How to Vet a Cloud Storage Vendor for HIPAA Compliance

Choosing a cloud storage partner for ePHI is high stakes. Use this guide to vet vendors methodically, focusing on the Business Associate Agreement, Technical Safeguards, Compliance Certifications, risk practices, encryption, access controls, and Disaster Recovery Documentation.

Evaluate Business Associate Agreement

The Business Associate Agreement (BAA) is the non‑negotiable foundation of HIPAA cloud engagements. It defines how the vendor will protect ePHI, support your compliance obligations, and cooperate during incidents, audits, and termination.

Essentials to require in the BAA

• Clear scope of PHI/ePHI, permitted uses/disclosures, and “minimum necessary” handling.
• Explicit alignment to HIPAA Security, Privacy, and Breach Notification Rules, including Technical Safeguards and documented administrative/physical controls.
• Prompt security incident and breach notification with defined escalation, evidence preservation, and cooperation obligations.
• Subcontractor “flow‑down” requiring BAAs with all downstream providers that touch ePHI.
• Data lifecycle terms: export on request, secure deletion, retention limits, and support for verification of destruction.
• Audit/assessment rights, including access to Compliance Certifications, Internal Audits summaries, penetration test overviews, and remediation tracking.
• Right to review Disaster Recovery Documentation and test results relevant to your workloads.
• Termination assistance, indemnification, and liability alignment proportionate to risk.

Red flags

• “HIPAA-ready” marketing with refusal to sign a BAA or heavy carve‑outs.
• Ambiguous breach definitions, long or undefined notification timelines, or no forensic cooperation.
• Prohibitions on reasonable audits or on reviewing third‑party assurance reports.
• No obligation to bind subcontractors handling ePHI.

Verify Technical Safeguards

HIPAA’s Security Rule expects practical Technical Safeguards that prevent unauthorized access, ensure integrity, and protect data in transit. The vendor should demonstrate mature, well‑documented controls across identity, data, networks, and logging.

Controls to confirm

• MFA and SSO (SAML/OIDC) for all consoles and APIs; role‑based or attribute‑based access with least privilege.
• Encryption in transit (TLS 1.2+ with modern ciphers) and at rest backed by FIPS-140-2 Encryption modules.
• Integrity controls: hashing, object immutability/WORM options, and tamper‑evident logs.
• Comprehensive audit controls: centralized logs, immutable storage, and SIEM integration.
• Network protections: private connectivity, IP allow‑lists, DDoS and WAF capabilities, and segregation by account/project.
• Secure APIs: scoped tokens, short‑lived credentials, signed requests, and automated key rotation.
• Secure configuration baselines, vulnerability management, and rapid patching SLAs.

Evidence to request

• Security architecture diagrams and data‑flow maps for your intended services.
• Penetration test executive summaries, vulnerability scan trends, and remediation cadence.
• Incident response playbooks, tabletop results, and contact pathways for 24×7 escalation.

Assess Certifications and Compliance

There is no official “HIPAA certification.” Instead, evaluate the breadth and depth of the vendor’s Compliance Certifications and the rigor of independent audits that map to HIPAA safeguards.

High‑value certifications and reports

• HITRUST CSF Certification covering relevant in‑scope services.
• SOC 2 Type II with controls mapped to HIPAA requirements and detailed testing periods.
• ISO/IEC 27001 for ISMS, plus 27017 (cloud security) and 27018 (protection of PII in cloud).
• FedRAMP Moderate/High (where applicable) indicating strong baseline controls and continuous monitoring.

What to collect and review

• Current reports with bridge letters, scope statements, and noted exceptions.
• Policy library excerpts (especially Risk Management Policies), training attestations, and Internal Audits summaries.
• Control mappings to HIPAA safeguards, remediation plans for findings, and evidence of continuous monitoring.

Examine Risk Assessment Procedures

HIPAA requires ongoing risk analysis and risk management. Your vendor should operate a formal program that identifies threats to ePHI, prioritizes remediation, and tracks residual risk over time.

What good looks like

• Documented methodology (e.g., asset inventories, data‑flow diagrams, threat modeling) and a living risk register.
• Defined Risk Management Policies linking risks to owners, due dates, acceptance criteria, and verification evidence.
• Regular vulnerability scanning, penetration testing, code security, and change‑management gates.
• Third‑party risk review of subcontractors and clear criteria for onboarding/continuous evaluation.
• Measurable KPIs: mean time to remediate, patch compliance, and reduction of high‑risk findings.

