[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3315 Reported in Senate (RS)]

<DOC>





                                                       Calendar No. 365
119th CONGRESS
  2d Session
                                S. 3315

To require the Secretary of Health and Human Services and the Director 
 of the Cybersecurity and Infrastructure Security Agency to coordinate 
to improve cybersecurity in the health care and public health sectors, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            December 2, 2025

   Mr. Cassidy (for himself, Ms. Hassan, Mr. Cornyn, and Mr. Warner) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

                             March 23, 2026

               Reported by Mr. Cassidy, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
To require the Secretary of Health and Human Services and the Director 
 of the Cybersecurity and Infrastructure Security Agency to coordinate 
to improve cybersecurity in the health care and public health sectors, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Health Care Cybersecurity 
and Resiliency Act of 2025''.</DELETED>

<DELETED>SEC. 2. DEFINITIONS.</DELETED>

<DELETED>    In this Act:</DELETED>
        <DELETED>    (1) Agency.--The term ``Agency'' means the 
        Cybersecurity and Infrastructure Security Agency.</DELETED>
        <DELETED>    (2) Cybersecurity incident.--The term 
        ``cybersecurity incident'' has the meaning given the term 
        ``incident'' in section 3552 of title 44, United States 
        Code.</DELETED>
        <DELETED>    (3) Cybersecurity state coordinator.--The term 
        ``Cybersecurity State Coordinator'' means a Cybersecurity State 
        Coordinator appointed under section 2217(a) of the Homeland 
        Security Act of 2002 (6 U.S.C. 665c(a)).</DELETED>
        <DELETED>    (4) Director.--The term ``Director'' means the 
        Director of the Agency.</DELETED>
        <DELETED>    (5) Healthcare and public health sector.--The term 
        ``Healthcare and Public Health Sector'' means the Healthcare 
        and Public Health sector, as identified in Presidential Policy 
        Directive 21 (February 12, 2013; relating to critical 
        infrastructure security and resilience).</DELETED>
        <DELETED>    (6) Information sharing and analysis 
        organization.--The term ``Information Sharing and Analysis 
        Organization'' has the meaning given such term in section 2200 
        of the Homeland Security Act of 2002 (6 U.S.C. 650).</DELETED>
        <DELETED>    (7) Information system.--The term ``information 
        system'' has the meaning given such term in section 102 of the 
        Cybersecurity Information Sharing Act of 2015 (6 U.S.C. 
        1501).</DELETED>
        <DELETED>    (8) Secretary.--The term ``Secretary'' means the 
        Secretary of Health and Human Services.</DELETED>

<DELETED>SEC. 3. DEPARTMENT COORDINATION WITH THE AGENCY.</DELETED>

<DELETED>    (a) In General.--The Secretary and the Director shall 
coordinate, including by entering into a cooperative agreement, as 
appropriate, to improve cybersecurity in the Healthcare and Public 
Health Sector.</DELETED>
<DELETED>    (b) Assistance.--</DELETED>
        <DELETED>    (1) In general.--The Secretary shall coordinate 
        with the Director to make resources available to entities that 
        are receiving information shared through programs managed by 
        the Director or the Secretary, including Information Sharing 
        and Analysis Organizations, information sharing and analysis 
        centers, and non-Federal entities.</DELETED>
        <DELETED>    (2) Scope.--The coordination under paragraph (1) 
        shall include--</DELETED>
                <DELETED>    (A) developing products specific to the 
                needs of Healthcare and Public Health Sector entities; 
                and</DELETED>
                <DELETED>    (B) sharing information relating to cyber 
                threat indicators and appropriate defensive 
                measures.</DELETED>

<DELETED>SEC. 4. CLARIFYING CYBERSECURITY RESPONSIBILITIES AT THE 
              DEPARTMENT OF HEALTH AND HUMAN SERVICES.</DELETED>

<DELETED>    Part A of title III of the Public Health Service Act (42 
U.S.C. 241 et seq.) is amended by adding at the end the 
following:</DELETED>

<DELETED>``SEC. 310C. OVERSIGHT OF CYBERSECURITY ACTIVITIES.</DELETED>

<DELETED>    ``The Secretary, acting through the Assistant Secretary 
for Preparedness and Response, in coordination with the Director of the 
Cybersecurity and Infrastructure Security Agency pursuant to section 
2218 of the Homeland Security Act of 2002, shall lead oversight and 
coordination of activities within the Department of Health and Human 
Services to support cybersecurity resiliency within the Healthcare and 
Public Health Sector (as defined in section 2 of the Health Care 
Cybersecurity and Resiliency Act of 2025), including coordination and 
communication with other public and private entities related to 
preparedness for, and responses to, cybersecurity incidents, consistent 
with applicable provisions of this Act, other applicable laws, and 
Presidential Policy Directive 21 (February 12, 2013; relating to 
critical infrastructure security and resilience).''.</DELETED>

