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HIPAA Security Rule guide

HIPAA Security Rule policies and procedures template for small practices

Every practice that handles electronic patient records needs written security policies. Here is what the HIPAA Security Rule asks for in plain English, where the proposed update stands, and editable templates to get started.

  • Plain English
  • Editable Word & Excel
  • Free self-assessment

Updated October 18, 2026 · Get the free self-assessment

The requirement

What the HIPAA Security Rule requires, in plain English

The HIPAA Security Rule (45 CFR Part 164, Subpart C) protects electronic protected health information (ePHI). Every covered entity and business associate must have administrative, physical and technical safeguards that fit their size and risk.

The starting point is an accurate and thorough risk analysis of where ePHI lives and what could happen to it, followed by risk management to reduce those risks. On top of that you need a named security official, workforce training, access controls, audit controls, contingency (backup and recovery) plans, incident procedures and business associate agreements.

The rule also requires written policies and procedures, kept for six years from when they were created or last in effect, and reviewed as your practice changes.

HHS proposed a major update in January 2025 that would make items like MFA, encryption and an asset inventory explicit requirements. As of October 2026 it has not been finalized. Policies that already cover these controls put you ahead either way.

Requirement by requirement

Where each requirement is covered in the Healthcare CyberSecure kit

Every document is editable Word or Excel. Items marked Pro are in the Professional Edition only.

RequirementWhat it means for youKit documents
Security management and risk analysisAssess risks to ePHI and manage them.
  • Risk Management PolicyPro
  • Healthcare Cybersecurity Operational ToolkitPro
Assigned security responsibilityName a security official.
  • Cybersecurity Roles & Responsibilities PolicyPro
  • Information Security PolicyStarter & Pro
Workforce trainingTrain staff on phishing, passwords and handling ePHI.
  • Security Awareness & Training PolicyStarter & Pro
  • Employee Cybersecurity Quick GuidePro
Access control and authenticationUnique logins, MFA and least-privilege access to the EHR.
  • Access Control PolicyStarter & Pro
  • Password & Authentication PolicyStarter & Pro
  • Multi-Factor Authentication PolicyPro
Encryption and data protectionProtect ePHI at rest and in transit.
  • Data Protection & Encryption PolicyStarter & Pro
Device, endpoint and remote accessSecure laptops, phones and remote sessions.
  • Endpoint Security PolicyPro
  • Mobile Device & Remote Work PolicyStarter & Pro
  • Remote Access PolicyStarter & Pro
Contingency planBack up ePHI and be able to restore it.
  • Backup & Recovery PolicyStarter & Pro
  • Business Continuity & Disaster Recovery PolicyStarter & Pro
Security incident proceduresIdentify, respond to and document incidents.
  • Incident Response PolicyStarter & Pro
  • Incident Response PlanPro
Business associates and vendorsOversee vendors that handle ePHI.
  • Vendor & Third-Party Security PolicyStarter & Pro
Patching and vulnerabilitiesKeep systems updated and scan for weaknesses.
  • Vulnerability & Patch Management PolicyStarter & Pro
See a sample page

What the Risk Management Policy looks like

Plain-language templates with bracketed fields for your details, policy IDs that stay the same when you upgrade, and a footer reminding you to customize before use.

  • Download right after checkout
  • Edit in Microsoft Word, Google Docs or any word processor
  • One-time price: Starter $149 · Professional $349
Sample first page of the Healthcare CyberSecure Risk Management Policy template
Page 1 of the Healthcare Risk Management Policy (HC-CYB-003).
What's inside

Every file in each edition

Policy numbers carry over from the Starter Kit to the Professional Edition, so you can start small and upgrade without renumbering.

