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<!DOCTYPE html><html lang="en"><head><meta charSet="utf-8"/><meta name="viewport" content="width=device-width, initial-scale=1"/><link rel="preload" as="image" href="/_next/static/media/CyberGeek-logo.8e9bbd2b.svg" fetchPriority="high"/><link rel="stylesheet" href="/_next/static/css/ef46db3751d8e999.css" data-precedence="next"/><link rel="stylesheet" href="/_next/static/css/0759e90f4fecfde7.css" data-precedence="next"/><link rel="preload" as="script" fetchPriority="low" href="/_next/static/chunks/webpack-182b67d00f496f9d.js"/><script src="/_next/static/chunks/fd9d1056-ad09c71b7719f2fb.js" async=""></script><script src="/_next/static/chunks/23-260042deb5df7a88.js" async=""></script><script src="/_next/static/chunks/main-app-6de3c3100b91a0a9.js" async=""></script><script src="/_next/static/chunks/30-49b1c1429d73281d.js" async=""></script><script src="/_next/static/chunks/317-0f87feacc1712b2f.js" async=""></script><script src="/_next/static/chunks/223-bc9ed43510898bbb.js" 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padding-x-2 desktop:padding-x-0 padding-top-4 padding-bottom-6 desktop:padding-y-7"><div class="tablet:grid-container position-relative "><div class="hero__row grid-row grid-gap"><div class="tablet:grid-col-5 widescreen:position-relative"></div><div class="hero__column tablet:grid-col-7 flow padding-bottom-2"><h1 class="hero__heading margin-0 line-height-sans-3 desktop:line-height-sans-2">CMS Breach Analysis Team (BAT) Handbook</h1><p class="hero__description">Procedures for the Breach Analysis Team (BAT) to follow when a team is convened to address a breach of PII at CMS</p><p class="font-sans-2xs line-height-sans-5 margin-bottom-0">Last reviewed<!-- -->: <!-- -->11/8/2022</p><div class="hero__meta radius-lg padding-x-2 padding-y-1 bg-white font-sans-2xs line-height-sans-5 display-inline-block text-primary-darker">Contact: <span class="text-bold">Incident Management Team</span><span class="hidden-mobile"> | </span><span class="break-mobile"><a href="mailto:IMT@cms.hhs.gov">IMT@cms.hhs.gov</a></span></div></div></div></div></div></section><div class="grid-container"><div class="grid-row grid-gap margin-top-5"><div class="tablet:grid-col-4"><nav class="table-of-contents overflow-y-auto overflow-x-hidden position-sticky top-3 padding-1 radius-lg shadow-2 display-none tablet:display-block" aria-label="Table of contents"><div class="text-uppercase text-bold border-bottom border-base-lighter padding-bottom-1">Table of Contents</div><p class="text-italic text-base font-sans-xs">No table of content entries to display.</p></nav></div><div class="tablet:grid-col-8"><section class="resource-collection radius-md padding-y-2 padding-x-3 bg-base-lightest"><h1 class="resource-collection__header h3 margin-top-0 margin-bottom-2">Related Resources</h1><div class="grid-row grid-gap-4"><div class="tablet:grid-col-4 tablet:margin-top-0"><a class="text-no-underline text-bold" href="/policy-guidance/cms-breach-response-handbook">CMS Breach Response Handbook</a></div><div class="tablet:grid-col-4 margin-top-4 tablet:margin-top-0"><a class="text-no-underline text-bold" href="/learn/breach-response">Breach Response</a></div><div class="tablet:grid-col-4 margin-top-4 tablet:margin-top-0"><a class="text-no-underline text-bold" href="/learn/cms-security-and-privacy-handbooks">CMS Security and Privacy Handbooks (all)</a></div></div></section><section><div class="text-block text-block--theme-library"><h2>Introduction</h2><p>Whenever there is an incident that has potentially compromised the security or privacy of CMS information or information systems, it is investigated by the Incident Management Team (IMT). They assess whether any categories of sensitive data may be compromised. If so, the incident is considered a suspected <strong>breach</strong>. </p><p>At this point (in collaboration with the Business Owner and the Information System Security Officer), the IMT may decide that a Breach Analysis Team should be convened, and notifies ISPG. This handbook is a guide for members of the Breach Analysis Team (BAT) to follow as they work to assess and mitigate the risks caused by a suspected breach.</p><h2>Who is on the BAT?