<DELETED>SEC. 5. CYBERSECURITY INCIDENT RESPONSE PLAN.</DELETED>

<DELETED>    Section 405 of the Cybersecurity Act of 2015 (6 U.S.C. 
1533) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)--</DELETED>
                <DELETED>    (A) in paragraph (4)--</DELETED>
                        <DELETED>    (i) in the paragraph heading, by 
                        inserting ``information system;'' after 
                        ``Federal entity;''; and</DELETED>
                        <DELETED>    (ii) by inserting ```information 
                        system','' after ```Federal 
                        entity','';</DELETED>
                <DELETED>    (B) by redesignating paragraphs (4) 
                through (7) as paragraphs (6) through (9), 
                respectively; and</DELETED>
                <DELETED>    (C) by inserting after paragraph (3) the 
                following:</DELETED>
        <DELETED>    ``(4) Cybersecurity incident.--The term 
        `cybersecurity incident' has the meaning given the term 
        `incident' in section 3552 of title 44, United States 
        Code.</DELETED>
        <DELETED>    ``(5) Cybersecurity risk.--The term `cybersecurity 
        risk' has the meaning given such term in section 2200 of the 
        Homeland Security Act of 2002 (6 U.S.C. 650).''; and</DELETED>
        <DELETED>    (2) in subsection (d), by adding at the end the 
        following:</DELETED>
        <DELETED>    ``(4) Plan.--</DELETED>
                <DELETED>    ``(A) In general.--Not later than 1 year 
                after the date of enactment of the Health Care 
                Cybersecurity and Resiliency Act of 2025, the Secretary 
                shall develop and implement a cybersecurity incident 
                response plan to inform applicable personnel within the 
                Department of Health and Human Services of processes 
                and protocols to prepare for, and respond to, 
                cybersecurity incidents involving information, 
                including hardware, software, databases, and networks, 
                used or maintained by, or on behalf of, the Department, 
                including strategies--</DELETED>
                        <DELETED>    ``(i) to assess cybersecurity 
                        risks;</DELETED>
                        <DELETED>    ``(ii) to prevent cybersecurity 
                        incidents;</DELETED>
                        <DELETED>    ``(iii) to detect and identify 
                        cybersecurity incidents;</DELETED>
                        <DELETED>    ``(iv) to minimize damage in the 
                        event of a cybersecurity incident;</DELETED>
                        <DELETED>    ``(v) to protect data; 
                        and</DELETED>
                        <DELETED>    ``(vi) to recover from any 
                        cybersecurity incidents 
                        expeditiously.</DELETED>
                <DELETED>    ``(B) Consultation.--In developing the 
                plan under subparagraph (A), the Secretary shall 
                consult with the Director of the Cybersecurity and 
                Infrastructure Security Agency, the Director of the 
                Office of Management and Budget, and the Director of 
                the National Institute of Standards and Technology, and 
                relevant experts, as appropriate.</DELETED>
                <DELETED>    ``(C) Report.--Not later than 60 days 
                before the date on which the Secretary begins 
                implementing the plan under subparagraph (A), the 
                Secretary shall submit to the Committee on Health, 
                Education, Labor, and Pensions and the Committee on 
                Homeland Security and Governmental Affairs of the 
                Senate and the Committee on Energy and Commerce, the 
                Committee on Oversight and Reform, and the Committee on 
                Homeland Security of the House of Representatives a 
                report that describes such plan.''.</DELETED>

<DELETED>SEC. 6. BREACH REPORTING PORTAL.</DELETED>

<DELETED>    (a) Updates to Breach Reporting Portal.--Section 13402 of 
the HITECH Act (42 U.S.C. 17932) is amended by adding at the end the 
following:</DELETED>
<DELETED>    ``(k) Updates to Regulations.--Not later than 1 year after 
the date of enactment of the Health Care Cybersecurity and Resiliency 
Act of 2025, the Secretary shall update the regulations promulgated 
pursuant to subsection (j) to require that information required to be 
publicly displayed in the breach reporting portal established pursuant 
to this section includes--</DELETED>
        <DELETED>    ``(1) information on any corrective action taken 
        against a covered entity that provided notification of a breach 
        under this section;</DELETED>
        <DELETED>    ``(2) information on whether and to what extent, 
        as appropriate, recognized security practices (as defined in 
        section 13412(b)(1)) were considered in the investigation of 
        such a breach; and</DELETED>
        <DELETED>    ``(3) such additional information about such a 
        breach as the Secretary may require.''.</DELETED>

<DELETED>SEC. 7. CLARIFYING BREACH REPORTING OBLIGATIONS.</DELETED>

<DELETED>    Section 13402(f) of the HITECH Act (42 U.S.C. 17932(f)) is 
amended by adding at the end the following:</DELETED>
        <DELETED>    ``(6) The number of individuals affected by the 
        breach.''.</DELETED>

<DELETED>SEC. 8. ENHANCING RECOGNITION OF SECURITY PRACTICES.</DELETED>

<DELETED>    (a) Recognized Security Practices.--Section 13412(b)(1) of 
the HITECH Act (42 U.S.C. 17941(b)(1)) is amended, in the first 
sentence, by inserting ``, investments,'' after ``other 
programs''.</DELETED>
<DELETED>    (b) Guidance.--Not later than 1 year after the date of 
enactment of this Act, the Secretary shall issue guidance on the 
implementation of section 13412 of the HITECH Act (42 U.S.C. 17941), 
which shall include--</DELETED>
        <DELETED>    (1) recognized security practices (as defined in 
        subsection (b)(1) of such section) that the Secretary may 
        consider when determining fines under such section;</DELETED>
        <DELETED>    (2) the extent to which such recognized security 
        practices should be in place for consideration by the 
        Secretary; and</DELETED>
        <DELETED>    (3) procedural requirements or information that 
        shall be submitted by a covered entity or business associate 
        (as such terms are defined in section 13400 of the HITECH Act 
        (42 U.S.C. 17921)) to the Secretary for 
        consideration.</DELETED>
<DELETED>    (c) Annual Report.--Not later than 2 years after the date 
of enactment of this Act, and annually thereafter, the Secretary shall 
include in the annual report required under section 13424(a) of the 
HITECH Act (42 U.S.C. 17953(a)) information on implementation of 
section 13412 of such Act (42 U.S.C. 17941), including an accounting of 
every case in which the Secretary considered recognized security 
practices (as defined in subsection (b)(1) of such section) when 
effectuating audits and assessing fines under such section.</DELETED>

