Strengthening System and Information Integrity at CMS

At the Centers for Medicare & Medicaid Services (CMS), protecting the integrity of our systems and data is a mission-critical responsibility. The System and Information Integrity (SI) program helps ensure that sensitive information is safeguarded, healthcare operations remain resilient, and the public can trust in the digital backbone of our nation’s healthcare system.

Why System and Information Integrity Matters

The CMS SI program ensures that systems operate securely, reliably, and in compliance with federal standards by:

• Rapidly detecting and correcting software flaws.
• Monitoring for security alerts, advisories, and unauthorized access.
• Protecting against malicious code, spam, and phishing threats.
• Validating data inputs and outputs to prevent corruption or tampering.
• Supporting the confidentiality, integrity, and availability of CMS information assets.
• Enabling continuous delivery of critical healthcare services for millions of Americans.

Core Components of the CMS SI Program

The SI program is proactive, layered, and continuously monitored. Key components include:

Flaw Remediation & Patch Management

CMS conducts frequent vulnerability scans, applies security patches quickly, and leverages automated tools and technical standards such as the CMS Technical Reference Architecture (TRA). These practices ensure vulnerabilities are identified and resolved before they can be exploited.

Malicious Code and Threat Protection

CMS employs Endpoint Detection and Response (EDR), anti-malware tools, and sandboxing to defend against malicious code. Real-time monitoring identifies suspicious activity, while secure channels and awareness programs help users recognize and report phishing and spam threats.

Security Alerts and Incident Response

CMS actively monitors federal and industry security advisories. Through enterprise alerting tools, our Incident Response teams coordinate rapid investigations, supported by threat intelligence, vulnerability scanning, and established playbooks.

Audit Logging and Privileged Access Monitoring

All critical activities, system changes, and data access are logged. Privileged user activity—such as that of administrators and database managers—is closely monitored with least-privilege enforcement. This ensures accountability and protects High Value Assets (HVAs).

Network and Intrusion Monitoring

Centralized Intrusion Detection and Prevention Systems (IDS/IPS) monitor traffic across CMS networks, while Wireless Intrusion Prevention Systems (WIPS) detect and block unauthorized wireless access points.

Input Validation and Error Handling

CMS business applications are required to validate inputs, filter suspicious data, and ensure error messages do not expose sensitive information. This safeguards application integrity and reduces risks from injection or corruption attacks.

Secure Information Lifecycle Management

From data collection through secure disposal, CMS follows federal records management and retention requirements. This includes secure deletion methods, legally permissible de-identification of data for testing or training, and honoring requests for data amendments to ensure accuracy.

Cryptography and Memory Protection

CMS uses FIPS 140-3 validated cryptographic modules to protect data in transit and at rest. System defenses also include memory protection measures such as Data Execution Prevention (DEP) and Address Space Layout Randomization (ASLR).

Protecting PII and PHI

CMS is deeply committed to safeguarding both Personally Identifiable Information (PII) and Protected Health Information (PHI). We conduct regular reviews of data holdings, enforce strict privacy policies, and provide procedures for handling individual amendment requests in line with HHS guidance.

Together, We Safeguard CMS’s Mission

Through a blend of cutting-edge tools, coordinated response, and alignment with federal standards like NIST SP 800-53 and the CMS Information Security and Privacy Policy (IS2P2), the SI program upholds the highest standards of system and data integrity.

Every member of the CMS community plays a role in this effort. By working together, we can ensure the secure, reliable delivery of healthcare services that millions of Americans depend on every day.