</h2><p>The BAT consists of breach response stakeholders in leadership positions and security and privacy subject matter experts for the affected system. This may include:</p><ul><li>Representatives from the Incident Management Team (IMT) within the CMS Cybersecurity Integration Center (CCIC)</li><li>Representatives from ISPG (which may include the DCTSO Incident Commander and Senior Official for Privacy)</li><li>Business and/or System Owner of the affected system</li><li>Other people as needed:<ul><li>Information System Security Officer (ISSO)</li><li>System Maintainer</li><li>Contracting Officer Representative (COR) – if the affected system is a contractor system</li><li>CPI point of contact</li></ul></li></ul><h2>BAT responsibilities and steps</h2><p>Once convened, the Breach Analysis Team is responsible for the following:</p><h3>Conduct risk assessment</h3><p>The BAT conducts a risk assessment (using the <strong>Risk Assessment for Breach Notification</strong> worksheet) to determine the risk of harm to the affected individuals whose PII/PHI has been compromised. The assessment also helps determine who should be notified of the breach, and to what extent (if any).</p><p>When conducting the Risk Assessment, consider the following elements:</p><h4>How sensitive is the PII?</h4><p>Determine the nature and sensitivity of the PII potentially compromised by the breach, including the potential harms that an individual could experience from the compromise of that type of PII. These are the minimum data points that must be considered at this step:</p><ul><li><strong>Data Elements</strong> – analysis of the sensitivity of each individual data element as well as the sensitivity of all the data elements together</li><li><strong>Context</strong> – purpose for which the PII was collected, maintained, and used</li><li><strong>Private Information</strong> – extent to which the PII, in a given context, may reveal particularly private information about an individual</li><li><strong>Vulnerable Populations</strong> – extent to which the PII identifies or disproportionately impacts a particularly vulnerable population</li><li><strong>Permanence </strong>– the continued relevance and utility of the PII over time and whether it is easily replaced or substituted</li></ul><h4>How likely is the PII to be accessed and used?</h4><p>Determine the likelihood of access and use of the compromised PII, including whether it was properly encrypted or rendered partially or completely inaccessible by other means. These are the minimum data points that must be considered at this step:</p><ul><li><strong>Security Safeguards</strong> – whether the PII was properly encrypted or rendered partially or completely inaccessible by other means</li><li><strong>Format and Media </strong>– whether the format of the PII may make it difficult and resource-intensive to use</li><li><strong>Duration of Exposure</strong> – how long the PII was exposed</li><li><strong>Evidence of Misuse</strong> – any evidence confirming that the PII is being misused or that it was never accessed</li></ul><h4>What kind of breach and who is involved?</h4><p>Determine and document the type of breach, including the circumstances of the breach, as well as the actors involved and their intent. These are the minimum data points that must be considered at this step:</p><ul><li>Intent – whether the PII was compromised intentionally or unintentionally (or if the intent is unknown)</li><li>Recipient – whether the PII was disclosed to a known or unknown recipient, and the trustworthiness of a known recipient</li></ul><h4>What is CMS’ ability to mitigate risk?</h4><p>Within an information system, the risk of harm will depend on how CMS is able to mitigate further compromise of the system(s) affected by a breach.</p><p>Consider how best to mitigate the identified risks and whether to notify individuals potentially affected by breach (including whether to offer credit monitoring services).</p><h3>Document risk assessment results</h3><p>Document the results of the above risk assessment on the <strong>Risk Assessment for Breach Notification</strong> worksheet, and submit the completed form to the CMS Senior Official for Privacy: <a href="mailto:privacy@cms.hhs.gov">privacy@cms.hhs.gov</a> </p><p>If the above risk assessment indicates that there is a <strong>low probability</strong> that the PII has been compromised, inform the Incident Management Team of the risk assessment so they can coordinate with the CMS Computer Security Incident Response Team (CSIRT) to update and close the applicable ticket.