Starter Kit

$149

17 editable files

Policies 15

  • HC-CYB-001Information Security Policy
  • HC-CYB-004Password & Authentication Policy
  • HC-CYB-005Access Control Policy
  • HC-CYB-007Acceptable Use Policy
  • HC-CYB-008Security Awareness & Training Policy
  • HC-CYB-009Email & Phishing Security Policy
  • HC-CYB-011Mobile Device & Remote Work Policy
  • HC-CYB-012Data Protection & Encryption Policy
  • HC-CYB-013Backup & Recovery Policy
  • HC-CYB-014Incident Response Policy
  • HC-CYB-015Business Continuity & Disaster Recovery Policy
  • HC-CYB-016Remote Access Policy
  • HC-CYB-017Vendor & Third-Party Security Policy
  • HC-CYB-018AI Acceptable Use Policy
  • HC-CYB-019Vulnerability & Patch Management Policy

Plans, guides & assessments 1

  • WordImplementation Guide

Workbook 1

  • ExcelHealthcare CyberSecure Starter Toolkit

Professional Edition

$349

26 editable files

Policies 20

  • HC-CYB-001Information Security Policy
  • HC-CYB-002Cybersecurity Roles & Responsibilities Policy
  • HC-CYB-003Risk Management Policy
  • HC-CYB-004Password & Authentication Policy
  • HC-CYB-005Access Control Policy
  • HC-CYB-006Multi-Factor Authentication Policy
  • HC-CYB-007Acceptable Use Policy
  • HC-CYB-008Security Awareness & Training Policy
  • HC-CYB-009Email & Phishing Security Policy
  • HC-CYB-010Endpoint Security Policy
  • HC-CYB-011Mobile Device & Remote Work Policy
  • HC-CYB-012Data Protection & Encryption Policy
  • HC-CYB-013Backup & Recovery Policy
  • HC-CYB-014Incident Response Policy
  • HC-CYB-015Business Continuity & Disaster Recovery Policy
  • HC-CYB-016Remote Access Policy
  • HC-CYB-017Vendor & Third-Party Security Policy
  • HC-CYB-018AI Acceptable Use Policy
  • HC-CYB-019Vulnerability & Patch Management Policy
  • HC-CYB-020AI Governance Policy

Plans, guides & assessments 5

  • Word30-60-90 Day Action Plan
  • Word50-Question Healthcare Cybersecurity Self-Assessment
  • WordEmployee Cybersecurity Quick Guide
  • WordHealthcare CyberSecure Professional Implementation Guide
  • WordIncident Response Plan

Workbook 1

  • ExcelHealthcare Cybersecurity Operational Toolkit
Questions

Frequently asked questions

Is the new HIPAA Security Rule final?

No. HHS published a proposed rule on January 6, 2025. As of October 2026 it has not been finalized. The current Security Rule still applies.

Does a small practice really need written security policies?

Yes. The Security Rule requires written policies and procedures, kept for six years, scaled to your size and risk.

Is a policy template the same as a HIPAA risk analysis?

No. The kit helps you document and manage risk, but your practice still has to do its own risk analysis. The templates are not a risk analysis or a compliance determination.

How fast do we have to report a breach?

Notify affected individuals without unreasonable delay and no later than 60 days after discovery. Breaches of 500 or more also go to HHS and the media; smaller breaches are logged and reported to HHS annually.

Is this legal advice?

No. These are editable templates and plain-English education. Have your attorney or compliance advisor review them.

Free download

Free Healthcare cybersecurity self-assessment

Answer 50 yes / no / not sure questions across 10 areas. Score your results and get clear next steps for your industry.

  • Small Business, Law Office, Real Estate, Healthcare, Accounting & Tax, Insurance Agency, Financial Advisor, Auto Dealer, Mortgage & Title, and Cyber Insurance Readiness editions
  • Starred priority questions and a scoring table
  • Printable PDF

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Ready to put it in writing?

Get the Healthcare CyberSecure kit

Start with the Starter Kit or get every policy, form and workbook in the Professional Edition. Policy numbers carry over if you upgrade.

See the full Healthcare CyberSecure page

Sources

  1. HHS: HIPAA Security Rule NPRM
  2. Federal Register: proposed HIPAA Security Rule update (Jan. 6, 2025)
  3. HHS: HIPAA Breach Notification Rule
  4. Pact-One: Is the HIPAA Security Rule final in 2026?

This guide is plain-English education, current as of October 18, 2026. It is not legal advice, an audit or a compliance determination, and Cybriva is not affiliated with any regulator or standards body named here. Rules change and vary by state; confirm how they apply to you with your attorney or compliance advisor.

Free self-assessment