HDS compliance-matrix
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HIPAA Privacy Rule HIPAA-Privacy

regulation · US · 45 CFR Part 164 Subpart E (HITECH 2013 Omnibus Final Rule) US · layered on Pryv hipaa-privacy

164.502 Uses and disclosures of PHI — general rules draft

A covered entity, or a business associate acting on its behalf, may use or disclose protected health information only as permitted or required by the Privacy Rule.

Pryv platform facilitated

Pryv's permission model is the technical enforcement layer for Article 502: an app or counterparty can only read or write streams its access permits. The "permitted or required by the Privacy Rule" determination — which use cases are TPO, when authorization is required, what minimum-necessary means in your workflow — is your programmatic decision; Pryv enforces whatever scope you grant.

HDS facilitated USCH

On top of Pryv's permission model, HDS operates the platform that enforces it: as a business associate, HDS uses or discloses PHI only as its BAA and the covered entity's instructions permit. The substantive determination of which uses are permitted remains the covered entity's.

detail

Every workforce, app, and counterparty action on PHI is mediated by an access whose permissions bound the streams and levels reachable. HDS configures no use or disclosure of customer PHI for its own purposes, and the audit log makes each use attributable to a specific access at a specific time.

  • 🔒 hipaa/policies/uses-and-disclosures available on request
Implementer
covered-entity documented

Decide which uses and disclosures are permitted under the Privacy Rule and configure access scopes accordingly.

business-associate documented 📄 baa

Use or disclose PHI only as your BAA and the covered entity's instructions permit.

individual out-of-scope

164.506 Uses and disclosures for treatment, payment, healthcare operations (TPO) draft

Use and disclosure of PHI is permitted for the entity's own treatment, payment and healthcare operations, and under defined conditions for another entity's TPO.

Pryv platform facilitated

TPO is the largest category of permitted uses. Pryv lets you mint accesses tagged with the TPO purpose in `clientData` (e.g., `purpose: "treatment"`); the permission model enforces the scope. The TPO-vs-not classification of any specific workflow is your programmatic judgement; Pryv carries it forward into the audit trail.

HDS facilitated USCH

HDS provides the means to mint per-purpose accesses tagged with the TPO purpose, each independently revocable and auditable. The classification of any given workflow as TPO is the covered entity's judgement, which HDS carries forward into the audit trail.

detail

A common pattern separates accesses by purpose — one per treatment, billing and operations workflow — so the TPO classification becomes a durable artefact rather than a verbal claim. HDS stores the purpose tag and preserves it across the access version chain.

  • 🔒 hipaa/policies/uses-and-disclosures available on request
Implementer
covered-entity documented

Classify your workflows as TPO or not and provision purpose-tagged accesses accordingly.

business-associate documented 📄 baa

Act on TPO data only within the scope your BAA permits.

individual out-of-scope

164.508 Uses and disclosures requiring authorization draft

Uses and disclosures not otherwise permitted require a written authorization from the individual that meets defined content requirements.

Pryv platform implemented

The authorization Pryv mints when your subject grants an access IS the §164.508 authorization record — versioned, immutable per version, with the granted scope (permissions) and the authorization text (clientData or a `consent/request-cmc` event) inseparable. Withdrawal is a single API call. For cross-account / cross-entity authorizations, the CMC plugin carries the negotiation state.

HDS facilitated USCH

HDS exposes consent primitives (the @pryv/cmc consent flow and access grant) so the authorization captured when an individual grants an access is a versioned, immutable record binding the granted scope to the authorization text. Withdrawal is a single API call.

detail

The §164.508(c) elements map onto access and client-data fields: the information disclosed onto permissions, the recipient onto the access counterparty, the signature equivalent onto the auditable grant act, the expiration onto the access expiry, and the right to revoke onto access deletion. HDS ships the primitives; presenting the §508(c) elements at the grant moment is the covered entity's UX responsibility.

  • 🔒 hipaa/policies/authorizations available on request
Implementer
covered-entity documented

Ensure your consent surface presents all §508(c) authorization elements and retains the authorization record.

individual facilitated

You grant and revoke authorizations through the consent flow; each act is recorded.

business-associate documented 📄 baa

Honour and record authorizations as instructed by the covered entity.

164.510 Uses and disclosures requiring opportunity to agree or object draft

Disclosures to family or friends, or for facility-directory purposes, may proceed if the individual is given the opportunity to agree or object and no objection is reasonably inferred.

Pryv platform facilitated

The opportunity-to-agree-or- object construct is operational. Pryv lets you record the offered choice and the individual's response as durable artefacts (clientData on the relevant access, or a `consent/notice-cmc` / custom event), so the §164.510 reasonable-inference becomes a record rather than recollection.

HDS facilitated USCH

HDS provides durable storage for the offered choice and the individual's response as client-data on the relevant access or as a consent event, so the reasonable-inference standard rests on a record rather than recollection. The operational offer itself is the covered entity's.

detail

The opportunity-to-agree-or-object construct is operational and circumstance-driven. HDS stores the offered choice and the recorded response so the §164.510 determination is reconstructable later.

