What evidence do auditors commonly ask for on 164.312(e)(2)(ii) Encryption of Transmissions (Addressable)?

Encryption-in-transit standard; Coverage report for all ePHI flows; Exception register with compensating controls; Cloud provider TLS attestations; Documented addressable-specification decision: whether it is reasonable and appropriate in your environment, and if not, why, with the equivalent alternative adopted where one is.

What is the most common gap auditors find on 164.312(e)(2)(ii)?

Internal network treated as trusted and unencrypted

HIPAA Security Rule · Technical

`164.312(e)(2)(ii)` Encryption of Transmissions (Addressable)

Implement a mechanism to encrypt ePHI whenever deemed appropriate. NIST recommends defaulting to encryption for all ePHI transmissions, with documented exception only where infeasible.

Source: HIPAA Security Rule, 164.312(e)(2)(ii). The statement above is our statement of the clause, read from the published text and cited so you can check it against the official text, not the instrument verbatim. Open HIPAA Security Rule in the compliance library.

Scope: Addressable, not optional: assess whether it is reasonable and appropriate; implement it, or document why not and adopt an equivalent alternative where reasonable (45 CFR 164.306(d)(3)).

Applies to covered entities and business associates. An addressable specification can be met by a documented, reasonable alternative.

artefacts

held by a system

at each review

hard

to go live

Policy repository / GRC workspace

where the evidence lives

teal = a system already holds it · olive = produced at each review. To go live: easy when half or more of the artefacts are already held by a system, moderate from a quarter to a half, hard below a quarter.

These are the artefacts auditors commonly ask for on this requirement, our guidance rather than text from the standard. Your assessor decides what is sufficient in your context, and asks for samples across the period when a report covers one.

system holds itEvidence a system already holds

none for this control

periodic reviewEvidence produced at each review

Coverage report for all ePHI flows · Document repository
Cloud provider TLS attestations · Cloud console / configuration management

governing documentDocuments that govern the control

Encryption-in-transit standard · Policy repository / GRC workspace
Exception register with compensating controls · Policy repository / GRC workspace
Documented addressable-specification decision: whether it is reasonable and appropriate in your environment, and if not, why, with the equivalent alternative adopted where one is · Policy repository / GRC workspace

First move

No system holds this evidence for you: it is people and documents. Reminders and routing to the owner still save time. Put the document under version control with an owner and review date, and log each review as a record with reviewer and date.

Common gaps auditors find

Internal network treated as trusted and unencrypted
Fax or unsecure messaging in use without compensating control
No periodic scan of cipher quality

Do this for your whole sheet

Paste the rows you run your controls from and get this mapping for every control at once, with the periodic-review ones flagged and a first move per row. No account for the first run.

Build my evidence sheet

164.312(e)(2)(i) Integrity Controls for Transmission (Addressable) · 164.314(a)(1) Business Associate Contracts or Other Arrangements (Standard)