In April 2025, the CA/Browser Forum (CA/B Forum) approved Ballot SC-081v3, reducing the maximum validity of SSL/TLS certificates. Starting in March 2026, the lifespan of public SSL/TLS certificates will begin decreasing from the current 398 days to 47 days by March 2029.
This will greatly affect healthcare IT teams, since certificates will need more frequent renewal, validation data will expire faster, and manual management will become more difficult.
However, HIPAA compliant email solutions, like Paubox, eliminate the need for TLS certificate management altogether, simplifying compliance and safeguarding patients’ protected health information (PHI).
The Health Insurance Portability and Accountability Act (HIPAA) requires healthcare entities and business associates to ensure the confidentiality, integrity, and availability of electronic PHI. TLS is a critical component in meeting the [HIPAA] Security Rule’s transmission security standard,” explains A Comparative Study of Modern HTTPS Implementations Evaluating the Security Efficacy of TLS Protocols.
TLS certificates encrypt data in transit across patient portals, telehealth platforms, electronic health record (EHR) systems, APIs, and email. Without proper SSL/TLS management, these systems could become vulnerable to cyberattacks, data breaches, or service interruptions.
If a patient portal fails to load because its certificate has expired, patients may bypass unsafe connections, possibly exposing their PHI.
Similarly, telehealth sessions could be interrupted, delaying care and potentially leading to a data breach. Even APIs that connect EHR systems or transmit data from medical devices could fail, preventing secure communication.
In these cases, an expired certificate creates gaps in data protection, which could result in a costly data breach. According to IBM’s cybersecurity report, the average global cost of a healthcare data breach increased to $4.88 million, the largest increase since the start of the pandemic.
Since HIPAA mandates that PHI must be encrypted in transit, any interruption in TLS protection can be interpreted as a failure to implement required technical safeguards. The costs of a HIPAA violation are layered, escalating, and legally unavoidable, with the maximum annual cost set at $1,919,173.
Go deeper: The complete guide to HIPAA violations
Shortened lifespans also require more frequent validation of organizational and domain credentials. Organizations that use OV or EV certificates will need to revalidate their identity multiple times each year to maintain encrypted communications.
If these validations are not performed in a timely manner, the organization risks non-compliance with HIPAA’s technical safeguards, which mandate the continuous protection of electronic PHI during transmission.
HIPAA compliance now depends on active encryption; however, manually managing certificates won’t be a viable option due to its increased complexity. Large healthcare organizations, especially, will require certificate automation.
The National Cybersecurity Center of Excellence (NCCoE) TLS server certificate management programs reinforce this, showing how certificate automation can help “organizations prevent, detect, and recover from certificate-related incidents.”
Automated certificate management maintains renewals, so encryption isn’t interrupted. It also keeps logs as evidence of compliance during audits.
Ultimately, expired certificates directly affect patient care, operations, and regulatory compliance.
Paubox is the best solution for healthcare organizations facing shorter certificate lifespans. The platform automatically encrypts all messages, so IT teams managing TLS certificates don’t have to manually manage them for email communications. It keeps patient emails, lab results, appointment reminders, and other sensitive communications secure.
Moreover, Paubox removes the risk of expired certificates disrupting email, helping healthcare organizations maintain continuous HIPAA compliance and decreasing operational burden.
For example, a hospital that automates certificate renewals for its telehealth platform can also use Paubox for secure email to maintain continuous encryption, safeguarding PHI during transmission and at rest.
Secure emails can facilitate care coordination to enhance patient care, improve patient and provider satisfaction, and reduce overall healthcare costs. Patients, providers, and partners can communicate securely, maintaining continuity of care and preventing delays in treatment.
Paubox works with existing email clients (Outlook, Gmail, etc.), making it simple for staff to adopt without additional training. This allows large healthcare organizations to send thousands of patient lab results via email daily.
Even with Paubox simplifying email, healthcare organizations still need to manage certificates for other systems, like portals, APIs, devices, and EHR integrations.
Healthcare organizations must first identify every SSL/TLS certificate in use, including domains, subdomains, medical devices, and API endpoints.
Invest in certificate management tools that can automatically request, validate, and deploy certificates.
More specifically, these tools must have the following features:
Hospitals using multiple telehealth platforms must implement automation so that if a certificate is renewed, scripts automatically deploy it to all servers and devices. No downtime occurs, and it could help IT teams save time.
The CA/B Forum rollout is phased, with a 200-day maximum in 2026, a 100-day maximum in 2027, and a 47-day maximum in 2029. Organizations should align internal processes with these timelines for a smooth adoption.
Many EHR and telehealth providers rely on certificates for secure connections. HIPAA-covered entities must confirm that their vendors can handle shorter certificate lifespans and automated deployment.
Staff should understand new validation requirements, automation, and how to monitor certificate health to prevent compliance or operational issues.
The transition to 47-day SSL/TLS certificates compels healthcare organizations to adapt to prevent service disruptions, protect PHI, and maintain HIPAA compliance. While portals, telehealth platforms, APIs, and medical devices will require automated certificate management, Paubox email relieves the burden of preserving HIPAA compliant email encryption.
Furthermore, it helps healthcare organizations maintain patient care and improve their overall cybersecurity posture.
Yes. HIPAA’s Security Rule requires that all PHI in transit be encrypted using “industry-standard mechanisms.” When a certificate expires, browsers, APIs, mobile apps, and backend services may stop enforcing secure TLS connections. Traffic will then downgrade to unencrypted transport or fail entirely.
Historically, organizations reviewed certificates quarterly or annually. However, with certificate lifespans reducing from 13 months down to 47 days, organizations must continuously monitor their SSL/TLS certificates.
CI/CD stands for continuous integration and continuous delivery/deployment. A CI/CD pipeline is an automation framework that builds, tests, and deploys software updates from development to production.
During every deployment, the pipeline can automatically apply security checks, validate TLS configurations, prevent expired certificates from being pushed into production, rotate keys, and maintain encryption.