HIPAA requires strong encryption in transit for all Protected Health Information (PHI). That means Transport Layer Security (TLS) must be locked down. A sloppy TLS setup is a direct violation and a direct security hole.
Start with the TLS version. HIPAA-aligned systems should disable TLS 1.0 and 1.1. Only TLS 1.2 and TLS 1.3 meet current encryption strength requirements. Check every endpoint. Outbound services, load balancers, APIs — if they accept weaker protocols, they’re a risk.
Cipher suites matter. Remove any suite with RC4, DES, or 3DES. Disable weak 128-bit ciphers unless they meet NIST-approved guidelines. Prefer AES-256-GCM or CHACHA20-POLY1305 for resilience against modern attacks. Strip out NULL or EXPORT ciphers entirely.
Certificates must be signed by a trusted CA with a minimum 2048-bit RSA or better (ECC 256-bit). Rotate them before expiration. Avoid SHA-1. Use SHA-256 or stronger for signatures. Enable OCSP stapling to speed up revocation checks without leaking privacy through browser requests.