Health care data hub gets authority to operate

Despite testing delays, a key piece of technology needed to enroll applicants in the insurance marketplaces created by the 2010 health care overhaul has been cleared to operate, setting the stage for an Oct. 1 launch.

health data

A key piece of technology needed to enroll applicants in the insurance marketplaces created by the 2010 health care overhaul has received authorization to operate, setting the stage for the exchanges' Oct. 1 launch.

News of the authorization stunned many observers, given that a  report from the Health and Human Services Inspector General revealed that testing for the data hub had fallen behind schedule, and that security authorization wasn't due to be completed until Sept. 30, one day before the hub is scheduled to go online.

Former Social Security Commissioner Michael Astrue called assurances that the data hub meets security standards "untrue or problematic" in testimony Sept. 11 before the Homeland Security Cybersecurity, Infrastructure Protection, and Security Subcommittee. "Despite the [CMS] letter this morning, many states will be unready for Oct. 1," he added.

According to Astrue, the system needs to store data in order to investigate reports of security breaches, although CMS continues to stress in public statements that the system does not store data.

According to CMS, the system is protected by continuous monitoring and other security systems to detect anomalous behavior and possible breaches. Potential security incidents would be reported to authorities, including the HHS Office of Inspector General Cyber Crimes Unit which are authorized to investigate.

Despite the doubters, administration officials hailed the latest development.

"The hub is critical to the operation of both the Federally Facilitated Marketplace and State-Based Marketplaces, enabling them to provide accurate and timely eligibility determinations,” Federal Chief Technology Officer Todd Park said in an e-mailed statement. “After over two years of work, it is built and ready for operation, and we have completed security testing and certification to operate.  This is an important step in being ready for open enrollment on October 1."

Security testing for the data hub, which connects information from a variety of government databases to determine individual eligibility for insurance coverage, was completed Aug. 23, and the authority to operate was issued Sept. 6, according to a letter from Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, to Rep. Bennie Thompson of Mississippi, ranking Democrat on the Homeland Security Committee.

"The completion of this testing confirms that the hub comports with the stringent standards," Tavenner wrote, including the requirements of the Federal Information Security Management Act and other federal laws, as well as internal standards from the Office of Management and Budget, the Department of Homeland Security, the National Institute of Standards and Technology, and other agencies.

The size of the system presents a potentially inviting target to hackers and information thieves. Stephen Parente, an academic who specializes in health insurance technology, said the combined databases connected under the hub, "constitute the largest personal data integration government project in the history of the republic, with up to 300 million American citizen records needing to be combined from five federal agencies."

Rep. Patrick Meehan (R-Pa.), chairman of the subcommittee that held the hearing, said that he is concerned that "personally identifiable information for every applicant and their families will pass through the data hub." He's worried about the "increasing sophistication" of online malefactors, "including state-sponsored actors who may wish to do us harm."

Many of the critical specifications of the data hub remain a secret, even from Congress and the inspector general, in large part as a security measure, so it's not possible to evaluate assurances from CMS that the system does not store data. Parente noted that, "the fact that only a handful of individuals know truly how this will operate may preserve some security," but he said that more transparency would strengthen the overall operation of the hub.

CMS still needs to conclude service level agreements with federal partners before the hub can be operational. These are expected to be wrapped up by Sept. 27, according to the HHS Assistant Inspector General Kay Daly.

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