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<dc:title>104 S4697 IS: Healthcare Cybersecurity Act of 2024</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2024-07-11</dc:date>
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<dc:language>EN</dc:language>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>2d Session</session><legis-num>S. 4697</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20240711" legis-day="20240710">July 11 (legislative day, July 10), 2024</action-date><action-desc><sponsor name-id="S402">Ms. Rosen</sponsor> (for herself, <cosponsor name-id="S391">Mr. Young</cosponsor>, and <cosponsor name-id="S363">Mr. King</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSGA00">Committee on Homeland Security and Governmental Affairs</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To enhance the cybersecurity of the Healthcare and Public Health Sector.</official-title></form><legis-body display-enacting-clause="yes-display-enacting-clause"></legis-body><legis-body display-enacting-clause="no-display-enacting-clause" changed="not-changed"><section section-type="section-one" id="idabc83f54-3934-4d88-b484-3da65c178052" changed="not-changed"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Healthcare Cybersecurity Act of 2024</short-title></quote>.</text></section><section id="id0e09f803-1969-459a-8ea5-db9dd3345fea" changed="not-changed"><enum>2.</enum><header>Definitions</header><text display-inline="no-display-inline">In this Act—</text><paragraph id="id6b66a6e9-67c6-4b9f-aaab-efe96bcfe3e6" changed="not-changed"><enum>(1)</enum><text>the term <term>Agency</term> means the Cybersecurity and Infrastructure Security Agency;</text></paragraph><paragraph changed="not-changed" id="id6C44919DB5D44BE29606E0030BF8E267"><enum>(2)</enum><text>the term <term>covered asset</term> means a Healthcare and Public Health Sector asset, including technologies, services, and utilities; </text></paragraph><paragraph id="idea080ee2-7b5c-4c99-a72d-8c6bdf45a55d" changed="not-changed"><enum>(3)</enum><text>the term <term>Cybersecurity State Coordinator</term> means a Cybersecurity State Coordinator appointed under section 2217(a) of the Homeland Security Act of 2002 (<external-xref legal-doc="usc" parsable-cite="usc/6/665c">6 U.S.C. 665c(a)</external-xref>);</text></paragraph><paragraph id="idc44aaa5f-f2f3-405e-bb7b-e8fd888a5849" changed="not-changed"><enum>(4)</enum><text>the term <term>Department</term> means the Department of Health and Human Services;</text></paragraph><paragraph id="ida4c23c38-f3a7-487c-83bf-3c10e0478872" changed="not-changed"><enum>(5)</enum><text>the term <term>Director</term> means the Director of the Agency;</text></paragraph><paragraph id="id3113d257-c269-4d5f-bdf5-daf46d95f74e" changed="not-changed"><enum>(6)</enum><text>the term <term>Healthcare and Public Health Sector</term> means the Healthcare and Public Health sector, as identified in Presidential Policy Directive 21 (February 12, 2013; relating to critical infrastructure security and resilience);</text></paragraph><paragraph id="idb246cd27-7c3f-448d-96f4-07985141a41a" changed="not-changed"><enum>(7)</enum><text>the term <term>Information Sharing and Analysis Organizations</term> has the meaning given that term in section 2200 of the Homeland Security Act of 2002 (<external-xref legal-doc="usc" parsable-cite="usc/6/650">6 U.S.C. 650</external-xref>); </text></paragraph><paragraph changed="not-changed" id="id0A506DC63344418A86D5ACEAD8394BF4"><enum>(8)</enum><text>the term <term>Plan</term> means the Healthcare and Public Health Sector Specific Plan; and</text></paragraph><paragraph id="id5f9788c9-f484-4fac-bc03-9e15cb736651" changed="not-changed"><enum>(9)</enum><text>the term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph></section><section id="idc29d8c97-e7f3-4256-8b63-72982ba65978" changed="not-changed"><enum>3.</enum><header>Findings</header><text display-inline="no-display-inline">Congress finds the following:</text><paragraph id="idcf6c61d8-fa90-480a-8efe-fd9c079874d8" changed="not-changed"><enum>(1)</enum><text>Covered assets are increasingly the targets of malicious cyberattacks, which result not only in data breaches, but also increased healthcare delivery costs, and can ultimately affect patient health outcomes.