at HHS in the Office for Civil Rights for over a decade. And when I left, I was the acting deputy director for data privacy and security. So that was mostly HIPAA stuff. But some other things, patient safety, genetic information, crossover, civil rights issues, and that sort of thing. I'm also a certified information systems security professional, so I have an IT credential because I have a large team at HHS, and that was lawyers and medical records folks, but also
IT folks, which is very on point for the discussion we're going to have today and is super helpful when we get all these questions about IT security controls and how they overlap within the security role, et cetera, et cetera. So a lot of what I do nowadays in private practice is, of course, HIPAA work, but also other domestic data privacy and security work, particularly now with complicated IT questions, complicated data sharing projects, more and more AI-related issues. work because of those complicated IT and data sharing questions. So I am very eager to see where we go in the HIPAA space on this stuff too, and happy to talk about it with you today.
Well, excellent. Appreciate the opportunity to draw on your experience and expertise here for this conversation. Let's start with the big picture. As we're talking right now, the morning of May 14th, the HIPAA Security Rule NPRM is still pending action. With that in mind, how should healthcare organizations understand the HIPAA Security Rule landscape, given that the proposed rule is not final, but OCR enforcement continues?
I think it's a really good question and obviously a question that I'm getting from lots of folks, both clients, but also industry trade press reporters, vendors and consultants like Clearwater that I work with. I think we're all very excited about what may come, but until it does come, I think we are in a holding pattern and should be in a holding pattern. I know that there has been some chatter from at least some vendors in this space that covered entities and business associates should be anticipating that rule and beginning their compliance efforts. I would caution against that because I think there may be significant changes. from the notice of proposed rulemaking and what HHS proposed in terms of changes to address cybersecurity in the HIPAA security rule to the final rule. And I just, you know, security rule implementation, as you all know, John, is hard enough. And if we start anticipating what the changes might be, then, you know, we get teams all wound up about making changes that we may have to dial back or may have to
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Chapters
6 chapters
1
What is the current state of HIPAA Security Rule enforcement and why are organizations in a holding pattern?
0:05–4:25
2
Which HIPAA security obligations remain enforceable while the NPRM is pending?
4:25–8:55
3
What are the most significant proposed changes in the Security Rule NPRM, especially for business associates?
8:55–13:55
4
Why is the distinction between required and addressable safeguards risky for covered entities?
13:55–18:14
5
How does OCR evaluate whether a risk‑management plan is truly being acted on, not just documented?
18:14–22:29
6
What practical steps should health organizations take now while the Security Rule rulemaking remains unresolved?
22:29–26:58
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