<DELETED>SEC. 9. REQUIRED CYBERSECURITY STANDARDS.</DELETED>

<DELETED>    (a) In General.--The Secretary shall update the privacy, 
security, and breach notification regulations under parts 160 and 164 
of title 45, Code of Federal Regulations (or any successor regulation) 
to require covered entities and business associates to adopt the 
following cybersecurity practices:</DELETED>
        <DELETED>    (1) Multifactor authentication, or a successor 
        technology, for access to any information systems that may 
        include protected health information.</DELETED>
        <DELETED>    (2) Safeguards to encrypt protected health 
        information.</DELETED>
        <DELETED>    (3) Requirements to conduct audits, including 
        penetration testing, to maintain the protections of information 
        systems.</DELETED>
        <DELETED>    (4) Other minimum cybersecurity standards, as 
        determined by the Secretary, in consultation with private 
        sector entities, based on landscape analysis of emerging and 
        existing cybersecurity vulnerabilities and consensus-based best 
        practices.</DELETED>
<DELETED>    (b) Effective Dates.--The Secretary shall specify in the 
regulations the effective date for each of the new requirements under 
the regulations updated in accordance with subsection (a). Each such 
effective date shall provide reasonable time for the entities subject 
to the requirement to come into compliance.</DELETED>

<DELETED>SEC. 10. GUIDANCE ON RURAL CYBERSECURITY READINESS.</DELETED>

<DELETED>    Section 405(d) of the Cybersecurity Act of 2015 (6 U.S.C. 
1533(d)) (as amended by section 5(2)) is amended by adding at the end 
the following:</DELETED>
        <DELETED>    ``(5) Rural cybersecurity guidance.--</DELETED>
                <DELETED>    ``(A) Definition of rural.--In this 
                paragraph, the term `rural' has the meaning given such 
                term by the Health Resources and Services 
                Administration.</DELETED>
                <DELETED>    ``(B) Guidance on rural cybersecurity 
                readiness.--Not later than 1 year after the date of 
                enactment of the Health Care Cybersecurity and 
                Resiliency Act of 2025, the Secretary shall issue 
                guidance to rural entities on best practices to improve 
                cyber readiness, including strategies--</DELETED>
                        <DELETED>    ``(i) to improve cyber 
                        infrastructure, including any technical 
                        safeguards to mitigate cybersecurity 
                        risk;</DELETED>
                        <DELETED>    ``(ii) to integrate best practices 
                        issued by the Secretary to improve 
                        cybersecurity preparedness;</DELETED>
                        <DELETED>    ``(iii) to improve employee 
                        preparation to mitigate any cybersecurity 
                        risks, including existing public-private 
                        programs to support educational initiatives; 
                        and</DELETED>
                        <DELETED>    ``(iv) to implement policies to 
                        facilitate mandatory cybersecurity incident 
                        reporting requirements under law.</DELETED>
                <DELETED>    ``(C) GAO study and report.--</DELETED>
                        <DELETED>    ``(i) In general.--Not later than 
                        3 years after the date of enactment of the 
                        Health Care Cybersecurity and Resiliency Act of 
                        2025, the Comptroller General of the United 
                        States shall conduct, and submit to the 
                        Committee on Health, Education, Labor, and 
                        Pensions of the Senate and the Committee on 
                        Energy and Commerce of the House of 
                        Representatives a report that describes the 
                        results of, a study to examine how rural 
                        entities have implemented the recommendations 
                        included in the guidance under subparagraph 
                        (B).</DELETED>
                        <DELETED>    ``(ii) Requirements.--The study 
                        under clause (i) shall assess--</DELETED>
                                <DELETED>    ``(I) how rural entities 
                                have implemented any technical 
                                safeguards and any challenges faced by 
                                such rural entities in areas for which 
                                safeguards were not 
                                implemented;</DELETED>
                                <DELETED>    ``(II) steps to further 
                                support cyber resilience for rural 
                                entities;</DELETED>
                                <DELETED>    ``(III) areas to improve 
                                coordination between Federal agencies, 
                                including for the purposes of required 
                                cyber reporting; and</DELETED>
                                <DELETED>    ``(IV) any opportunities 
                                to support public-private collaboration 
                                in the area of cyber 
                                readiness.''.</DELETED>

<DELETED>SEC. 11. GRANTS TO ENHANCE CYBERSECURITY IN THE HEALTH AND 
              PUBLIC HEALTH SECTORS.</DELETED>

<DELETED>    Part P of title III of the Public Health Service Act (42 
U.S.C. 280g et seq.) is amended by adding at the end the 
following:</DELETED>