</text></paragraph><paragraph id="idb945d8f1-20af-4101-8cd8-b218eef8c5db" changed="not-changed"><enum>(2)</enum><text>Data reported to the Department shows that large cyber breaches of the information systems of healthcare facilities rose 93 percent between 2018 to 2022 . </text></paragraph><paragraph id="id0605a5cc-ba48-4618-9c75-06ddd0bfbf0d" changed="not-changed"><enum>(3)</enum><text>According to data from the Office for Civil Rights of the Department, health information breaches have increased since 2016, and in 2022 alone, the Department reported 626 breaches on covered entities, as defined under the Health Insurance Portability and Accountability Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>), affecting more than 500 people, with nearly 42,000,000 total people affected by health information breaches.</text></paragraph></section><section id="idb20b1817-d71b-473b-b521-b5b4eab24199" changed="not-changed"><enum>4.</enum><header>Agency coordination with the Department</header><subsection id="ida13aac6b-995c-4a03-80a1-ba8169bc09ce" changed="not-changed"><enum>(a)</enum><header>In general</header><text>The Agency shall coordinate with the Department, including by entering into an agreement, as appropriate, to improve cybersecurity in the Healthcare and Public Health Sector.</text></subsection><subsection changed="not-changed" id="idD92BAA13521448ED8AC0D151F42C0B6F"><enum>(b)</enum><header>Agency liaison to the Department</header><paragraph id="id8848e464590445ca8bb5b56b8cfade9a"><enum>(1)</enum><header>Appointment</header><text>The Director shall, in coordination with the Secretary, appoint an individual, who shall be an employee of the Agency or a detailee assigned to the Department by the Director, to serve as the liaison of the Agency to the Department, who shall—</text><subparagraph id="id9D457A946A7C4153A43CB61E90CC584E"><enum>(A)</enum><text>have appropriate cybersecurity qualifications and expertise; and</text></subparagraph><subparagraph id="id4352E6E8E47B4C5DA2B11AF3FF75909F"><enum>(B)</enum><text>report directly to the Director.</text></subparagraph></paragraph><paragraph id="id6e8f306c0a264c0982abee3d3a096836"><enum>(2)</enum><header>Responsibilities and duties</header><text>The liaison appointed under paragraph (1) shall—</text><subparagraph id="id0f242b98e0e9498b8610be3da1e38e24"><enum>(A)</enum><text>provide to the owners and operators of covered assets technical assistance regarding, information on, and best practices relating to improving cybersecurity;</text></subparagraph><subparagraph id="idcb46e2a8630c4a02b8fb75d38fa41d5c"><enum>(B)</enum><text>serve as a primary contact of the Department to coordinate cybersecurity issues with the Agency;</text></subparagraph><subparagraph id="id975b4fb100c24670b29f54685353ecb2"><enum>(C)</enum><text>support the implementation and execution of the Plan and assist in the development of updates to the Plan;</text></subparagraph><subparagraph id="id3d8451f72e024460b93a50ee9a40fe7b"><enum>(D)</enum><text>facilitate the sharing of cyber threat information to improve understanding of cybersecurity risks and situational awareness of cybersecurity incidents; </text></subparagraph><subparagraph id="id3b1bfa4061db4420b5294154ea30fdc0"><enum>(E)</enum><text>manage the implementation of the agreement entered into under subsection (a); </text></subparagraph><subparagraph id="id0795ea4bfb884cfabdaea756b9cbe3f7"><enum>(F)</enum><text>implement the training described in section 5; </text></subparagraph><subparagraph id="id97a6e70ce5664a8399d2c10352eb5570"><enum>(G)</enum><text>coordinate between the Agency and the Department during cybersecurity incidents within the Healthcare and Public Health Sector; and </text></subparagraph><subparagraph id="ided1107a0f6a744bfa0f40e15993b5da8"><enum>(H)</enum><text>perform such other duties as determined necessary by the Secretary to achieve the goal of improving the cybersecurity of the Healthcare and Public Health Sector.</text></subparagraph></paragraph><paragraph id="idfcaa07f63b1747df97714b05abbe323b"><enum>(3)</enum><header>Report</header><text>Not later than 18 months after the date of enactment of this Act, the liaison appointed under paragraph (1), in consultation with the Secretary and the Director, shall submit a report that describes the activities undertaken to improve cybersecurity coordination between the Agency and the Department to—</text><subparagraph id="idfc25d45f855345089abbaaa7273b8471"><enum>(A)</enum><text>the Committee on Health, Education, Labor, and Pensions, the Committee on Finance, and the Committee on Homeland Security and Governmental Affairs of the Senate; and</text></subparagraph><subparagraph id="id87f6cbec4cc94fefab9acbec9938a6cd"><enum>(B)</enum><text>the Committee on Energy and Commerce, the Committee on Ways and Means, and the Committee on Homeland Security of the House of Representatives. </text></subparagraph></paragraph></subsection><subsection id="id8837eb51-1579-49d9-9574-33f2ee5990ce" changed="not-changed"><enum>(c)</enum><header>Assistance</header><paragraph id="id1c627ec5-cc39-4106-a92c-40bc299e1b30" changed="not-changed"><enum>(1)</enum><header>In general</header><text>The Agency shall coordinate with and make resources available to Information Sharing and Analysis Organizations, information sharing and analysis centers, the sector coordinating councils, and non-Federal entities that are receiving information shared through programs managed by the Department.