  • 🔒 hipaa/policies/uses-and-disclosures available on request
Implementer
covered-entity documented

Offer the opportunity to agree or object and record the individual's response.

individual out-of-scope

164.512 Uses and disclosures for which authorization or opportunity is not required draft

Twelve categories of disclosures are permitted without authorization (public health, law enforcement and others), each subject to specific conditions.

Pryv platform facilitated

Section 512 disclosures are operationally driven by the circumstances (subpoena, public- health request, etc.). Pryv's contribution is durability: every such disclosure must still go through an access, and the audit log captures it. Recording the §512 category and rationale in `access.clientData.legal_basis` makes the disclosure justification recoverable later.

HDS facilitated USCH

HDS contributes durability: every §164.512 disclosure still rides on an access and is captured in the audit log, and the §512 category and rationale can be recorded against the access. Whether a disclosure qualifies is the covered entity's legal determination.

detail

The recommended pattern mints a purpose-specific access per §512 invocation, records the disclosure category and statutory basis, executes the disclosure, then revokes the access. The audit trail shows the full lifecycle attached to the legal-basis claim.

  • 🔒 hipaa/policies/uses-and-disclosures available on request
Implementer
covered-entity documented

Determine whether each disclosure qualifies under §512 and record its category and statutory basis.

individual out-of-scope

164.514(a) De-identification of PHI draft

PHI de-identified by the Safe Harbor method or by Expert Determination is no longer subject to the Privacy Rule.

Pryv platform facilitated

Pryv stores whatever event content you write; de-identification is a transformation you perform on the data before storage (or before disclosure). Custom event types + the per-stream design let you keep an identified and a de-identified copy under separate permission scopes, simplifying §514(a) workflows.

HDS facilitated USCH

HDS stores whatever event content is written and lets identified and de-identified copies sit under separate permission scopes, simplifying §514(a) workflows. The de-identification determination and transformation are the covered entity's.

detail

A typical layout keeps identified events on a restricted clinical stream tree and de-identified projections on a parallel tree accessible to a broader analyst group. The de-identification logic is the covered entity's application code; HDS stores its output.

  • 🔒 hipaa/policies/de-identification available on request
Implementer
covered-entity documented

Choose the de-identification method, perform the transformation, and retain the determination record.

individual out-of-scope

164.514(d) Minimum necessary use, disclosure and requests draft

Reasonable efforts must be made to limit PHI to the minimum necessary to accomplish the intended purpose.

Pryv platform implemented

Per-stream permissions are the minimum-necessary primitive: each access carries only the streams + levels needed for its purpose, so by construction the holder cannot see more PHI than granted. Your stream layout + permission-design choices determine the granularity at which "minimum necessary" can be enforced technically.

HDS facilitated USCH

Per-stream, per-level access tokens are the minimum-necessary primitive HDS exposes: each access carries only the streams and levels its purpose needs, so by construction the holder cannot see more PHI than granted. The granularity of "minimum necessary" follows the covered entity's stream and permission design.

detail

HDS facilitates a stream topology where distinct purposes live on distinct subtrees and per-purpose accesses point at the smallest necessary subtree, avoiding blanket permissions except for stated unrestricted roles.

  • 🔒 hipaa/policies/minimum-necessary available on request
Implementer
covered-entity documented

Design stream topology and permission scopes so each access is limited to the minimum necessary, and document the rationale.

business-associate documented 📄 baa

Request only the minimum-necessary scope for your processing.

individual out-of-scope

164.520 Notice of privacy practices draft

A notice must be provided that adequately describes the entity's uses and disclosures of PHI and the individual's rights.

Pryv platform facilitated

The notice itself is your editorial content. Pryv preserves the notice text shown to each subject — typically on `access.clientData.privacy_notice` or as a dedicated event — so the same words presented are recoverable per subject per time. The customer-facing `app-web-auth3` template is the surface where the notice typically appears.

HDS facilitated USCH

HDS preserves the notice text shown to each individual, on the relevant access client-data or as a dedicated event, so the exact words presented are recoverable per individual and per time. The notice content is the covered entity's editorial responsibility.

detail

The customer-facing authentication surface is where the notice typically appears at grant time. HDS stores the presented notice as a durable artefact bound to the individual's session.

  • 🔒 hipaa/policies/notice-of-privacy-practices available on request
Implementer
covered-entity documented

Author and maintain your notice of privacy practices and present it to individuals as required.

individual out-of-scope

164.522 Right to request restriction; confidential communications draft

An individual may request restrictions on uses and disclosures and may request to receive confidential communications by alternative means or at alternative locations.

Pryv platform configurable

A granted restriction is a scope-down on the relevant access (`accesses.update` to narrower permissions) or a revocation (`accesses.delete`). The access-version chain proves what state was in force before the restriction and from when it applies. Confidential-communications choices (alternate address, phone) live in `account.clientData` or a dedicated event.