</p><h4>Low risk determination</h4><p>If the above risk assessment indicates that there is a <strong>low probability</strong> that the PII has been compromised, inform the Incident Management Team of the risk assessment so they can coordinate with the CMS Computer Security Incident Response Team (CSIRT) to update and close the applicable ticket.</p><h4>Medium or high risk determination</h4><p>If the above risk assessment indicates that there is a <strong>medium or high probability</strong> that the PII has been compromised, coordinate with the HHS Privacy Incident Response Team (PIRT) to perform the following:</p><p><strong>Notification measures for PII</strong></p><p>The CMS Senior Official for Privacy and Business Owner coordinate to notify, without unreasonable delay, the individuals affected.</p><p><strong>Notification measures for PHI</strong></p><p>This step does not apply unless PHI (as defined by HIPAA) is involved. If the data is only PII (as defined by the Privacy Act), then proceed to the next step: Recommendations to HHS PIRT.</p><p>If the PHI breach involves 500 or more individuals:</p><ul><li>The Director of the Division of Security, Privacy Policy, and Oversight (DSPPO) and the Business Owner coordinate to notify HHS Office for Civil Rights (OCR) of the breach via the <a href="http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html">OCR website</a> using the form: “<a href="https://ocrportal.hhs.gov/ocr/breach/wizard_breach.jsf?faces-redirect=true">Submit a notice for a breach affecting 500 or more individuals</a>”. This provides the Secretary with notice of the breach without unreasonable delay – and <strong>never later than 60 days from discovery of the breach</strong>.</li></ul><p>If the PHI breach involves fewer than 500 individuals:</p><ul><li>The Director of the Division of Security, Privacy Policy, and Oversight (DSPPO) and the Business Owner coordinate to notify HHS Office for Civil Rights (OCR) within the deadline via the <a href="http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html">OCR website</a> using the form “<a href="https://ocrportal.hhs.gov/ocr/breach/wizard_breach.jsf?faces-redirect=true">Submit a notice for a breach affecting fewer than 500 individuals</a>”.</li></ul><p>If the PHI breach involves more than 500 residents of a State or Jurisdiction:</p><ul><li>The CMS Senior Official for Privacy and Business Owner coordinate to notify prominent media outlets serving the applicable State or Jurisdiction of the breach.</li></ul><h4>Recommendations to HHS PIRT </h4><p>The last step is to make a recommendation about breach notification to the HHS Privacy Incident Response Team (PIRT). Do this by creating a draft plan for notification and mitigation using the HHS PIRT Response Plan Template. Submit this draft to HHS PIRT so they can review it.</p><p>The PIRT may overrule the BAT on whether notification and mitigation are necessary or they may request changes to the plan. If the PIRT approves, the Business Owner of the affected system (and the COR if the affected system is a contractor system) are responsible for executing the approved plan.</p><h2>Closing breach response activities</h2><p>Verify all of the above steps have been completed fully (as necessary, depending on the type of breach, type of sensitive information, level of risk, and so on.) 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They assess whether any categories of sensitive data may be compromised. If so, the incident is considered a suspected \u003cstrong\u003ebreach\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAt this point (in collaboration with the Business Owner and the Information System Security Officer), the IMT may decide that a Breach Analysis Team should be convened, and notifies ISPG. This handbook is a guide for members of the Breach Analysis Team (BAT) to follow as they work to assess and mitigate the risks caused by a suspected breach.\u003c/p\u003e\u003ch2\u003e\u003cstrong\u003eWho is on the BAT?\u003c/strong\u003e\u003c/h2\u003e\u003cp\u003eThe BAT consists of breach response stakeholders in leadership positions and security and privacy subject matter experts for the affected system. 