</text></paragraph><paragraph id="idcc24fd3c-ed92-47e7-a68c-4bf84f7c4259" changed="not-changed"><enum>(2)</enum><header>Scope</header><text>The coordination under paragraph (1) shall include—</text><subparagraph id="id405aa448-fce5-4faa-a330-437727bea4f1" changed="not-changed"><enum>(A)</enum><text>developing products specific to the needs of Healthcare and Public Health Sector entities; and</text></subparagraph><subparagraph id="idf1010306-ba65-4699-aed9-c0b878503b5e" changed="not-changed"><enum>(B)</enum><text>sharing information relating to cyber threat indicators and appropriate defensive measures.</text></subparagraph></paragraph></subsection></section><section id="id0be0f30f-1f9e-40a0-9fba-2401a6d66847" changed="not-changed"><enum>5.</enum><header>Training for healthcare experts</header><text display-inline="no-display-inline">The Cyber Security Advisors and Cybersecurity State Coordinators of the Agency shall, in coordination, as appropriate, with the liaison appointed under section 4(b)(1) and private sector healthcare experts, provide training to the owners and operators of covered assets on— </text><paragraph id="idefc0e558-9b41-4d03-9841-85e563314f99" changed="not-changed"><enum>(1)</enum><text>cybersecurity risks to the Healthcare and Public Health Sector and covered assets; and</text></paragraph><paragraph id="id8420c29e-7fbd-4151-9b88-d5dc3a7ceb5f" changed="not-changed"><enum>(2)</enum><text>ways to mitigate the risks to information systems in the Healthcare and Public Health Sector.</text></paragraph></section><section id="id77a54818-8ab7-4998-a088-59e47cb7ef77" changed="not-changed"><enum>6.</enum><header>Sector-specific plan</header><subsection id="id5fcbc008-a96b-4fd7-9091-17d3108505d9" changed="not-changed"><enum>(a)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of this Act, the Secretary, in coordination with the Director, shall update the Plan, which shall include the following elements:</text><paragraph id="id8b6622f6-dde9-47e3-811e-de90c2965da9" changed="not-changed"><enum>(1)</enum><text>An analysis of how identified cybersecurity risks specifically impact covered assets, including the impact on rural and small and medium-sized covered assets.</text></paragraph><paragraph id="id9868e5a3-09c6-4ce2-8311-61f0b87aff0c" changed="not-changed"><enum>(2)</enum><text>An evaluation of the challenges the owners and operators of covered assets face in—</text><subparagraph id="id5efb0457-ca78-48d4-9e4e-f19eb60dcc5f" changed="not-changed"><enum>(A)</enum><text>securing—</text><clause id="id7aafa33f-6182-48fe-b121-c5e41279df74" changed="not-changed"><enum>(i)</enum><text>updated information systems owned, leased, or relied upon by covered assets;</text></clause><clause id="id32d1b801-c31e-4910-af9c-0dab06824e9d" changed="not-changed"><enum>(ii)</enum><text>medical devices or equipment owned, leased, or relied upon by covered assets, which shall include an analysis of the threat landscape and cybersecurity vulnerabilities of such medical devices or equipment; and</text></clause><clause id="id4bac1d54-5fd3-4142-a64d-b24d9a5ee370" changed="not-changed"><enum>(iii)</enum><text>sensitive patient health information and electronic health records;</text></clause></subparagraph><subparagraph id="id9656f604-b924-4fa9-b5c1-525016b9ba32" changed="not-changed"><enum>(B)</enum><text>implementing cybersecurity protocols; and</text></subparagraph><subparagraph id="idfa176532-078b-46eb-9582-e99709501464" changed="not-changed"><enum>(C)</enum><text>responding to data breaches or cybersecurity attacks, including the impact on patient access to care, quality of patient care, timeliness of health care delivery, and health outcomes.</text></subparagraph></paragraph><paragraph id="idf6e4e827-e1fe-46e6-918e-1cc3a2b976cd" changed="not-changed"><enum>(3)</enum><text>An evaluation of best practices for the deployment of trained Cyber Security Advisors and Cybersecurity State Coordinators of the Agency into covered assets before, during, and after data breaches or cybersecurity attacks.