Any vendor that creates, receives, maintains, or transmits Protected Health Information (PHI) on your behalf is a business associate under HIPAA—and must sign a BAA before you share PHI. Miss this, and you expose yourself to hefty fines and serious reputational damage. Below, we list the common vendor categories that require BAAs and outline a robust process for managing them end to end.
Cloud Infrastructure & Platform Providers
IaaS/PaaS: AWS EC2/S3, Azure VMs/Blob Storage, Google Cloud Compute/Storage
Kubernetes services, container registries, serverless platforms
Software-as-a-Service (SaaS) Tools
EHR/EMR systems, practice-management software
Telehealth and video-conferencing platforms
Data Analytics & Monitoring
Business-intelligence dashboards (Tableau, Power BI)
Application performance monitoring (Datadog, New Relic)
Logging/SIEM solutions (Splunk, LogRhythm)
Payment & Billing Processors
Credit-card gateways, claims-processing vendors, revenue-cycle management services
Backup & Disaster-Recovery Services
Off-site backup vendors, cloud-based DR orchestration
Communication & Collaboration
Email-as-a-service (Office 365, Google Workspace) when PHI flows through mail
Secure messaging platforms, SMS gateways
Transcription & Coding Services
Speech-to-text/transcription vendors
Medical-coding firms that map PHI to billing codes
Support & Maintenance
Managed-service providers with admin or root access to PHI systems
Remote-support tools (e.g., TeamViewer, AnyDesk) if used on PHI-bearing devices
Machine-Learning & AI Vendors
Any AI/ML service or LLM API that processes PHI (e.g., custom-model training, inference)
Consultants & Contractors
Security auditors, penetration-testing firms, code-review consultants
Rule of thumb: If they touch PHI—directly or in logs—you need a BAA.
Scope of PHI Use: Clearly define permitted uses (e.g., “storage only,” “analytics only,” “support only”).
Sub-contractors (“Sub-BAs”): Vendor must flow down BAA obligations to any downstream partner.
Security Safeguards: Reference the HIPAA Security Rule’s Administrative, Physical, and Technical safeguards.
Breach Notification: Vendor must notify you of any security incident within a specified timeframe (e.g., 24–48 hours).
Termination & Return/Destruction: On contract end, PHI must be returned or irreversibly destroyed.
Audit Rights: You—or your auditor—reserve the right to inspect the vendor’s controls and reports.
Vendor Inventory & Risk Classification
Maintain a live registry (spreadsheet or GRC tool) listing each vendor, their PHI scope, BAA status, renewal date, and risk rating.
Standard BAA Template
Use a law-reviewed master BAA. Don’t rely solely on vendor-provided templates—they often understate your rights.
Negotiation & Signature
Assign a responsible owner (legal or compliance) to drive negotiations.
Track red-lines and maintain version history in your contract-management system.
Onboarding Checklist
Only upon signed BAA:
Provision PHI access credentials
Configure network/firewall rules
Enable audit-logging and SIEM feeds
Continuous Monitoring & Review
Annual Review: Confirm the vendor’s security posture hasn’t degraded (ask for SOC 2 or ISO 27001 reports).
Trigger-Based Checks: Re-evaluate after major service upgrades, acquisitions, or security incidents.
Renewal & Offboarding
Automate calendar reminders 60 days before BAA expiration.
On termination: enforce PHI return/destruction, revoke all credentials, archive final audit logs.
GRC Platforms: OneTrust, Drata, Vanta—for vendor risk workflows and BAA tracking.
Contract Repositories: Store signed BAAs in a version-controlled, access-restricted vault (e.g., SharePoint with MFA).
Automated Alerts: Use calendaring or ticketing integrations to warn stakeholders of upcoming renewals or audits.
Treat BAAs not as paperwork, but as a dynamic control in your HIPAA compliance ecosystem. By systematically identifying all PHI-touching vendors, negotiating airtight agreements, and rigor