Questions to ask

• When was the last enterprise risk assessment and what were the top unresolved risks?
• How are risks tracked to closure and validated by Internal Audits or independent reviewers?
• What triggers an out‑of‑cycle assessment (new region, service, architecture change)?

Review Data Encryption Standards

Encryption must protect data at rest, in transit, and in backups without weakening usability. Prefer designs that separate duties, minimize key exposure, and provide auditable key usage trails.

Standards to require

• FIPS-140-2 Encryption validation for cryptographic modules (e.g., AES‑256 at rest; TLS 1.2/1.3 with PFS in transit).
• Dedicated KMS or HSMs, with options for customer‑managed keys (CMK) and BYOK/BYOKMS.
• Automated key rotation, dual‑control approvals, and strict access to key material.
• Envelope encryption for objects, databases, and logs; encryption for snapshots and backups.
• Immutable backups and recovery workflows that preserve encryption and integrity.

Validation steps

• Request crypto architecture docs, module validation identifiers, and key‑management runbooks.
• Verify that cross‑region replication, lifecycle policies, and restore processes maintain encryption.
• Review procedures for key compromise, revocation, re‑encryption, and customer notification.

Inspect Access Control Mechanisms

Identity is the new perimeter. Strong access control reduces blast radius and deters misuse while supporting operational agility.

Controls and practices to look for

• SSO with SAML/OIDC, mandatory MFA, and automated provisioning/deprovisioning (e.g., SCIM).
• RBAC/ABAC with least privilege, just‑in‑time elevation, and time‑bound approvals for admin access.
• Managed secrets for service accounts, short‑lived credentials, and rotation policies.
• Network‑level controls: private links, IP allow‑lists, conditional access, and egress restrictions.
• Session management: inactivity timeouts, device posture checks, and anomaly detection.

Oversight and review

• Comprehensive admin and data‑access logs with retention and integrity protections.
• Regular access reviews, separation of duties, and “break‑glass” procedures with monitoring.

Analyze Disaster Recovery Plans

HIPAA expects availability and integrity of ePHI. Your vendor’s business continuity and disaster recovery posture must be proven, documented, and tested against realistic scenarios.

What to review

• Disaster Recovery Documentation with defined RTO/RPO targets for your services and regions.
• Multi‑region replication, backup schedules, and verification of backup integrity and restorability.
• Failover runbooks, automation, capacity planning, and dependencies (DNS, identity, KMS).
• Encryption continuity during recovery and procedures for data corruption or ransomware.
• Exercise cadence (tabletops, partial and full restores) and continuous improvement tracking.

Evidence to request

• Most recent recovery test reports, success criteria, findings, and remediation status.
• Sample restore results for representative datasets, including time to recover and data integrity checks.
• Communication plans for incidents and named 24×7 escalation contacts.

Conclusion

To vet a cloud storage vendor for HIPAA compliance, anchor on a robust BAA, require verifiable Technical Safeguards, scrutinize Compliance Certifications and Internal Audits, confirm disciplined risk practices, demand strong encryption with FIPS-140-2 Encryption, enforce least‑privilege access, and insist on tested recovery. Document each decision so your due diligence stands up to audits.

FAQs.

What is a Business Associate Agreement in HIPAA compliance?

A Business Associate Agreement is a contract that binds a vendor handling ePHI to HIPAA obligations. It defines permitted uses of ePHI, required safeguards, breach notification, subcontractor flow‑down, audit rights, and data‑lifecycle terms so you can verify and enforce compliance.

How do technical safeguards protect ePHI in cloud storage?

Technical safeguards combine identity controls (SSO, MFA, least privilege), encryption in transit and at rest, integrity protections, and auditable logging. Together, they prevent unauthorized access, detect misuse, and preserve confidentiality and integrity of ePHI across services and networks.

What certifications should a HIPAA-compliant cloud vendor have?

There is no official HIPAA certification. Look for strong Compliance Certifications and third‑party reports such as HITRUST CSF, SOC 2 Type II with HIPAA mapping, and ISO/IEC 27001/27017/27018. FedRAMP can add assurance for government‑oriented workloads.

How often should compliance reviews be conducted with a cloud provider?

Conduct formal reviews at least annually and whenever major changes occur (new regions, services, or architecture). Refresh risk assessments, access reviews, and control evidence; update the BAA as needed; and request current reports, Internal Audits summaries, and Disaster Recovery Documentation after each test cycle.