United States (federal) · regulation

HIPAA: what it requires, and the records to keep

The Privacy Rule limits how covered entities and business associates may use and disclose protected health information (PHI) and gives patients rights over it. It has no AI-specific provisions, but it governs any AI tool that ingests, is trained on, or outputs PHI on behalf of a covered entity.

Legal forceBinding law
StatusIn force
Applies from14 Apr 2003
JurisdictionUnited States (federal)
Checked21 Oct 2026

01 / What it requires

What HIPAA requires

Covered entities (health plans, health care clearinghouses and providers that bill electronically) and their business associates, including AI vendors that handle protected health information for them.

  1. 01Use or disclose PHI in AI tools only for a permitted purpose, such as treatment, payment or operations, or with patient authorization.
  2. 02Sign a business associate agreement before an AI vendor creates, receives, maintains or transmits PHI for you.
  3. 03Limit PHI sent to AI tools to the minimum necessary, except for treatment disclosures.
  4. 04De-identify data by Safe Harbor or Expert Determination before treating it as outside HIPAA, for example for model training.
  5. 05Get authorization or an IRB or privacy board waiver before using PHI for research, including AI research.
  6. 06Assess and notify under the Breach Notification Rule if an AI tool exposes unsecured PHI.

02 / AI work

Where it touches AI work

HHS has stated that PHI in AI training data, prediction models and algorithm data held by a regulated entity for covered functions is protected by the HIPAA Rules. Generative AI tools that memorize or reveal training data can cause impermissible disclosures.

03 / Dates

The dates that matter

28 Dec 2000

Privacy Rule final rule published

14 Apr 2003

Compliance date for most covered entities

25 Jan 2013

Omnibus Rule makes business associates directly liable

6 Jan 2025

HHS states PHI in AI training data is protected (Security NPRM preamble)

28 Jan 2026

Latest civil penalty inflation adjustment codified

04 / Enforcement

Who enforces it

HHS Office for Civil Rights and state attorneys general. Civil penalties adjusted for inflation range from $145 to $2,190,294 per violation, with an annual cap of $2,190,294 per identical provision; knowing violations can bring DOJ criminal charges.

05 / Records

Records an organisation keeps

What an auditor or an inquiry usually asks to see. Your obligations depend on your role and your facts.

  1. 01Business associate agreements with each AI vendor handling PHI
  2. 02Data-flow map showing what PHI each AI tool receives
  3. 03De-identification method records or expert determination reports
  4. 04Authorizations or IRB waivers for AI research uses

Optional evidence · where Planisphere fits

Keep a record anyone can check

When your team meets a duty, Planisphere can seal the event it reports as a receipt.

01 · Your teamRecord the event

A disclosure shown, a review signed, a model change approved: the event your system reports.

02 · PlanisphereSeal it

The event becomes a sealed receipt, dated and attributed to whoever is signed in.

03 · AnyoneCheck it

Paste the receipt into Verify. No account or key.

A record supports your compliance evidence process. It is not a legal finding or a certification. Systems that call Planisphere's gate API can also hold or refuse an action before it runs.

SOURCES

Go back to the source

CHANGE LOG

What changed, and when

21 Oct 2026

Rebuilt from primary sources; facts checked on this date.

Related: HIPAA vs HHS §1557 · HIPAA vs FERPA · HIPAA vs FDA PCCP / SaMD · HIPAA for medicine AI workflows · NIST AI RMF · OMB M-25-21/22 · DoW RAI S&IP · EO 14179 · FIPS 140-3 · SHA-256 / FIPS 180-4