</text></paragraph><paragraph id="idf49a5a4d-1fe7-4c91-a365-921621f0c1d4" changed="not-changed"><enum>(4)</enum><text>An assessment of relevant Healthcare and Public Health Sector cybersecurity workforce shortages, including—</text><subparagraph id="id27962b17-e667-495e-91b1-c3fa53a1da19" changed="not-changed"><enum>(A)</enum><text>training, recruitment, and retention issues; and</text></subparagraph><subparagraph id="idd5d61bc9-3099-4b5e-9291-7f81eb0635eb" changed="not-changed"><enum>(B)</enum><text>recommendations for how to address these shortages and issues, particularly at rural and small and medium-sized covered assets.</text></subparagraph></paragraph><paragraph id="id4d90a69f-09b1-4231-85a4-a9dbe8836819" changed="not-changed"><enum>(5)</enum><text>An evaluation of the most accessible and timely ways for the Agency and the Department to communicate and deploy cybersecurity recommendations and tools to the owners and operators of covered assets.</text></paragraph></subsection><subsection id="ide8989786-4670-4ff0-9585-a8cc221ee4b2" changed="not-changed"><enum>(b)</enum><header>Congressional briefing</header><text>Not later than 120 days after the date of enactment of this Act, the Secretary, in consultation with the Director, shall provide a briefing on the updating of the Plan under subsection (a) to—</text><paragraph id="id6359a2ca-7806-4c4e-aaa7-59852664eba3" changed="not-changed"><enum>(1)</enum><text>the Committee on Health, Education, Labor, and Pensions, the Committee on Finance, and the Committee on Homeland Security and Governmental Affairs of the Senate; and</text></paragraph><paragraph id="id3259a2b2-5eee-4ee0-971e-a50ed4169152" changed="not-changed"><enum>(2)</enum><text>the Committee on Energy and Commerce, the Committee on Ways and Means, and the Committee on Homeland Security of the House of Representatives. </text></paragraph></subsection></section><section id="id96d75659bf2349b9ae38451b29e861fd"><enum>7.</enum><header>Identifying high-risk covered assets</header><subsection id="idE7DBF7F3976E4B7C9E7636001EDF502B"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 90 days after the date of enactment of this Act, the Director shall establish objective criteria for determining whether a covered asset should be designated as a high-risk covered asset.</text></subsection><subsection id="id9a2e23f6c5df4f24b9eefd12dfc01489"><enum>(b)</enum><header>Methodology</header><text>The Director, in consultation with the Secretary, as appropriate, shall establish a methodology for determining whether a covered asset meets the criteria established under subsection (a) to be designated as a high-risk covered asset.</text></subsection><subsection id="id937bdd6b0a094e71a4f9ee131f25a056"><enum>(c)</enum><header>List of high-Risk covered assets</header><paragraph id="id8CFA148537DF426F84A3AEF77E3182BE"><enum>(1)</enum><header>In general</header><text>The Secretary shall develop a list of, and notify, the owners and operators of each covered asset determined to be a high-risk covered asset using the methodology established under subsection (b).</text></paragraph><paragraph id="id0CB88CFFD2674D4DB13F025866A57B08"><enum>(2)</enum><header>Biannual updating</header><text>The Secretary shall— </text><subparagraph id="idD45740E16D7D4EA98B3B83252EAB5B66"><enum>(A)</enum><text>biannually review and update the list of high-risk covered assets developed under paragraph (1); and </text></subparagraph><subparagraph id="idB73B2F7DEAEE430CB8775579A5F9576E"><enum>(B)</enum><text>notify the owners and operators of each covered asset added to or removed from the list as part of a review and update of the list under subparagraph (A).</text></subparagraph></paragraph><paragraph id="id136ea0f776cf41a3907d26bcdad703e9"><enum>(3)</enum><header>Notice to Congress</header><text>The Secretary shall notify Congress when the initial list of high-risk covered assets is developed under paragraph (1) and each time the list is updated under paragraph (2). </text></paragraph><paragraph id="id91c5165dde8d4ea6a8c505b23bfd585b"><enum>(4)</enum><header>Use</header><text>The list developed and updated under this subsection shall be used by the Department to prioritize resource allocation to high-risk covered assets to bolster cyber resilience.</text></paragraph></subsection></section><section id="id01EC67B6BFC84107A8C43BAED7224AF7"><enum>8.</enum><header>Report on Assistance Provided to Entities of Healthcare and Public Health Sector</header><text display-inline="no-display-inline">Not later than 120 days after the date of enactment of this Act, the Agency shall submit to Congress a report on the organization-wide level of support and activities that the Agency has provided to the healthcare and public health sector to proactively prepare the sector to face cyber threats and respond to cyber attacks when such threats or attacks occur.</text></section></legis-body></bill> 