<DELETED>``SEC. 399V-8. GRANTS.</DELETED>

<DELETED>    ``(a) In General.--The Secretary may award grants to 
eligible entities for the adoption and use of cybersecurity best 
practices.</DELETED>
<DELETED>    ``(b) Eligible Entity.--To be eligible to receive a grant 
under subsection (a) an entity shall be--</DELETED>
        <DELETED>    ``(1) a public or nonprofit private health center 
        (including a Federally qualified health center (as defined in 
        section 1861(aa)(4) of the Social Security Act));</DELETED>
        <DELETED>    ``(2) a health facility operated by or pursuant to 
        a contract with the Indian Health Service;</DELETED>
        <DELETED>    ``(3) a hospital;</DELETED>
        <DELETED>    ``(4) a cancer center;</DELETED>
        <DELETED>    ``(5) a rural health clinic;</DELETED>
        <DELETED>    ``(6) an academic health center; or</DELETED>
        <DELETED>    ``(7) a nonprofit entity that enters into a 
        partnership or coordinates referrals with an entity described 
        in any of paragraphs (1) through (6).</DELETED>
<DELETED>    ``(c) Use of Funds.--In adopting and using cybersecurity 
best practices pursuant to a grant under subsection (a), an eligible 
entity may use grant funds--</DELETED>
        <DELETED>    ``(1) to hire and train personnel in such 
        cybersecurity best practices;</DELETED>
        <DELETED>    ``(2) to update electronic data systems, such as 
        by migrating to cloud based platforms;</DELETED>
        <DELETED>    ``(3) to join and participate in health 
        cybersecurity threat information sharing 
        organizations;</DELETED>
        <DELETED>    ``(4) to reduce the use of legacy systems; 
        and</DELETED>
        <DELETED>    ``(5) to contract with third parties to assist 
        with the activities described in paragraphs (1) through 
        (5).</DELETED>
<DELETED>    ``(d) Grant Period.--The Secretary may award a grant under 
this section for a period of not more than 3 years.</DELETED>
<DELETED>    ``(e) Application.--An eligible entity seeking a grant 
under subsection (a) shall submit to the Secretary an application at 
such time, in such manner, and containing such information as the 
Secretary may require including, at a minimum a description of how the 
eligible entity will establish baseline measures and benchmarks that 
meet the Secretary's requirements to evaluate program 
outcomes.</DELETED>
<DELETED>    ``(f) Authorization of Appropriations.--There are 
authorized to be appropriated to carry out this section such sums as 
may be necessary for each of fiscal years 2025 through 
2030.''.</DELETED>

<DELETED>SEC. 12. HEALTHCARE CYBERSECURITY WORKFORCE.</DELETED>

<DELETED>    (a) Training for Healthcare Experts.--The Secretary, in 
coordination with the Cybersecurity State Coordinators of the Agency 
and private sector health care experts, as appropriate, shall provide 
training to Healthcare and Public Health Sector asset owners and 
operators on--</DELETED>
        <DELETED>    (1) cybersecurity risks to information systems 
        within the Healthcare and Public Health Sector; and</DELETED>
        <DELETED>    (2) ways to mitigate the risks to information 
        systems in the Healthcare and Public Health Sector.</DELETED>
<DELETED>    (b) Cross-Agency Educational Tools.--</DELETED>
        <DELETED>    (1) In general.--Not later than 1 year after the 
        date of enactment of this Act, the Secretary, acting through 
        the Administrator of the Health Resources and Services 
        Administration, in coordination with the Agency, shall develop 
        a strategic plan to support growing the cybersecurity workforce 
        for health care entities.</DELETED>
        <DELETED>    (2) Inclusions.--The strategic plan under 
        paragraph (1) shall include--</DELETED>
                <DELETED>    (A) recommendations for existing 
                educational programs that can be used to support 
                cybersecurity training;</DELETED>
                <DELETED>    (B) dissemination and development of 
                educational materials on how to improve cybersecurity 
                resilience;</DELETED>
                <DELETED>    (C) development of best practices to train 
                the health care workforce on cybersecurity best 
                practices; and</DELETED>
                <DELETED>    (D) opportunities for public-private 
                collaboration to strengthen the cybersecurity 
                workforce.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care Cybersecurity and 
Resiliency Act of 2026''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Agency.--The term ``Agency'' means the Cybersecurity 
        and Infrastructure Security Agency.
            (2) Business associate.--The term ``business associate'' 
        has the meaning given such term in section 160.103 of title 45, 
        Code of Federal Regulations (or a successor regulation).
            (3) Covered entity.--The term ``covered entity'' has the 
        meaning given such term in section 160.103 of title 45, Code of 
        Federal Regulations (or a successor regulation).
            (4) Cybersecurity incident.--The term ``cybersecurity 
        incident'' has the meaning given the term ``incident'' in 
        section 3552 of title 44, United States Code.
            (5) Cybersecurity state coordinator.--The term 
        ``Cybersecurity State Coordinator'' means a Cybersecurity State 
        Coordinator appointed under section 2217(a) of the Homeland 
        Security Act of 2002 (6 U.S.C. 665c(a)).
            (6) Director.--The term ``Director'' means the Director of 
        the Agency.
            (7) Healthcare and public health sector.--The term 
        ``Healthcare and Public Health Sector'' means the Healthcare 
        and Public Health sector, as identified in National Security 
        Memorandum-22 (April 30, 2024; relating to critical 
        infrastructure security and resilience).
            (8) Information sharing and analysis organization.--The 
        term ``Information Sharing and Analysis Organization'' has the 
        meaning given such term in section 2200 of the Homeland 
        Security Act of 2002 (6 U.S.C. 650).
            (9) Information system.--The term ``information system'' 
        has the meaning given such term in section 2200 of the Homeland 
        Security Act of 2002 (6 U.S.C. 650).
            (10) Recognized security practices.--The term ``recognized 
        security practices'' has the meaning given such term in section 
        13412(b)(1) of the HITECH Act (42 U.S.C. 17941(b)(1)).
            (11) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 3. DEPARTMENT COORDINATION WITH THE AGENCY.