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These are the minimum data points that must be considered at this step:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cstrong\u003eSecurity Safeguards\u003c/strong\u003e – whether the PII was properly encrypted or rendered partially or completely inaccessible by other means\u003c/li\u003e\u003cli\u003e\u003cstrong\u003eFormat and Media \u003c/strong\u003e– whether the format of the PII may make it difficult and resource-intensive to use\u003c/li\u003e\u003cli\u003e\u003cstrong\u003eDuration of Exposure\u003c/strong\u003e – how long the PII was exposed\u003c/li\u003e\u003cli\u003e\u003cstrong\u003eEvidence of Misuse\u003c/strong\u003e – any evidence confirming that the PII is being misused or that it was never accessed\u003c/li\u003e\u003c/ul\u003e\u003ch4\u003e\u003cstrong\u003eWhat kind of breach and who is involved?\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eDetermine and document the type of breach, including the circumstances of the breach, as well as the actors involved and their intent. These are the minimum data points that must be considered at this step:\u003c/p\u003e\u003cul\u003e\u003cli\u003eIntent – whether the PII was compromised intentionally or unintentionally (or if the intent is unknown)\u003c/li\u003e\u003cli\u003eRecipient – whether the PII was disclosed to a known or unknown recipient, and the trustworthiness of a known recipient\u003c/li\u003e\u003c/ul\u003e\u003ch4\u003e\u003cstrong\u003eWhat is CMS’ ability to mitigate risk?\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eWithin an information system, the risk of harm will depend on how CMS is able to mitigate further compromise of the system(s) affected by a breach.\u003c/p\u003e\u003cp\u003eConsider how best to mitigate the identified risks and whether to notify individuals potentially affected by breach (including whether to offer credit monitoring services).\u003c/p\u003e\u003ch3\u003e\u003cstrong\u003eDocument risk assessment results\u003c/strong\u003e\u003c/h3\u003e\u003cp\u003eDocument the results of the above risk assessment on the \u003cstrong\u003eRisk Assessment for Breach Notification\u003c/strong\u003e worksheet, and submit the completed form to the CMS Senior Official for Privacy: \u003ca href=\"mailto:privacy@cms.hhs.gov\"\u003eprivacy@cms.hhs.gov\u003c/a\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003eIf the above risk assessment indicates that there is a \u003cstrong\u003elow probability\u003c/strong\u003e that the PII has been compromised, inform the Incident Management Team of the risk assessment so they can coordinate with the CMS Computer Security Incident Response Team (CSIRT) to update and close the applicable ticket.\u003c/p\u003e\u003ch4\u003e\u003cstrong\u003eLow risk determination\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eIf the above risk assessment indicates that there is a \u003cstrong\u003elow probability\u003c/strong\u003e that the PII has been compromised, inform the Incident Management Team of the risk assessment so they can coordinate with the CMS Computer Security Incident Response Team (CSIRT) to update and close the applicable ticket.\u003c/p\u003e\u003ch4\u003e\u003cstrong\u003eMedium or high risk determination\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eIf the above risk assessment indicates that there is a \u003cstrong\u003emedium or high probability\u003c/strong\u003e that the PII has been compromised, coordinate with the HHS Privacy Incident Response Team (PIRT) to perform the following:\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNotification measures for PII\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThe CMS Senior Official for Privacy and Business Owner coordinate to notify, without unreasonable delay, the individuals affected.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNotification measures for PHI\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThis step does not apply unless PHI (as defined by HIPAA) is involved. 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This provides the Secretary with notice of the breach without unreasonable delay – and \u003cstrong\u003enever later than 60 days from discovery of the breach\u003c/strong\u003e.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eIf the PHI breach involves fewer than 500 individuals:\u003c/p\u003e\u003cul\u003e\u003cli\u003eThe Director of the Division of Security, Privacy Policy, and Oversight (DSPPO) and the Business Owner coordinate to notify HHS Office for Civil Rights (OCR) within the deadline via the \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html\"\u003eOCR website\u003c/a\u003e using the form “\u003ca href=\"https://ocrportal.hhs.gov/ocr/breach/wizard_breach.jsf?faces-redirect=true\"\u003eSubmit a notice for a breach affecting fewer than 500 individuals\u003c/a\u003e”.