HDS configurable USCH

A granted restriction is configured as a scope-down or revocation of the relevant access, and the access version chain proves what state was in force before and from when the restriction applies. Confidential- communication preferences are stored as account client-data or a dedicated event.

detail

Post-HITECH §522(a)(1)(vi) makes restrictions on disclosure to a health plan for out-of-pocket-paid services mandatory on request; the configuration pattern is identical, but the covered entity must apply it without discretion when that condition is met.

  • 🔒 hipaa/procedures/restriction-requests available on request
Implementer
covered-entity documented

Evaluate restriction and confidential-communication requests and apply the corresponding access changes.

individual facilitated

You request restrictions and alternative-communication preferences, which are recorded against your account.

business-associate out-of-scope

164.524 Right of access by the individual draft

An individual has the right to inspect and obtain a copy of their PHI in a designated record set, in the form and format requested if readily producible.

Pryv platform implemented

Your subject, holding a personal token, reads everything via the standard Pryv API — events, streams, accesses (with history), audit records, attachments — in the canonical event-type schemas. Wrap that in a subject-portal app and you have §164.524 covered end-to-end. The 30-day response timeline is your process target, not a software latency.

HDS implemented USCH

Pryv is user-centric: the individual owns their data and, holding a personal token, reads everything through the standard API — events, streams, accesses with history, audit records and attachments. HDS operates this access capability end-to-end across both regions.

detail

Events return as canonical JSON validated against the data-type schemas — structured, machine-readable and consumer-friendly — and attachments download in their stored MIME type. The 30-day response timeline is the covered entity's process target, not a software latency, and any non-native export format is produced by the implementer's portal.

  • 🔒 hipaa/procedures/individual-right-of-access available on request
Implementer
individual facilitated

You access and export your own PHI directly through the standard API or a subject portal built on it.

covered-entity documented

Run the access-request process and meet the response timeline; provide any requested non-native export format.

business-associate documented 📄 baa

Make PHI available to the covered entity to satisfy access requests.

164.526 Right to amend draft

An individual has the right to have a covered entity amend PHI or a record about the individual in a designated record set.

Pryv platform implemented

`events.update` is the amendment primitive; event versioning preserves the prior content so the amendment trail is auditable. The §164.526 process (request → decision → action → notice) is yours to run; the technical record-keeping is shipped.

HDS facilitated USCH

HDS exposes event update as the amendment primitive, with event versioning preserving prior content so the amendment trail is auditable. The §164.526 process of request, decision, action and notice is the covered entity's to run.

detail

For denied amendments where the individual files a statement of disagreement, the statement can be stored as a separate event on the designated-record-set stream linked back to the original, so the disagreement travels with the data on subsequent disclosures.

  • 🔒 hipaa/procedures/amendment-requests available on request
Implementer
covered-entity documented

Run the amendment request, decision and notice process and record accepted amendments and statements of disagreement.

individual facilitated

You request amendments; accepted changes and any disagreement statement are preserved with version history.

business-associate out-of-scope

164.528 Accounting of disclosures draft

An individual has the right to an accounting of disclosures of their PHI made in the six years prior to the request, with specified exceptions.

Pryv platform implemented

Pryv's audit log is the §164.528 substrate: every API method call attributed to an access (with version) is recorded. Filtering by access category — TPO accesses, §164.512 disclosures, etc. — lets you derive the §164.528-eligible subset (which excludes TPO). Six-year retention of the audit log is your operator-side configuration.

HDS facilitated USCH

The audit log is the §164.528 substrate: every API method call attributed to an access and version is recorded, and filtering by access category lets the covered entity derive the accountable subset. Six-year retention of the audit log is an HDS-operated configuration on both regions.

detail

Each accounting field has an audit-log source: date from the row timestamp, recipient from the access holder or counterparty, description from the recorded API method and path, and purpose from the access purpose tag. The audit log does not capture request bodies, so the description is at the API-shape level — sufficient under §164.528 and favourable for data minimisation.

  • 🔒 hipaa/procedures/accounting-of-disclosures available on request
Implementer
covered-entity documented

Compile and deliver the accounting, applying the §164.528 exceptions and your retention policy.

individual facilitated

You request an accounting; the audit log provides the underlying disclosure record.

business-associate documented 📄 baa

Provide the covered entity with the disclosure records you hold.

164.530(a) Privacy officer / contact person draft

A covered entity must designate a privacy official and a contact person responsible for receiving complaints.

Pryv platform facilitated

Designation is organizational. Pryv's contribution is indirect: the audit log gives the privacy official a concrete artifact to review when investigating complaints or auditing internal use.

HDS documented USCH

Designation of a privacy official is the covered entity's organizational decision. HDS's contribution is indirect: the audit log gives that official a concrete artefact to review when investigating complaints or internal use. HDS maintains its own privacy contact under its BA role.

detail

HDS operates as a business associate and names its own responsible contact, but the covered entity's privacy-official designation is a programme element outside HDS's scope.

