Today, we’re releasing the HIPAA Security Rule on AWS: Technical Safeguards Implementation and Readiness Guidance. This helps covered entities and business associates configure, implement, and evidence compliance with the HIPAA Security Rule Technical Safeguard requirements (45 CFR §164.312) when building healthcare workloads on AWS.

The HIPAA Security Rule’s Technical Safeguards (§164.312) define five standards and nine implementation specifications covering access control, audit controls, integrity, authentication, and transmission security.

The guidance also covers the 2025 NPRM proposed changes, including encryption at rest and in transit becoming required, multi-factor authentication (MFA) becoming mandatory for all electronic Personal Health Information (ePHI) access, and new specifications for network segmentation, configuration management, anti-malware protection, patch management, software removal, incident response and breach notification.

Key topics included

• Shared responsibility for HIPAA on AWS – A responsibility matrix mapping each §164.312 specification to what AWS manages nd what the customer must configure and operate.
• ePHI boundary architecture – Guidance on establishing a defined ePHI boundary
• ePHI data flow and encryption – A reference architecture tracing ePHI with the applicable §164.312 specification
• Foundation checklist – Prerequisite recommendation before configuring individual Technical Safeguard controls.

This guidance is written for cloud architects, security engineers, CISOs, and compliance teams at covered entities and business associates building or operating AWS healthcare workloads. It assumes familiarity with AWS services and is intended as a practical implementation reference, not a legal or regulatory interpretation. This guidance focuses exclusively on Technical Safeguards.

HHS published a Notice of Proposed Rulemaking in January 2025, proposing significant updates to the HIPAA Security Rule—including eliminating the Addressable designation, making encryption, MFA, and asset inventory mandatory, and introducing new technical requirements not present in the current rule. As of June 2026, the final rule has not been published. This guidance covers both the current rule and the proposed changes and recommends treating all specifications as Required for new workloads.

Download HIPAA Security Rule on AWS: Technical Safeguards Implementation and Readiness Guidance.

For questions about HIPAA readiness on AWS, including Administrative Safeguards, Physical Safeguards, risk analysis, and assessment preparation, contact the AWS Security Assurance Services team or your AWS account representative.

This guidance is provided by AWS Security Assurance Services, LLC, a HITRUST External Assessor Firm and PCI-QSAC along with contribution from AWS HCLS, AWS Compliance teams. It is for informational and guidance purposes only and does not constitute legal, regulatory, or compliance advice. Recipients are solely responsible for determining applicability to their specific environments and legal obligations.

If you have feedback about this post, submit comments in the Comments section below.

AWS Security Assurance Services is announcing the release of the Cloud Security Alliance (CSA) Compliance Guide on Amazon Web Service (AWS), a new resource that maps the 17 control domains and 207 control objectives of the Cloud Controls Matrix v4.1 (CCM) to AWS services and recommended implementation practices. The guide is intended to help organizations using AWS plan, implement, and evidence the controls relevant to their CCM scope, including those pursuing or maintaining CSA STAR certification.

The Cloud Security Alliance is a not-for-profit organization dedicated to defining and raising awareness of best practices for cloud security. AWS maintains CSA STAR Level 2 certification, which couples the requirements of ISO/IEC 27001:2022 with the CCM. The CSA STAR documentation and the AWS Consensus Assessments Initiative Questionnaire (CAIQ) are available to AWS customers through AWS Artifact.

The CSA Cloud Controls Matrix is a cybersecurity controls framework developed by the CSA that provides a detailed set of security controls mapped across multiple domains (such as audit and assurance, identity and access management, and encryption and key management) specifically designed to assess and manage security risks in cloud computing environments. The CCM is cloud agnostic, designed to be applicable to any cloud service provider or deployment model, such as infrastructure as a service (IaaS), platform as a service (PaaS), and software as a service (SaaS), regardless of the underlying technology or vendor, providing universal security controls that organizations can apply across cloud platforms.

CCM defines its own Shared Security Responsibility Model (SSRM) with three categories: Cloud service provider (CSP)-owned, customer-owned, and shared (independent or dependent). The guide recommends using the SSRM together with the AWS Shared Responsibility Model. For controls that AWS owns, the guide points to AWS attestations available through AWS Artifact (for example, SOC reports, ISO certificates, and the CSA STAR attestation) as inherited evidence. For controls that customers own or share, the guide describes how to implement and evidence them using AWS services. Using a CSA STAR–certified AWS service doesn’t by itself make a customer workload compliant. Customers remain responsible for configuring services, managing access, protecting data, and implementing additional controls based on their environment, risk assessments, and regulatory obligations. The guide is informational and doesn’t replace the AWS compliance documentation and certifications available through AWS Artifact.

For each control, the guide states applicability, describes how organizations can implement the control on AWS, identifies common pitfalls, and lists examples that can be used as evidence during an assessment.

• CSA Cloud Controls Matrix
• AWS CSA compliance page
• AWS Services in Scope by Compliance Program

Download available: Here

For further assistance, contact AWS Security Assurance Services. If you have feedback about this post, submit comments in the Comments section below.