February 24, 2024

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HHS Office for Civil Rights and the Federal Trade Commission Warn Hospital Systems and Telehealth Providers about Privacy and Security Risks from Online Tracking Technologies

Letters highlight concerns about use of online tracking technologies such as Google Analytics and Meta Pixel in violation of HIPAA

The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) and the Federal Trade Commission (FTC) are cautioning hospitals and telehealth providers about the privacy and security risks related to the use of online tracking technologies that may be integrated into their websites or mobile apps that may be impermissibly disclosing consumers’ sensitive personal health data to third parties. Tracking technologies are used to collect and analyze information about how users interact with websites or mobile apps. Generally, tracking technologies developed by third parties send information directly to the third parties who developed such technologies and may continue to track users and gather information about them even after they navigate away from the original website to other websites. 

OCR administers and enforces the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security and Breach Notification Rules which set minimum privacy and security standards for the protection of certain individually identifiable health information. FTC’s mission is protecting the public from deceptive or unfair business practices and from unfair methods of competition through law enforcement, advocacy, research, and education. 

“Although online tracking technologies can be used for beneficial purposes, patients and others should not have to sacrifice the privacy of their health information when using a hospital’s website,” said Melanie Fontes Rainer, OCR Director. “OCR continues to be concerned about impermissible disclosures of health information to third parties and will use all of its resources to address this issue.”

“When consumers visit a hospital’s website or seek telehealth services, they should not have to worry that their most private and sensitive health information may be disclosed to advertisers and other unnamed, hidden third parties,” said Samuel Levine, Director of the FTC’s Bureau of Consumer Protection. “The FTC is again serving notice that companies need to exercise extreme caution when using online tracking technologies and that we will continue doing everything in our powers to protect consumers’ health information from potential misuse and exploitation.”

The two agencies sent the joint letter* to approximately 130 hospital systems and telehealth providers to emphasize the risks and concerns about the use of technologies, such as the Meta/Facebook pixel and Google Analytics, that can track a user’s online activities. These tracking technologies gather identifiable information about users, usually without their knowledge and in ways that are hard for users to avoid, as users interact with a website or mobile app.

OCR highlighted these concerns in a bulletin it issued late last year that reminded entities covered by HIPAA of their responsibilities to protect health data from unauthorized disclosure under the law.  Since that time, OCR has confirmed its active investigations nationwide to ensure compliance with HIPAA.

Companies not covered by HIPAA still have a responsibility to protect against the unauthorized disclosure of personal health information—even when a third party developed their website or mobile app. Through its recent enforcement actions against BetterHelp, GoodRx and Premom, as well as recent guidance from the FTC’s Office of Technology, the FTC has put companies on notice that they must monitor the flow of health information to third parties that use tracking technologies integrated into websites and apps. The unauthorized disclosure of such information may violate the FTC Act and could constitute a breach of security under the FTC’s Health Breach Notification Rule.

OCR is committed to enforcing the HIPAA Rules that protect the privacy and security of peoples’ health information. If you believe that your or another person’s health information privacy or civil rights have been violated, you can file a complaint with OCR at: https://www.hhs.gov/ocr/complaints/index.html.

*People using assistive technology may not be able to fully access information in this file. For assistance, contact the HHS Office for Civil Rights at (800) 368-1019, TDD toll-free: (800) 537-7697, or by emailing [email protected].

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