  • 🔒 hipaa/policies/privacy-program-governance available on request
Implementer
covered-entity documented

Designate and document your privacy official and complaint contact.

individual out-of-scope

164.530(b) Training draft

A covered entity must train all workforce members on its privacy policies and procedures.

Pryv platform facilitated

Training itself is your programme. Pryv's contribution to operationalizing it: the audit log + observability data make training-effectiveness measurable (e.g., does role X exercise access patterns matching policy after training?). The training content + record-keeping are yours.

HDS documented USCH

Workforce privacy training is the covered entity's programme. HDS trains its own workforce on its privacy and security policies as a business associate and retains the training records; the customer's programme is out of HDS's scope.

detail

Audit and observability data can make training effectiveness measurable by revealing whether access patterns match policy after training, but the training content and record-keeping belong to the implementer.

  • 🔒 hipaa/procedures/workforce-training available on request
Implementer
covered-entity documented

Train your workforce on your privacy policies and retain the training records.

business-associate documented 📄 baa

Train your own workforce on safeguarding PHI under your BAA.

individual out-of-scope

164.530(c) Safeguards draft

A covered entity must have appropriate administrative, technical and physical safeguards to protect the privacy of PHI.

Pryv platform facilitated

Section 530(c) is the Privacy Rule's pointer to the Security Rule and to physical / administrative safeguards. See the HIPAA-Security rows for the technical safeguards Pryv contributes; §164.310 (Physical) for the operator's hosting environment. Together those rows constitute the §530(c) answer for this Pryv deployment.

HDS facilitated USCH

Section 530(c) points to the Security Rule and to physical and administrative safeguards. HDS supplies the technical and hosting safeguards documented in the HIPAA-Security scope — access control, audit, encryption in transit and at rest, regional residency — that partly answer §530(c) for an HDS deployment.

detail

See the HIPAA-Security rows for the technical safeguards HDS operates and the physical-safeguard coverage of the hosting environment. Together they constitute the §530(c) technical and physical answer; the administrative safeguards remain the covered entity's.

  • 🔒 hipaa/policies/privacy-safeguards available on request
Implementer
covered-entity documented

Maintain administrative safeguards and document how the technical and physical safeguards meet §530(c).

individual out-of-scope

164.530(f) Mitigation draft

A covered entity must mitigate, to the extent practicable, any harmful effect of a use or disclosure in violation of its policies or the Privacy Rule.

Pryv platform facilitated

Audit log + access version chain let you scope what was disclosed to whom and when — the first step in any mitigation. `bin/backup.js --restore` is available if mitigation involves rolling back data state; `accesses.delete` is the primitive to revoke access from the offending counterparty.

HDS facilitated USCH

Audit log and access version chain let the covered entity scope what was disclosed, to whom and when — the first step in any mitigation. HDS provides access revocation and operates backup and restore should mitigation require rolling back data state.

detail

HDS exposes access deletion to revoke an offending counterparty and operates the backup-restore capability across both regions; the mitigation decision and any breach notification follow the covered entity's process.

  • 🔒 hipaa/procedures/incident-mitigation available on request
Implementer
covered-entity documented

Investigate violations, decide and execute mitigation, and run any required notifications.

business-associate documented 📄 baa

Report incidents to the covered entity and assist mitigation per your BAA.

individual out-of-scope

164.502(b) Minimum necessary uses, disclosures and requests draft

Reasonable efforts must be made to limit PHI to the minimum necessary, subject to enumerated exceptions including treatment disclosures, disclosures to the individual, authorized disclosures and disclosures required by law.

Pryv platform implemented

Same primitive mapping as §164.514(d) minimum-necessary: per- stream permissions are the technical control; the holder cannot see more PHI than the granted scope permits. §502(b)(2) exceptions are programmatic — the implementer leaves those accesses unscoped per the exception's permission, and the audit log records the broader access for accountability.

HDS facilitated USCH

Per-stream permissions are the same minimum-necessary control as §164.514(d): the holder cannot see more PHI than the granted scope permits. The §502(b)(2) exceptions are programmatic, and the audit log records any broader access for accountability.

detail

Where an exception applies, the implementer leaves the access scoped per that exception's permission; HDS records the broader access so it remains accountable. The substantive minimum-necessary policy is the covered entity's.

  • 🔒 hipaa/policies/minimum-necessary available on request
Implementer
covered-entity documented

Apply minimum-necessary scoping and document where exceptions are invoked.

business-associate documented 📄 baa

Limit your requests and uses of PHI to the minimum necessary.

individual out-of-scope

164.502(e)(1) Disclosures to business associates draft

A covered entity may disclose PHI to a business associate, and allow it to create, receive, maintain or transmit PHI on its behalf, only with satisfactory assurances — typically a written BAA — that the business associate will appropriately safeguard the information.