    (a) In General.--The Secretary and the Director shall coordinate, 
including by entering into a cooperative agreement, as appropriate, to 
improve cybersecurity in the Healthcare and Public Health Sector.
    (b) Assistance.--
            (1) In general.--The Secretary shall coordinate with the 
        Director to make resources available to entities that are 
        receiving information shared through programs managed by the 
        Director or the Secretary, including Information Sharing and 
        Analysis Organizations, sector coordinating councils, and non-
        Federal entities.
            (2) Scope.--The coordination under paragraph (1) shall 
        include--
                    (A) developing products specific to the needs of 
                Healthcare and Public Health Sector entities;
                    (B) sharing information relating to cyber threat 
                indicators and appropriate defensive measures, 
                including automating cyber threat information sharing, 
                in a manner that adequately protects against 
                unauthorized access or disclosure; and
                    (C) providing technical assistance to covered 
                entities and business associates to improve 
                cybersecurity preparedness.
    (c) Joint Cybersecurity Planning.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary and the Director shall 
        establish a joint cybersecurity capability plan to coordinate 
        responses to significant cybersecurity incidents affecting the 
        Healthcare and Public Health Sector.
            (2) Elements.--The joint cybersecurity capability plan 
        established under paragraph (1) shall include--
                    (A) protocols for rapid information sharing during 
                sector-wide cybersecurity incidents;
                    (B) coordination mechanisms with the sector 
                coordinating council for the Healthcare and Public 
                Health Sector; and
                    (C) coordination with Cybersecurity State 
                Coordinators for incidents affecting multiple States.
            (3) Submission to congress.--
                    (A) In general.--Not later than 1 year after the 
                date of enactment of this Act, the Secretary shall 
                submit to the Committee on Health, Education, Labor, 
                and Pensions of the Senate and the Committee on Energy 
                and Commerce of the House of Representatives the final 
                joint cybersecurity capability plan prepared under 
                paragraph (1) and a description of how such plan 
                implements the elements required under paragraph (2).
                    (B) Updates.--If the Secretary and the Director 
                update the joint cybersecurity capability plan required 
                under this subsection, the Secretary shall submit to 
                the Committee on Health, Education, Labor, and Pensions 
                of the Senate and the Committee on Energy and Commerce 
                of the House of Representatives such updated plan and a 
                description of how such plan implements the elements 
                required under paragraph (2).

SEC. 4. CLARIFYING CYBERSECURITY RESPONSIBILITIES AT THE DEPARTMENT OF 
              HEALTH AND HUMAN SERVICES.

    (a) In General.--The Secretary shall delegate a representative to 
lead oversight and coordination of activities within the Department of 
Health and Human Services to support internal and external 
cybersecurity resilience within the Healthcare and Public Health 
Sector, including coordination and communication with other public and 
private entities related to preparedness for, and responses to, 
cybersecurity incidents, consistent with applicable provisions of the 
Public Health Service Act (42 U.S.C. 201 et seq.), other applicable 
laws, and National Security Memorandum-22 (April 30, 2024; relating to 
critical infrastructure security and resilience). Such activities shall 
not include implementation or enforcement of part 160 and subparts A 
and C of part 164 of title 45, Code of Federal Regulations (or 
successor regulations) (commonly known as the ``HIPAA Security Rule'').
    (b) Reports.--
            (1) Report on delegation.--Not later than 60 days after 
        delegating a representative under subsection (a), and any time 
        a new representative is delegated under such subsection, the 
        Secretary shall submit to the Committee on Health, Education, 
        Labor, and Pensions of the Senate and the Committee on Energy 
        and Commerce of the House of Representatives a report that 
        describes how such representative will implement steps to 
        improve internal and external cybersecurity resilience within 
        the Healthcare and Public Health Sector.
            (2) Annual report.--Not later than 1 year after the date of 
        enactment of this Act, and annually thereafter, the Secretary 
        shall submit to the Committee on Health, Education, Labor, and 
        Pensions of the Senate and the Committee on Energy and Commerce 
        of the House of Representatives a report on the state of 
        cybersecurity in the Healthcare and Public Health Sector, 
        including--
                    (A) an assessment of the most significant 
                cybersecurity threats and vulnerabilities facing the 
                Healthcare and Public Health Sector;
                    (B) a summary of major cybersecurity incidents 
                affecting the Healthcare and Public Health Sector 
                during the preceding year;
                    (C) an assessment of the overall cybersecurity 
                posture of the Healthcare and Public Health Sector;
                    (D) a description of actions taken by the 
                Department of Health and Human Services to improve 
                cybersecurity; and
                    (E) recommendations to improve Healthcare and 
                Public Health Sector cybersecurity.