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eIf the PHI breach involves more than 500 residents of a State or Jurisdiction:\u003c/p\u003e\u003cul\u003e\u003cli\u003eThe CMS Senior Official for Privacy and Business Owner coordinate to notify prominent media outlets serving the applicable State or Jurisdiction of the breach.\u003c/li\u003e\u003c/ul\u003e\u003ch4\u003e\u003cstrong\u003eRecommendations to HHS PIRT\u0026nbsp;\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eThe last step is to make a recommendation about breach notification to the HHS Privacy Incident Response Team (PIRT). 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These are the minimum data points that must be considered at this step:\u003c/p\u003e\u003cul\u003e\u003cli\u003eIntent – whether the PII was compromised intentionally or unintentionally (or if the intent is unknown)\u003c/li\u003e\u003cli\u003eRecipient – whether the PII was disclosed to a known or unknown recipient, and the trustworthiness of a known recipient\u003c/li\u003e\u003c/ul\u003e\u003ch4\u003e\u003cstrong\u003eWhat is CMS’ ability to mitigate risk?\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eWithin an information system, the risk of harm will depend on how CMS is able to mitigate further compromise of the system(s) affected by a breach.\u003c/p\u003e\u003cp\u003eConsider how best to mitigate the identified risks and whether to notify individuals potentially affected by breach (including whether to offer credit monitoring services).\u003c/p\u003e\u003ch3\u003e\u003cstrong\u003eDocument risk assessment results\u003c/strong\u003e\u003c/h3\u003e\u003cp\u003eDocument the results of the above risk assessment on the \u003cstrong\u003eRisk Assessment for Breach Notification\u003c/strong\u003e worksheet, and submit the completed form to the CMS Senior Official for Privacy: \u003ca href=\"mailto:privacy@cms.hhs.gov\"\u003eprivacy@cms.hhs.gov\u003c/a\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003eIf the above risk assessment indicates that there is a \u003cstrong\u003elow probability\u003c/strong\u003e that the PII has been compromised, inform the Incident Management Team of the risk assessment so they can coordinate with the CMS Computer Security Incident Response Team (CSIRT) to update and close the applicable ticket.\u003c/p\u003e\u003ch4\u003e\u003cstrong\u003eLow risk determination\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eIf the above risk assessment indicates that there is a \u003cstrong\u003elow probability\u003c/strong\u003e that the PII has been compromised, inform the Incident Management Team of the risk assessment so they can coordinate with the CMS Computer Security Incident Response Team (CSIRT) to update and close the applicable ticket.\u003c/p\u003e\u003ch4\u003e\u003cstrong\u003eMedium or high risk determination\u003c/strong\u003e\u003c/h4\u003e\u003cp\u003eIf the above risk assessment indicates that there is a \u003cstrong\u003emedium or high probability\u003c/strong\u003e that the PII has been compromised, coordinate with the HHS Privacy Incident Response Team (PIRT) to perform the following:\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNotification measures for PII\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThe CMS Senior Official for Privacy and Business Owner coordinate to notify, without unreasonable delay, the individuals affected.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNotification measures for PHI\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThis step does not apply unless PHI (as defined by HIPAA) is involved. If the data is only PII (as defined by the Privacy Act), then proceed to the next step: Recommendations to HHS PIRT.\u003c/p\u003e\u003cp\u003eIf the PHI breach involves 500 or more individuals:\u003c/p\u003e\u003cul\u003e\u003cli\u003eThe Director of the Division of Security, Privacy Policy, and Oversight (DSPPO) and the Business Owner coordinate to notify HHS Office for Civil Rights (OCR) of the breach via the \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html\"\u003eOCR website\u003c/a\u003e using the form: “\u003ca href=\"https://ocrportal.hhs.gov/ocr/breach/wizard_breach.jsf?faces-redirect=true\"\u003eSubmit a notice for a breach affecting 500 or more individuals\u003c/a\u003e”. 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