Pryv platform facilitated

The technical disclosure is mediated by the access primitive — mint a BA-specific access with `clientData.role = "business_associate"` + `clientData.baa_id = "<contract-ref>"`, scoped to the subjects / streams covered by the BAA. Cross-platform BA arrangements (where the BA runs their own Pryv) inherit the CMC capability pattern for cross- account flow.

HDS facilitated USCH

HDS offers a Business Associate Agreement and the technical disclosure mechanism: a BA-specific access tagged with its role and contract reference, scoped to the subjects and streams the BAA covers. HDS itself signs a BAA when it acts as the business associate.

detail

Cross-platform business-associate arrangements inherit the cross-account capability pattern. The access carries its business-associate role and contract reference so disclosures are attributable to the BAA, while the contract itself is signed between the parties.

  • 🔒 hipaa/registers/baa-register available on request
Implementer
covered-entity documented 📄 baa

Execute a BAA with each business associate before disclosing PHI and scope their access to what the BAA covers.

business-associate documented 📄 baa

Sign the BAA and flow obligations down to any subcontractors.

individual out-of-scope

164.530(d) Complaints to the covered entity draft

A covered entity must provide a process for individuals to complain about its policies, procedures or compliance, and must document complaints received and their disposition.

Pryv platform facilitated

A complaint-intake workflow stores each complaint as an event on a designated `complaints/*` stream with `clientData.disposition` tracking outcome. The audit log captures the timestamp + actor on each disposition update — making the §530(d)(2) documentation requirement an automatic byproduct of normal record-keeping.

HDS facilitated USCH

HDS provides the means to store each complaint as an event on a dedicated stream with a disposition field, and the audit log captures the timestamp and actor on each disposition update. The complaint-handling process is the covered entity's.

detail

Storing complaints and dispositions as data makes the §530(d)(2) documentation requirement a byproduct of normal record-keeping. The intake workflow and response are the implementer's.

  • 🔒 hipaa/procedures/complaint-handling available on request
Implementer
covered-entity documented

Operate the complaint process and document complaints and their dispositions.

individual out-of-scope

164.530(e) Sanctions draft

A covered entity must have and apply appropriate sanctions against workforce members who fail to comply with its privacy policies and procedures.

Pryv platform out-of-scope

Sanctions are an HR / disciplinary process. No software role at the sanction-decision layer; the audit log gives the underlying evidence ("did this person actually access X?") that HR processes evaluate.

HDS documented USCH

Sanctions are an HR and disciplinary process with no software role at the decision layer. HDS maintains its own workforce sanction policy as a business associate; the audit log supplies the underlying evidence that disciplinary processes evaluate.

detail

HDS documents and applies sanctions for its own workforce, but the covered entity's sanction programme is outside HDS's scope.

  • 🔒 hipaa/policies/workforce-sanctions available on request
Implementer
covered-entity documented

Maintain and apply your workforce sanction policy and document enforcement.

business-associate documented 📄 baa

Maintain sanctions for your own workforce under your BAA.

individual out-of-scope

164.530(g) Refraining from intimidating and retaliatory acts draft

A covered entity may not intimidate, threaten, coerce, discriminate against or retaliate against an individual for exercising any right under the Privacy Rule.

Pryv platform out-of-scope

Anti-retaliation is an organizational policy + culture commitment; no software role.

HDS out-of-scope USCH

Anti-retaliation is an organizational policy and culture commitment with no software role. It rests entirely with the covered entity's programme.

detail

HDS provides no technical control bearing on this requirement; it is a conduct obligation of the covered entity.

Implementer
covered-entity documented

Maintain and enforce an anti-retaliation policy.

individual out-of-scope

164.530(i) Policies and procedures draft

A covered entity must implement policies and procedures designed to comply with the standards and implementation specifications of the Privacy Rule.

Pryv platform facilitated

Same pattern as HIPAA- Security §164.316(a): policies-as-data on a `compliance/policies/*` stream get versioning + retention + audit. The drafting + approval + review-cycle procedure is the privacy officer's. Cross-link to §164.316(a) preserves the Security Rule's parallel obligation.

HDS facilitated USCH

As with the Security Rule's documentation requirement, HDS provides the means to hold policies as versioned, retained, audited data on a dedicated stream. The drafting, approval and review cycle is the privacy officer's, and HDS maintains its own privacy policies as a BA.

detail

Policies-as-data on a dedicated compliance stream inherit versioning, retention and audit. The covered entity's policy programme is its own; HDS documents the policies governing its operations.

  • 🔒 hipaa/policies/privacy-policy-management available on request
Implementer
covered-entity documented

Author, approve and periodically review your privacy policies and procedures.

business-associate documented 📄 baa

Maintain policies and procedures for safeguarding PHI under your BAA.

individual out-of-scope

164.510(b) Disclosures for involvement in care and for notification purposes draft

A covered entity may disclose to a family member, relative, close friend or other person identified by the individual PHI directly relevant to that person's involvement in the individual's care or payment for care.

