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ideas/compliance/hipaa.org

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+:PROPERTIES:
+:ID:       auto-hipaa
+:CREATED:  [2026-05-23 Sat]
+:END:
+#+title: HIPAA (Health Insurance Portability and Accountability Act)
+#+filetags: :passepartout:compliance:framework:hipaa:
+
+* HIPAA (Health Insurance Portability and Accountability Act)
+
+** What it is
+
+US federal law enacted 1996. Governs how protected health information (PHI)
+is stored, transmitted, and accessed. Two relevant rules:
+
+- **Privacy Rule:** controls use and disclosure of PHI. Patients have rights
+  to access, amend, and request accounting of disclosures. Minimum necessary
+  standard — only the minimum PHI needed for the task may be used.
+- **Security Rule:** administrative, physical, and technical safeguards for
+  electronic PHI (ePHI). Requires access controls, audit controls, integrity
+  controls, person/entity authentication, and transmission security.
+
+** Who must comply
+
+Covered entities (health plans, healthcare clearinghouses, healthcare providers
+who transmit any ePHI) and business associates (any vendor handling PHI on behalf
+of a covered entity). Business Associate Agreements (BAAs) are mandatory.
+
+** Penalties
+
+Tiered civil penalties: $100-$50,000 per violation, up to $1.5M per year per
+violation category. Criminal penalties for knowing misuse (up to 10 years
+imprisonment). State AGs can also bring civil actions.
+
+** Why it matters for the triad
+
+HIPAA is the largest single compliance market in US healthcare — every hospital,
+clinic, insurer, and health-tech vendor must comply. The [[file:domain-gate-packages.org][HIPAA gate package]]
+($50K/yr) encodes the Privacy Rule and Security Rule as ACL2-verifiable gate
+constraints. Every PHI access attempt passes through the gate stack, producing
+a machine-checkable audit trail that satisfies the Security Rule's audit control
+requirement automatically. No separate logging infrastructure needed. Over a
+five-year deployment, the accumulated fact store and proof history create
+[[file:infrastructure-lock-in.org][infrastructure lock-in]] — switching to a competitor means discarding all of it.
+