Is AI HIPAA compliant?

There is no HHS-approved certification that proves a vendor complies with HIPAA. Compliance belongs to the practice: Microsoft says using its services does not on its own achieve HIPAA compliance, and OpenAI says accepting its BAA does not by itself make an application compliant. The questions below apply to every AI tool, whoever makes it.

What makes an AI tool usable with PHI?

1. A BAA that covers the exact product. The Privacy Rule lets a practice give PHI to a business associate only with satisfactory assurance that it will safeguard the information. Vendors list the products their BAA covers, and one brand name often spans covered and uncovered products.
2. The right plan and account. BAAs attach to business and enterprise plans used with organization accounts. Anthropic says Team, Free, Pro and Max plans cannot enable HIPAA; Microsoft's coverage applies to work accounts signed in through Microsoft Entra ID; Google's admins accept its BAA in the Admin console.
3. Features outside the BAA switched off. Web search, connectors, browser extensions, previews and third-party add-ons are common exclusions. Each vendor publishes its own list.
4. Settings that match the agreement. Some coverage starts only after an admin acts: the Claude Enterprise Primary Owner activates HIPAA, and the OpenAI API needs Modified Retention. Tools that search company files show each user what that user can already open, so fix sharing permissions first.
5. Minimum necessary. HIPAA requires reasonable efforts to limit PHI to the minimum necessary for the purpose. Paste the lines the task needs, never the whole chart.
6. The risk analysis. The Security Rule requires an accurate and thorough assessment of risks to electronic PHI and security measures that reduce them. Add each AI tool to it, train staff, and review the vendor's audit records on a schedule.

Which AI tools offer a BAA?

How does Microsoft Copilot's BAA work?

Microsoft's Data Protection Addendum says that when a customer is a covered entity or business associate and puts PHI in its data, executing the customer's agreement also executes the HIPAA BAA. Microsoft's HIPAA page lists Microsoft Copilot and Microsoft Copilot Chat among in-scope services, and a customer can opt out of the BAA in writing, so confirm nobody has. Microsoft renamed Microsoft 365 Copilot to Microsoft Copilot, which is also the consumer app's name, so the sign-in decides the terms: a work account through Entra ID or a personal Microsoft account.

Microsoft says the DPA and HIPAA compliance do not apply to the short queries Copilot sends to Bing for web search. Admins turn web search off with the Allow web search in Copilot policy. For clinicians, Microsoft places Dragon Copilot under its DPA and Dragon Copilot terms, and its general HIPAA list does not name it, so confirm the health system's BAA does.

What if the tool has no BAA?

Staff can use it for work with no PHI: policy drafts, template letters and patient education written from a blank page. Text is de-identified under Safe Harbor only when all 18 identifiers are removed for the patient and the patient's relatives, employers and household members, and the practice has no actual knowledge the remainder identifies the person. Removing a name alone leaves PHI.