Pryv platform facilitated

The §510(b) "directly relevant" determination + relationship verification are clinical-workflow concerns. Pryv pattern: mint a time-bounded access for the involved person with permissions narrowed to "directly relevant" streams + `clientData.relationship` capturing the §510(b)(1) basis (family member name, role, individual's opportunity-to-object record).

HDS facilitated USCH

HDS supports minting a time-bounded access for the involved person, with permissions narrowed to the directly-relevant streams and client-data capturing the relationship and the §510(b) basis. The directly-relevant determination and relationship verification are clinical-workflow concerns of the covered entity.

detail

The access records the relationship, the involved person's role, and the individual's opportunity-to-object record. HDS stores and enforces the narrowed scope; the disclosure decision is the implementer's.

  • 🔒 hipaa/policies/uses-and-disclosures available on request
Implementer
covered-entity documented

Determine directly-relevant scope, verify the relationship, and record the disclosure basis.

individual facilitated

You identify the persons involved in your care and may object.

business-associate out-of-scope

164.512(b) Uses and disclosures for public-health activities draft

A covered entity may disclose PHI for public-health activities to authorities authorized by law to collect or receive it, including disease and injury reporting, vital-event reporting and public-health surveillance.

Pryv platform facilitated

Public-health-authority recipient is recorded on the access's `clientData.recipient_authority` + `clientData.statute` for the §512(b) statutory basis. Audit log anchors the disclosure to a specific timestamp + event range. The "authorized by law" determination is the covered entity's legal judgement.

HDS facilitated USCH

HDS lets the recipient authority and statutory basis be recorded on the access, and the audit log anchors the disclosure to a timestamp and event range. The authorized-by-law determination is the covered entity's legal judgement.

detail

A per-instance access carries the public-health-authority recipient and the statutory basis; the audit trail preserves the disclosure. HDS makes no public-health disclosure of customer PHI on its own initiative.

  • 🔒 hipaa/policies/uses-and-disclosures available on request
Implementer
covered-entity documented

Confirm the public-health authority's legal basis and record the disclosure.

individual out-of-scope

164.512(f) Uses and disclosures for law-enforcement purposes draft

A covered entity may disclose PHI for law-enforcement purposes under specific conditions, such as court order or warrant, administrative request, identification and location, victim of crime, or decedent.

Pryv platform facilitated

§512(f) categories drive vocabulary for `clientData.law_enforcement_basis` (e.g., `"f_1_i_court_order"`, `"f_2_ii_subpoena"`, `"f_4_victim"`). Per-instance disclosure access minted + revoked; audit log preserves the chain. The decision of whether the request qualifies under §512(f) is legal counsel's, not Pryv's.

HDS facilitated USCH

HDS supports recording the §512(f) category as the law-enforcement basis on a per-instance access that is minted and revoked around the disclosure, with the audit log preserving the chain. Whether the request qualifies under §512(f) is legal counsel's decision.

detail

The access carries the specific §512(f) basis vocabulary; HDS stores and audits the disclosure but makes no law-enforcement disclosure of customer PHI on its own initiative outside legal process served on it.

  • 🔒 hipaa/procedures/law-enforcement-requests available on request
Implementer
covered-entity documented

Evaluate law-enforcement requests against §512(f) conditions and record the basis.

individual out-of-scope

164.524(b) Right of access — requests and responses draft

A covered entity may require written access requests within reasonable limits and must act within 30 days, with one 30-day extension permitted on written notice.

Pryv platform facilitated

Request-intake workflow stores each request as an event on a designated `access-requests/*` stream with `clientData.due_by` computed from receipt timestamp. The 30/30-day operational cadence is the covered entity's process; once the response is ready, the individual exercises §524 directly via the standard Pryv API (see the §164.524 parent row).

HDS facilitated USCH

HDS supports storing each access request as an event on a dedicated stream with a computed due date, so the 30/30-day cadence is trackable. The operational cadence and decision remain the covered entity's; for individuals who can self-authenticate, the app-portability self-service tool bypasses the 30-day clock entirely (the individual obtains the data immediately, without a written-request intake).

detail

The request-intake artefact records receipt time and the resulting due date. The substantive response is delivered through the §164.524 access capability described in the parent row. Self-service via app-portability eliminates the need for a §524(b)(2) timely-response procedure on the individual-direct path; the timeline obligation remains operative on the partner-mediated path (covered entity intake → HDS-as-BA fulfilment).

  • doc: https://demo-portability.datasafe.dev
  • doc: https://portability.hds.ngo
  • 🔒 hipaa/procedures/individual-right-of-access available on request
Implementer
covered-entity documented

Operate the request intake and meet the §524(b) response timeline.

individual facilitated

You submit access requests, which are tracked to a due date.

business-associate out-of-scope

164.524(c) Right of access — provision of access draft

A covered entity must provide access in the form and format requested if readily producible, otherwise in readable hard copy or another agreed form, and must provide a summary if the individual agrees in advance.

