Do the HIPAA Rules allow a covered entity or business associate to use a CSP that stores ePHI on servers outside of the United States? Do the HIPAA Rules allow a covered entity or business associate to use a CSP that stores ePHI on servers outside of the United States?
Issued by: Office for Civil Rights (OCR)
Do the HIPAA Rules
allow a covered entity or business associate to use a CSP that stores
ePHI on servers outside of the United States?
Answer:
Yes, provided the covered entity (or business associate) enters into a
business associate agreement (BAA) with the CSP and otherwise complies
with the applicable requirements of the HIPAA Rules. However, while the
HIPAA Rules do not include requirements specific to protection of
electronic protected health information (ePHI) processed or stored by a
CSP or any other business associate outside of the United States, OCR
notes that the risks to such ePHI may vary greatly depending on its
geographic location. In particular, outsourcing storage or other
services for ePHI overseas may increase the risks and vulnerabilities to
the information or present special considerations with respect to
enforceability of privacy and security protections over the data.
Covered entities (and business associates, including the CSP) should
take these risks into account when conducting the risk analysis and risk
management required by the Security Rule. See 45 CFR §§
164.308(a)(1)(ii)(A) and (a)(1)(ii)(B). For example, if ePHI is
maintained in a country where there are documented increased attempts at
hacking or other malware attacks, such risks should be considered, and
entities must implement reasonable and appropriate technical safeguards
to address such threats.
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