HIPAA Compliance

Field	Value
Document ID	ASCEND-COMP-001
Version	1.0.0
Last Updated	December 19, 2025
Author	Ascend Engineering Team
Publisher	OW-KAI Technologies Inc.
Classification	Enterprise Client Documentation
Compliance	SOC 2 CC6.1/CC6.2, PCI-DSS 7.1/8.3, HIPAA 164.312, NIST 800-53 AC-2/SI-4

Reading Time: 7 minutes | Skill Level: Intermediate

Overview

ASCEND supports HIPAA compliance for healthcare organizations handling Protected Health Information (PHI). We provide the technical safeguards, administrative controls, and audit capabilities required by the HIPAA Security Rule.

Business Associate Agreement

ASCEND provides a Business Associate Agreement (BAA) for customers handling PHI.

Request BAA

curl -X POST "https://pilot.owkai.app/api/compliance/baa/request" \
  -H "Authorization: Bearer <admin_jwt>" \
  -d '{
    "organization_name": "Healthcare Corp",
    "contact_email": "compliance@healthcare.com",
    "phi_description": "Patient appointment scheduling data",
    "use_case": "AI agent scheduling optimization"
  }'

HIPAA Security Rule Mapping

Administrative Safeguards (§164.308)

Requirement	ASCEND Implementation
Security Management (164.308(a)(1))	Risk assessment, security policies
Workforce Security (164.308(a)(3))	Access authorization, termination procedures
Information Access (164.308(a)(4))	Role-based access control
Security Awareness (164.308(a)(5))	Audit logging, incident detection
Security Incident (164.308(a)(6))	Incident response procedures
Contingency Plan (164.308(a)(7))	Backup, disaster recovery
Evaluation (164.308(a)(8))	Periodic security assessments

Technical Safeguards (§164.312)

Requirement	ASCEND Implementation
Access Control (164.312(a)(1))	Unique user IDs, automatic logoff
Audit Controls (164.312(b))	Immutable audit logging
Integrity (164.312(c)(1))	Hash-chained audit logs
Authentication (164.312(d))	MFA, strong passwords
Transmission Security (164.312(e)(1))	TLS 1.3, encryption

PHI Protection

PHI Detection

ASCEND automatically detects PHI in action parameters:

curl -X POST "https://pilot.owkai.app/api/v1/actions/submit" \
  -H "X-API-Key: owkai_..." \
  -d '{
    "agent_id": "scheduling-agent",
    "action_type": "appointment_create",
    "parameters": {
      "patient_name": "John Doe",
      "patient_mrn": "MRN123456",
      "appointment_date": "2025-12-20"
    }
  }'

Response with PHI Detection:

{
  "action_id": "act_xyz789",
  "decision": "pending_approval",
  "risk_assessment": {
    "score": 75,
    "level": "high",
    "phi_detected": true,
    "phi_categories": ["patient_name", "medical_record_number"],
    "factors": [
      {"name": "phi_data", "score": 40},
      {"name": "write_operation", "score": 20},
      {"name": "patient_data", "score": 15}
    ]
  }
}

Configure PHI Handling

curl -X PUT "https://pilot.owkai.app/api/compliance/hipaa/phi-config" \
  -H "Authorization: Bearer <admin_jwt>" \
  -d '{
    "phi_detection_enabled": true,
    "phi_categories": [
      "patient_name",
      "medical_record_number",
      "ssn",
      "date_of_birth",
      "address",
      "phone_number",
      "email",
      "health_plan_number",
      "diagnosis_codes",
      "treatment_records"
    ],
    "phi_action": "REQUIRE_APPROVAL",
    "minimum_approval_level": 3,
    "audit_phi_access": true,
    "mask_phi_in_logs": true
  }'

Access Controls

Minimum Necessary Rule

Configure access to enforce minimum necessary:

curl -X POST "https://pilot.owkai.app/api/smart-rules" \
  -H "Authorization: Bearer <admin_jwt>" \
  -d '{
    "name": "PHI Minimum Necessary",
    "conditions": {
      "phi_detected": true,
      "data_scope": {"$ne": "minimum_necessary"}
    },
    "action": "REQUIRE_APPROVAL",
    "approval_level": 3,
    "audit_required": true
  }'

Role-Based PHI Access

curl -X PUT "https://pilot.owkai.app/api/compliance/hipaa/access-roles" \
  -H "Authorization: Bearer <admin_jwt>" \
  -d '{
    "roles": {
      "clinical_staff": {
        "phi_access": true,
        "phi_categories": ["all"],
        "requires_justification": true
      },
      "billing_staff": {
        "phi_access": true,
        "phi_categories": ["patient_name", "health_plan_number", "billing_codes"],
        "requires_justification": true
      },
      "administrative": {
        "phi_access": false,
        "phi_categories": []
      }
    }
  }'