Pryv platform implemented

The Pryv API delivers events in canonical JSON (data-types schemas) — "readily producible" in the §524(c) sense. Implementer's portal can transform to PDF / printed format where requested. Summaries are application-layer constructions from the same source events.

HDS implemented USCH

The HDS-operated API delivers events in canonical JSON validated against the data-type schemas — readily producible in the §524(c) sense — across both regions. The app-portability self-service web app gives individuals a one-click ZIP download of their full PHI dump; transformation to PDF or print and summary construction remain application-layer work on the same source events.

detail

HDS operates the standard read path that returns structured, machine-readable PHI. The app-portability tool (portability.hds.ngo) packages it into ZIPs the individual can keep or forward to another covered entity. Non-native formats and summaries are built by the implementer's portal from the same source events.

  • doc: https://demo-portability.datasafe.dev
  • doc: https://portability.hds.ngo
  • doc: https://github.com/healthdatasafe/app-portability
  • 🔒 hipaa/procedures/individual-right-of-access available on request
Implementer
individual facilitated

You obtain your PHI in canonical JSON or a format your portal produces.

covered-entity documented

Provide requested formats and summaries and agree applicable fees in advance.

business-associate out-of-scope

164.502(g) Personal representatives draft

A covered entity must treat a personal representative as the individual for uses and disclosures of PHI, subject to exceptions for abuse, neglect or endangerment concerns.

Pryv platform facilitated

Pryv pattern: the personal representative holds an `app` or `shared` access to the subject's data with full scope (the effective "treat as individual" technical permission). The access's `clientData.representative_relationship` + `clientData.legal_basis` capture the relationship; the revocation-by-exception pattern is `accesses.update` to narrow / `accesses.delete` to remove. The "abuse / neglect / endangerment" determination is clinical / legal judgement.

HDS facilitated USCH

HDS supports the representative holding an access to the individual's data with the appropriate scope — the technical "treat as the individual" permission — with the relationship and legal basis recorded as client-data. The abuse, neglect and endangerment exceptions are clinical and legal judgements of the covered entity.

detail

The exception pattern narrows or deletes the representative's access. HDS stores the representative relationship and legal basis; the determination of whether an exception applies is the implementer's.

  • 🔒 hipaa/policies/personal-representatives available on request
Implementer
covered-entity documented

Verify representative status, grant appropriate access, and apply exceptions where warranted.

individual facilitated

A verified personal representative may act on your behalf with recorded basis.

business-associate out-of-scope

164.512(a) Uses and disclosures required by law draft

A covered entity may use or disclose PHI to the extent required by law, limited to the relevant requirements of that law.

Pryv platform facilitated

"Required by law" disclosures still ride on accesses; record the statutory basis in `clientData.statute` so the audit chain ties the disclosure to the legal authority. The compliance burden of the cited law is separate.

HDS facilitated USCH

Required-by-law disclosures still ride on accesses, and HDS lets the statutory basis be recorded so the audit chain ties the disclosure to its legal authority. The compliance burden of the cited law is the covered entity's.

detail

The access carries the statute reference; the audit trail preserves the disclosure. HDS responds to legal process served on it as a business associate per its BAA and applicable law.

  • 🔒 hipaa/policies/uses-and-disclosures available on request
Implementer
covered-entity documented

Confirm the legal requirement, limit the disclosure to it, and record the basis.

business-associate documented 📄 baa

Disclose as required by law and notify the covered entity per your BAA.

individual out-of-scope

164.514(b) De-identification — implementation specifications draft

De-identification may use Expert Determination that re-identification risk is very small, or Safe Harbor removal of the 18 enumerated identifiers with no actual knowledge of residual re-identifiability.

Pryv platform out-of-scope

Choice of method + execution are app-side. Pryv stores the output of either method as ordinary events on the de-identified streams.

HDS documented USCH

The choice of method and its execution are application-side decisions of the covered entity. HDS stores the output of either method as ordinary events on the de-identified streams and provides no de-identification determination of its own.

detail

HDS documents that de-identification is the covered entity's responsibility; the platform simply persists whatever events the implementer's de-identification process produces.

  • 🔒 hipaa/policies/de-identification available on request
Implementer
covered-entity documented

Select and execute Expert Determination or Safe Harbor and retain the documentation.

individual out-of-scope

164.514(c) De-identification — re-identification draft

A covered entity may assign a re-identification code to de-identified information, provided the code is not derived from information about the individual and is not used or disclosed for any other purpose.

Pryv platform facilitated

When re-identification is a workflow requirement, the code-to-PHI mapping is a tightly scoped resource: keep it on a dedicated `re-id-map/*` system- stream-adjacent subtree with access permitted only to the re-identification administrator role. The code generation method (random / hash-of-non-PHI) must not encode PHI per §514(c)(1)(ii) — that's an editorial requirement on the implementer.