SEC. 5. CYBERSECURITY INCIDENT RESPONSE PLAN.

    Section 405 of the Cybersecurity Act of 2015 (6 U.S.C. 1533) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (4)--
                            (i) in the paragraph heading, by inserting 
                        ``information system;'' after ``federal 
                        entity;''; and
                            (ii) by inserting ```information system','' 
                        after ```Federal entity','';
                    (B) by redesignating paragraphs (4) through (7) as 
                paragraphs (6) through (9), respectively; and
                    (C) by inserting after paragraph (3) the following:
            ``(4) Cybersecurity incident.--The term `cybersecurity 
        incident' has the meaning given the term `incident' in section 
        3552 of title 44, United States Code.
            ``(5) Cybersecurity risk.--The term `cybersecurity risk' 
        has the meaning given such term in section 2200 of the Homeland 
        Security Act of 2002 (6 U.S.C. 650).''; and
            (2) in subsection (d), by adding at the end the following:
            ``(4) Plan.--
                    ``(A) In general.--Not later than 1 year after the 
                date of enactment of the Health Care Cybersecurity and 
                Resiliency Act of 2026, the Secretary shall expand and 
                implement the Cyber Annex of the All Hazards Plan of 
                the Department of Health and Human Services to inform 
                applicable personnel within the Department of Health 
                and Human Services of processes and protocols to 
                prepare for, and respond to, cybersecurity incidents.
                    ``(B) Scope.--The plan under subparagraph (A) shall 
                address cybersecurity incidents involving information 
                systems, including hardware, software, databases, and 
                networks, used or maintained by, or on behalf of, the 
                Department.
                    ``(C) Elements.--The plan under subparagraph (A) 
                shall include strategies--
                            ``(i) to assess cybersecurity risks;
                            ``(ii) to prevent cybersecurity incidents;
                            ``(iii) to detect and identify 
                        cybersecurity incidents;
                            ``(iv) to minimize damage in the event of a 
                        cybersecurity incident;
                            ``(v) to protect data;
                            ``(vi) to recover from any cybersecurity 
                        incidents expeditiously; and
                            ``(vii) to communicate and share non-
                        sensitive information about cybersecurity 
                        incidents with entities in the Healthcare and 
                        Public Health Sector (as defined in section 2 
                        of the Health Care Cybersecurity and Resiliency 
                        Act of 2026).
                    ``(D) Consultation.--In developing the plan under 
                subparagraph (A), the Secretary shall consult with the 
                Director of the Cybersecurity and Infrastructure 
                Security Agency, the Director of the Office of 
                Management and Budget, the Director of the National 
                Institute of Standards and Technology, and relevant 
                experts, as appropriate.
                    ``(E) Updates.--The Secretary shall review and 
                update the plan under subparagraph (A)--
                            ``(i) not less frequently than once every 2 
                        years; and
                            ``(ii) after any significant cybersecurity 
                        incident affecting the Department of Health and 
                        Human Services or a Federal health program.
                    ``(F) Report.--Not later than 60 days before the 
                date on which the Secretary begins implementing the 
                plan under subparagraph (A), the Secretary shall submit 
                to the Committee on Health, Education, Labor, and 
                Pensions and the Committee on Homeland Security and 
                Governmental Affairs of the Senate and the Committee on 
                Energy and Commerce, the Committee on Oversight and 
                Reform, and the Committee on Homeland Security of the 
                House of Representatives a report that describes such 
                plan.''.

SEC. 6. CLARIFYING BREACH REPORTING OBLIGATIONS.

    Section 13402(f) of the HITECH Act (42 U.S.C. 17932(f)) is amended 
by adding at the end the following:
            ``(6) The number of individuals affected by the breach.''.

SEC. 7. ENHANCING RECOGNITION OF SECURITY PRACTICES.

    (a) Recognized Security Practices.--Section 13412(b)(1) of the 
HITECH Act (42 U.S.C. 17941(b)(1)) is amended, in the first sentence, 
by inserting ``, investments,'' after ``other programs''.
    (b) Regulation.--Not later than 1 year after the date of enactment 
of this Act, the Secretary shall promulgate regulations implementing 
section 13412 of the HITECH Act (42 U.S.C. 17941), which shall 
include--
            (1) recognized security practices that the Secretary may 
        consider when determining fines under such section;
            (2) the extent to which such recognized security practices 
        should be in place for consideration by the Secretary;
            (3) procedural requirements or information that shall be 
        submitted by a covered entity or business associate to the 
        Secretary for consideration; and
            (4) how the Secretary will take into account such 
        recognized security practices when determining fines, earlier 
        favorable termination of audits, or mitigating remedies that 
        would otherwise be agreed to in any agreement with respect to 
        resolving potential violations of part 160 and subparts A and C 
        of part 164 of title 45, Code of Federal Regulations (or 
        successor regulations) (commonly known as the ``HIPAA Security 
        Rule'') between the covered entity or business associate and 
        the Department of Health and Human Services.
    (c) Annual Report.--Not later than 2 years after the date of 
enactment of this Act, and annually thereafter, the Secretary shall 
include in the annual report required under section 13424(a) of the 
HITECH Act (42 U.S.C. 17953(a)) information on implementation of 
section 13412 of such Act (42 U.S.C. 17941), including an accounting of 
every case in which the Secretary considered recognized security 
practices when effectuating audits and assessing fines under such 
section.

