Transmission Security 45 CFR 164.312(e)

Two addressable implementation specifications sit under this standard: integrity controls and encryption. Both are expected in 2025 - the proposed Security Rule NPRM treats encryption in transit as required for all ePHI transmissions.

Implementation specifications

Every Petronella HIPAA engagement maps 45 CFR 164.312(e)(1) to documented evidence in your environment. This is what that looks like in practice for the transmission security standard:

• TLS 1.2+ enforced on every endpoint that touches ePHI (web, email, API, EHR, fax-over-IP), with TLS 1.0/1.1 disabled.
• Email encryption with policy-based forced encryption on outbound messages containing PHI keywords.
• Site-to-site VPN or Zero Trust Network Access for remote ePHI access, with FIPS-validated cipher suites.
• Cloud-storage transfers use server-side encryption plus pre-share encryption for high-sensitivity datasets.

Built on top of ComplianceArmor for documentation, training records, and BAA inventory, with optional HIPAA managed IT services for the technical safeguard layer and vCISO services for the named Security Official role.

OCR resolution agreements, HHS audit reports, and our own engagements show the same handful of gaps under 45 CFR 164.312(e)(1). We surface these before they become a finding.

• Plain SMTP between the practice and a referring lab or hospital, with no enforced TLS - cited in many OCR resolution agreements where ePHI was intercepted.
• Email "encryption" misconfigured as a portal that requires patients to create yet another account, leading clinicians to bypass it.
• Fax transmission of PHI over public IP networks without encryption.
• Patient-facing texting and form submissions over plain HTTP, often through legacy practice management plug-ins.

Transmission Security interacts with several other Security Rule standards. Cover them together for a defensible program.