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Client Confidentiality When Lawyers Use AI Tools
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HIPAA applies to covered entities and business associates when they create, receive, maintain or transmit protected health information (PHI) in covered relationships.
An AI tool is not automatically subject to HIPAA simply because it discusses health, but a vendor handling PHI on behalf of a covered entity may be a business associate. Organizations must assess the data, role, permissions and required contracts before use.
The Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security and Breach Notification Rules apply to covered entities—health plans, health care clearinghouses and certain health care providers—and to business associates in defined relationships. Whether an AI vendor is a business associate depends on its role and access to protected health information, not on whether the software is branded as AI. HIPAA is not a general privacy law for every health-related application. HHS explains that a vendor providing services that involve creating, receiving, maintaining or transmitting PHI on behalf of a covered entity may be a business associate. A covered entity generally needs a written business associate agreement (BAA) that establishes permitted uses and disclosures, safeguards and other required obligations. HHS specifically lists a third-party AI chatbot in a patient portal as a potential business associate when it handles PHI for symptom assessment or appointment scheduling. If a cloud provider processes or stores ePHI for a covered entity, HHS says a BAA is required even if the data are encrypted and the provider lacks the key. A patient-selected app raises a different relationship question. HHS says an app’s facilitation of access at the individual’s request alone does not necessarily create a business associate relationship; the facts of the provider, developer and service arrangement matter. Other laws may still apply to non-HIPAA apps. Before putting PHI into an AI system, determine whether the organization is covered, whether the data are PHI, whether the vendor handles them on the organization’s behalf, and what permissions and BAA terms apply. Verify security, retention, subcontractors and incident reporting, and apply the organization’s risk analysis and minimum-necessary processes where required. De-identification must follow HIPAA’s recognized methods; removing names alone may not be enough. AI tools do not change the underlying duties to protect PHI and respond to breaches. Keep documentation for the intended use and approval decision.
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AI services may add features that change how they receive, store or reuse health information. A vendor’s role can differ across deployments, so organizations should review data flows and contract terms when a product or workflow changes. HHS guidance on business associates and cloud services remains relevant to AI tools that process PHI. Privacy and security assessments should include model logs, subcontractors, retention and secondary use, alongside HIPAA’s other requirements. Review quarterly in practice. Assign a privacy owner to review changes.
A clinic checks whether an AI note-drafting vendor will access patient information on the clinic’s behalf and whether a compliant business associate agreement is required.
A health system confirms that a cloud AI service creating or maintaining electronic PHI has a BAA and meets Security Rule requirements.
A patient asks a provider to send records to a consumer app; the provider examines whether the app is acting for the provider or only at the patient’s direction.
A developer verifies that a dataset was de-identified under HIPAA methods before concluding it is no longer PHI.
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HIPAA applies to covered entities and business associates when they create, receive, maintain or transmit protected health information (PHI) in covered relationships. An AI tool is not automatically subject to HIPAA simply because it discusses health, but a vendor handling PHI on behalf of a covered entity may be a business associate. Organizations must assess the data, role, permissions and required contracts before use.
HHS limits HIPAA coverage to covered entities and business associates as defined by the rules.
Business-associate status depends on function and PHI access in a covered relationship.
HHS describes a written BAA as setting permitted uses and required protections.
HHS says lack of an encryption key does not remove business-associate obligations.
HHS says individual-directed access alone does not necessarily establish the relationship.
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Client Confidentiality When Lawyers Use AI Tools
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