SEC. 8. REQUIRED CYBERSECURITY STANDARDS.

    (a) In General.--The Secretary shall update the security 
regulations under part 160 and subparts A and C of part 164 of title 
45, Code of Federal Regulations (or any successor regulation), to 
require non-governmental entities in the Healthcare and Public Health 
Sector and covered entities and business associates to adopt minimum 
risk-based cybersecurity practices, including--
            (1) multifactor authentication, or a successor technology;
            (2) encryption of protected health information, or a 
        successor technology;
            (3) requirements to conduct monitoring, including 
        penetration testing, to maintain the protections of information 
        systems; and
            (4) other minimum cybersecurity standards, as reflected in 
        national cybersecurity frameworks.
    (b) Requirements.--The minimum risk-based cybersecurity practices 
adopted pursuant to subsection (a) shall be based on--
            (1) national cybersecurity frameworks, as appropriate, such 
        as--
                    (A) the National Institute of Standards and 
                Technology Risk Management Framework (or a successor 
                framework);
                    (B) the National Institute of Standards and 
                Technology Cybersecurity Framework (or a successor 
                framework);
                    (C) the National Institute of Standards and 
                Technology SP 800-53 r5 Security and Privacy Controls 
                for Information Systems and Organizations (or a 
                successor special publication), with relevant 
                components of the National Institute of Standards and 
                Technology Privacy Framework; or
                    (D) the National Institute of Standards and 
                Technology Artificial Intelligence Risk Management 
                Framework;
            (2) the Health Sector Coordinating Council Cybersecurity 
        Healthcare and Public Health Cybersecurity Performance Goals; 
        and
            (3) the health care-specific cybersecurity performance 
        goals of the Cybersecurity and Infrastructure Security Agency.
    (c) Effective Dates.--The regulations updated in accordance with 
subsection (a), including each new requirement established, shall take 
effect on the date that is 36 months after the date of enactment of 
this Act.
    (d) Enforcement.--The Secretary may exercise enforcement discretion 
for entities experiencing extraordinary circumstances in complying with 
the requirements of subsection (a).

SEC. 9. GUIDANCE ON RURAL CYBERSECURITY READINESS.

    Section 405(d) of the Cybersecurity Act of 2015 (6 U.S.C. 1533(d)) 
(as amended by section 5(2)) is amended by adding at the end the 
following:
            ``(5) Rural cybersecurity guidance.--
                    ``(A) Definition of rural.--In this paragraph, the 
                term `rural' has the meaning given such term by the 
                Federal Office of Rural Health Policy.
                    ``(B) Guidance on rural cybersecurity readiness.--
                Not later than 1 year after the date of enactment of 
                the Health Care Cybersecurity and Resiliency Act of 
                2026, the Secretary shall issue guidance to rural 
                entities on best practices to improve cybersecurity 
                readiness, including strategies--
                            ``(i) to improve cybersecurity 
                        infrastructure, including any technical 
                        safeguards to mitigate cybersecurity risk;
                            ``(ii) to integrate best practices issued 
                        by the Secretary to improve cybersecurity 
                        preparedness;
                            ``(iii) to improve workforce preparation to 
                        mitigate any cybersecurity risks, including 
                        existing public-private programs to support 
                        educational initiatives;
                            ``(iv) to implement policies to facilitate 
                        mandatory cybersecurity incident reporting 
                        requirements under law; and
                            ``(v) to explore and recommend best 
                        practices, including--
                                    ``(I) outsourcing information 
                                technology and chief information 
                                security officer functions to third 
                                parties on a part-time basis;
                                    ``(II) participating in regional 
                                rural health care information 
                                technology management sharing programs; 
                                and
                                    ``(III) migrating data to secure 
                                cloud-based platforms.
                    ``(C) Technical assistance.--The Secretary shall 
                provide technical assistance to rural entities to 
                implement the recommendations included in the guidance 
                under subparagraph (B).
                    ``(D) GAO study and report.--
                            ``(i) In general.--Not later than 3 years 
                        after the date of enactment of the Health Care 
                        Cybersecurity and Resiliency Act of 2026, the 
                        Comptroller General of the United States shall 
                        conduct a study, and submit to the Committee on 
                        Health, Education, Labor, and Pensions of the 
                        Senate and the Committee on Energy and Commerce 
                        of the House of Representatives a report, on 
                        how rural entities have implemented the 
                        recommendations included in the guidance under 
                        subparagraph (B).
                            ``(ii) Contents.--The study under clause 
                        (i) shall assess--
                                    ``(I) how rural entities have 
                                implemented any technical safeguards 
                                and any challenges faced by such rural 
                                entities in areas for which safeguards 
                                were not implemented;
                                    ``(II) steps to further support 
                                cybersecurity resilience for rural 
                                entities;
                                    ``(III) areas to improve 
                                coordination between Federal agencies, 
                                including for the purposes of required 
                                cyber reporting; and
                                    ``(IV) any opportunities to support 
                                public-private collaboration in the 
                                area of cybersecurity readiness.''.

SEC. 10. GRANTS TO ENHANCE CYBERSECURITY IN THE HEALTH AND PUBLIC 
              HEALTH SECTORS.