Audit Requirements

Access Logging

All PHI access is logged:

curl "https://pilot.owkai.app/api/audit/phi-access?days=90" \
  -H "Authorization: Bearer <admin_jwt>"

Response:

{
  "phi_access_logs": [
    {
      "log_id": "log_phi_001",
      "timestamp": "2025-12-15T10:30:00Z",
      "user": "nurse@healthcare.com",
      "action": "view_patient_record",
      "patient_mrn": "MRN***456",
      "phi_categories_accessed": ["patient_name", "diagnosis"],
      "justification": "Scheduled appointment follow-up",
      "access_approved": true
    }
  ],
  "summary": {
    "total_accesses": 1250,
    "unique_users": 45,
    "unique_patients": 890
  }
}

Audit Report

curl -X POST "https://pilot.owkai.app/api/compliance-export/exports" \
  -H "Authorization: Bearer <admin_jwt>" \
  -d '{
    "framework": "hipaa",
    "report_type": "phi_access_audit",
    "period_start": "2025-01-01",
    "period_end": "2025-12-31",
    "include_sections": [
      "access_summary",
      "user_activity",
      "phi_categories",
      "exceptions",
      "incidents"
    ]
  }'

Breach Notification

Report Potential Breach

curl -X POST "https://pilot.owkai.app/api/compliance/hipaa/breach-report" \
  -H "Authorization: Bearer <admin_jwt>" \
  -d '{
    "discovery_date": "2025-12-15",
    "incident_description": "Unauthorized access attempt detected",
    "phi_involved": true,
    "individuals_affected": 0,
    "breach_type": "attempted_unauthorized_access",
    "containment_status": "contained",
    "risk_assessment": {
      "probability_of_compromise": "low",
      "phi_actually_accessed": false
    }
  }'

Breach Assessment

{
  "breach_id": "breach_001",
  "status": "under_investigation",
  "risk_level": "low",
  "notification_required": false,
  "assessment": {
    "nature_and_extent": "Limited to failed login attempts",
    "unauthorized_person": "Unknown external actor",
    "phi_accessed": false,
    "risk_mitigated": true
  },
  "next_steps": [
    "Complete investigation",
    "Document findings",
    "Update risk assessment"
  ]
}

Encryption

Data Encryption Status

curl "https://pilot.owkai.app/api/compliance/hipaa/encryption-status" \
  -H "Authorization: Bearer <admin_jwt>"

Response:

{
  "encryption_status": "compliant",
  "at_rest": {
    "algorithm": "AES-256-GCM",
    "key_management": "AWS KMS",
    "key_rotation": "annual"
  },
  "in_transit": {
    "protocol": "TLS 1.3",
    "certificate_expiry": "2026-06-15",
    "cipher_suites": ["TLS_AES_256_GCM_SHA384"]
  },
  "phi_specific": {
    "field_level_encryption": true,
    "encrypted_fields": ["patient_name", "ssn", "diagnosis"]
  }
}

Emergency Access

Break-Glass Procedure

curl -X POST "https://pilot.owkai.app/api/compliance/hipaa/emergency-access" \
  -H "Authorization: Bearer <admin_jwt>" \
  -d '{
    "requestor": "dr.emergency@healthcare.com",
    "patient_mrn": "MRN789012",
    "emergency_type": "patient_care_emergency",
    "justification": "Patient unconscious, need medical history",
    "duration_minutes": 60
  }'

Response:

{
  "access_granted": true,
  "access_id": "emerg_001",
  "expires_at": "2025-12-15T11:30:00Z",
  "audit_id": "audit_emerg_001",
  "review_required": true,
  "reviewer_notified": "compliance@healthcare.com"
}

Training Integration

Track Training Compliance

curl "https://pilot.owkai.app/api/compliance/hipaa/training-status" \
  -H "Authorization: Bearer <admin_jwt>"

Response:

{
  "training_compliance": {
    "total_users": 150,
    "trained_users": 148,
    "compliance_rate": 98.7,
    "overdue_users": [
      {
        "user": "new.employee@healthcare.com",
        "training_due": "2025-12-20"
      }
    ]
  }
}

Best Practices

1. Minimum Necessary

• Configure role-based PHI access
• Require justification for access
• Regular access reviews

2. Audit Everything

• Enable comprehensive logging
• Regular log reviews
• Automated anomaly detection

3. Encryption

• Encrypt PHI at rest and in transit
• Use field-level encryption for sensitive data
• Regular key rotation

4. Training

• Annual HIPAA training for all users
• Role-specific training
• Document completion

Next Steps

• SOC 2 Compliance - Security controls
• Compliance Overview - All frameworks
• Data Protection - Encryption details

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Document Version: 1.0.0 | Last Updated: December 2025