HDS facilitated USCH

When re-identification is needed, HDS supports keeping the code-to-PHI mapping as a tightly scoped resource reachable only by the re-identification administrator role. The code-generation method must not encode PHI, which is the covered entity's editorial requirement.

detail

The mapping lives on a dedicated subtree with access permitted only to the re-identification role. HDS enforces the scope and stores the mapping; ensuring the code is random or derived from non-PHI is the implementer's.

  • 🔒 hipaa/policies/de-identification available on request
Implementer
covered-entity documented

Generate codes that do not encode PHI and restrict their use to re-identification.

individual out-of-scope

164.528(b) Accounting of disclosures — implementation specifications draft

Each accounting entry must include the disclosure date, the recipient, a brief description of the PHI disclosed, and a brief statement of purpose or a copy of the written request.

Pryv platform implemented

Each §528(b)(2) field has a Pryv source (date / name / PHI description / purpose) — see the §164.528 parent row for the mapping. The pre-computed accounting report pattern (storing results on a dedicated stream) keeps the §528 response window tractable.

HDS facilitated USCH

Each §528(b)(2) field has an audit-log source — date, recipient, PHI description and purpose — as mapped in the parent accounting row. HDS operates the audit log that supplies these fields across both regions. The audit log is included verbatim in every app-portability backup (`audit_logs.json`), so individuals receive the raw §528 source data alongside their PHI in a single self-service download.

detail

Pre-computing per-subject accounting reports and storing them on a dedicated stream keeps the §528 response window tractable. Compiling and delivering the accounting is the covered entity's process. The app-portability tool ships the unfiltered audit-event stream (with timestamps, requesting access tokens, methods invoked) — sufficient source material for the covered entity to assemble the formal §528(b) accounting.

  • doc: https://demo-portability.datasafe.dev
  • doc: https://portability.hds.ngo
  • 🔒 hipaa/procedures/accounting-of-disclosures available on request
Implementer
covered-entity documented

Compile each accounting entry's required fields from the audit log and your records.

individual facilitated

You receive an accounting containing the §528(b) fields.

business-associate documented 📄 baa

Provide the covered entity with the disclosure details you hold.

164.504(e) Organizational requirements — business associate contracts draft

A covered entity may permit a business associate to create, receive, maintain or transmit PHI on its behalf only with satisfactory assurances via a written contract meeting the BAA content requirements of §164.504(e)(2).

Pryv platform facilitated

The §164.504(e) BAA content is contractual. Pryv-side support for executing the contract terms: BA access tagged with `clientData.baa_id` + `clientData.role = "business_associate"`, scope narrowed to subjects + streams covered by the BAA, audit-log accountability for every action under the BA access.

HDS facilitated USCH

HDS offers a BAA template and the technical means to execute its terms: a business-associate access tagged with the contract reference and role, scoped to the covered subjects and streams, with full audit-log accountability. The contract content itself is contractual.

detail

HDS signs BAAs as a business associate and flows obligations down to its own subcontractors. The access tags and audit log support enforcement and evidence of the §164.504(e) terms.

  • 🔒 hipaa/registers/baa-register available on request
Implementer
covered-entity documented 📄 baa

Execute a BAA meeting §164.504(e)(2) before any business associate handles PHI.

business-associate documented 📄 baa

Sign the BAA and execute back-to-back subcontractor agreements with downstream processors.

individual out-of-scope

164.504(g) Organizational requirements — group health plans draft

A group health plan may disclose PHI to a plan sponsor only after receiving certification that the plan documents have been amended to incorporate the §164.504(f) restrictions.

Pryv platform out-of-scope

Group-health-plan / plan-sponsor arrangements are organizational / contractual. No software role.

HDS out-of-scope USCH

Group health plan and plan-sponsor arrangements are organizational and contractual, with no software role. HDS provides no technical control specific to this requirement.

detail

The plan-document amendment and certification are entirely the covered entity's contractual obligations.

Implementer
covered-entity documented

Obtain the plan-sponsor certification before disclosing PHI to the sponsor.

individual out-of-scope

164.502(j) Disclosures by whistleblowers and workforce-member crime victims draft

A workforce member's or business associate's disclosure of PHI to a regulatory, oversight or law-enforcement authority is not a violation where made in good-faith belief of unlawful conduct and meeting the §502(j) conditions.

Pryv platform out-of-scope

Whistleblower protections are legal framing. No software role; the disclosing person's audit-trail evidence under their access may be cited in subsequent proceedings.

HDS out-of-scope USCH

Whistleblower protection is a legal framing with no software role. The audit-trail evidence of a disclosing person's access may be cited in subsequent proceedings, but HDS provides no control specific to this requirement.

detail

HDS neither enables nor restricts good-faith whistleblower disclosures beyond ordinary access controls; the protection is a matter of law.

Implementer
covered-entity documented

Recognize the §502(j) protection in your policies and non-retaliation handling.

business-associate documented 📄 baa

Understand the §502(j) good-faith disclosure protection.

individual out-of-scope