    (a) In General.--The Secretary may award grants to eligible 
entities for the adoption and implementation of cybersecurity best 
practices.
    (b) Eligible Entity.--To be eligible to receive a grant under 
subsection (a), an entity shall be--
            (1) a Federally qualified health center (as defined in 
        section 1861(aa)(4) of the Social Security Act (42 U.S.C. 
        1395x(aa)(4)));
            (2) a health facility operated by or pursuant to a contract 
        with the Indian Health Service;
            (3) a nonprofit hospital;
            (4) a rural health clinic (as defined in section 
        1861(aa)(2) of the Social Security Act (42 U.S.C. 
        1395x(aa)(2))); or
            (5) a nonprofit entity that enters into a partnership or 
        coordinates referrals with an entity described in any of 
        paragraphs (1) through (4).
    (c) Use of Funds.--In adopting and implementing cybersecurity best 
practices pursuant to a grant under subsection (a), an eligible entity 
may use grant funds--
            (1) to hire individuals with demonstrated cybersecurity 
        expertise and train personnel in such cybersecurity best 
        practices;
            (2) to update electronic data systems, such as by migrating 
        to cloud-based platforms;
            (3) to join and participate in health cybersecurity threat 
        information sharing organizations;
            (4) to contract with third parties to assist the eligible 
        entity in carrying out the activities described in this 
        subsection;
            (5) to conduct cybersecurity risk assessments and 
        vulnerability assessments; and
            (6) to develop or improve cybersecurity incident response 
        plans.
    (d) Grant Period.--A grant awarded under this section shall be for 
a period of not more than 3 years.
    (e) Priority.--In awarding grants under this section, the Secretary 
may give consideration to the demonstrated need of eligible entities.
    (f) Application.--An eligible entity seeking a grant under 
subsection (a) shall submit to the Secretary an application at such 
time, in such manner, and containing such information as the Secretary 
may require, including--
            (1) a description of how the eligible entity will establish 
        baseline measures and benchmarks that meet the Secretary's 
        requirements to evaluate performance outcomes; and
            (2) a strategic plan for how, after the end of the grant 
        period, the eligible entity will sustain the activities funded 
        under the grant and continue to adopt cybersecurity best 
        practices.
    (g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2026 through 2030.

SEC. 11. HEALTHCARE CYBERSECURITY WORKFORCE.

    (a) Training for Healthcare Experts.--The Secretary, in 
coordination with the Cybersecurity State Coordinators of the Agency, 
the Office of the National Cyber Director, and private sector health 
care experts, as appropriate, shall provide training to Healthcare and 
Public Health Sector entities on--
            (1) cybersecurity risks to information systems within the 
        Healthcare and Public Health Sector; and
            (2) ways to mitigate the risks to information systems in 
        the Healthcare and Public Health Sector.
    (b) Strategic Plan.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration, in coordination with the Agency, shall develop 
        a strategic plan to support growing the cybersecurity workforce 
        for health care entities.
            (2) Contents.--The strategic plan under paragraph (1) shall 
        include--
                    (A) recommendations for existing educational 
                programs that can be used to support cybersecurity 
                training;
                    (B) dissemination and development of educational 
                materials on how to improve cybersecurity resilience;
                    (C) development of best practices to train the 
                health care workforce on cybersecurity best practices;
                    (D) development of recommendations specific to 
                rural facilities;
                    (E) development of best practices to leverage 
                artificial intelligence to support cybersecurity 
                preparedness;
                    (F) opportunities for public-private collaboration 
                to strengthen the cybersecurity workforce; and
                    (G) alignment with the National Initiative for 
                Cybersecurity Education Workforce Framework.

SEC. 12. CYBERSECURITY INCIDENT REPORTING COORDINATION WORKING GROUP.

    (a) Working Group.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary shall convene a working 
        group to examine how to streamline and reduce duplicative 
        reporting for cybersecurity incidents.
            (2) Membership.--The working group described in paragraph 
        (1) shall include representatives of--
                    (A) the Cybersecurity and Infrastructure Security 
                Agency;
                    (B) the Securities and Exchange Commission;
                    (C) the Office of the National Cyber Director;
                    (D) the Federal Bureau of Investigation;
                    (E) the Federal Trade Commission;
                    (F) State attorneys general;
                    (G) State health departments; and
                    (H) private sector health care entities.
            (3) Conclusion.--The working group shall conclude not later 
        than 18 months after the date of the first meeting of the 
        working group.
    (b) Report.--Not later than 1 year after the conclusion of the 
working group under subsection (a)(3), the Secretary shall submit to 
the Committee on Health, Education, Labor, and Pensions of the Senate 
and the Committee on Energy and Commerce of the House of 
Representatives a report that--
            (1) identifies areas the working group has identified to 
        streamline and reduce duplicative reporting;
            (2) includes recommendations to Congress on further 
        streamlining such reporting; and
            (3) addresses coordination with State breach notification 
        laws.
                                                       Calendar No. 365

119th CONGRESS

  2d Session

                                S. 3315

_______________________________________________________________________

                                 A BILL

To require the Secretary of Health and Human Services and the Director 
 of the Cybersecurity and Infrastructure Security Agency to coordinate 
to improve cybersecurity in the health care and public health sectors, 
                        and for other purposes.

_______________________________________________________________________

                             March 23, 2026

                       Reported with an amendment