opencode-skills-collection 4.0.68 → 4.0.69

package/bundled-skills/hipaa-compliance/SKILL.md

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+---
+name: hipaa-compliance
+description: Implement HIPAA security and privacy rules. Configure PHI protections
+  and BAA requirements. Use when handling healthcare data.
+category: security
+risk: safe
+source: https://github.com/BagelHole/DevOps-Security-Agent-Skills
+source_repo: BagelHole/DevOps-Security-Agent-Skills
+source_type: community
+date_added: '2026-09-20'
+license: MIT
+license_source: https://github.com/BagelHole/DevOps-Security-Agent-Skills/blob/main/LICENSE
+compatibility: Checklist and framework guidance; no privileged tooling required. Apply
+  controls through your own change process.
+metadata:
+  author: devops-skills
+  version: '1.0'
+---
+
+# HIPAA Compliance
+
+Implement HIPAA Security Rule, Privacy Rule, and Breach Notification Rule requirements for systems that create, receive, maintain, or transmit electronic Protected Health Information (ePHI).
+
+## When to Use
+
+- Building or operating systems that handle electronic Protected Health Information
+- Configuring cloud infrastructure for HIPAA-eligible workloads
+- Establishing Business Associate Agreements with vendors
+- Implementing technical safeguards for PHI protection
+- Preparing for HIPAA compliance audits or OCR investigations
+
+## HIPAA Rules and Safeguards
+
+```yaml
+security_rule:
+  administrative_safeguards:
+    164.308_a_1: "Security Management Process"
+    actions:
+      - Conduct risk analysis (required)
+      - Implement risk management program (required)
+      - Apply sanction policy for violations (required)
+      - Review information system activity (required)
+
+    164.308_a_3: "Workforce Security"
+    actions:
+      - Authorization/supervision procedures (addressable)
+      - Workforce clearance procedure (addressable)
+      - Termination procedures (addressable)
+
+    164.308_a_4: "Information Access Management"
+    actions:
+      - Access authorization policies (addressable)
+      - Access establishment and modification (addressable)
+      - Isolate healthcare clearinghouse functions (required)
+
+    164.308_a_5: "Security Awareness and Training"
+    actions:
+      - Security reminders (addressable)
+      - Protection from malicious software (addressable)
+      - Log-in monitoring (addressable)
+      - Password management (addressable)
+
+    164.308_a_6: "Security Incident Procedures"
+    actions:
+      - Response and reporting procedures (required)
+
+    164.308_a_7: "Contingency Plan"
+    actions:
+      - Data backup plan (required)
+      - Disaster recovery plan (required)
+      - Emergency mode operation plan (required)
+      - Testing and revision procedures (addressable)
+      - Applications and data criticality analysis (addressable)
+
+    164.308_a_8: "Evaluation"
+    actions:
+      - Periodic technical and nontechnical evaluation (required)
+
+  physical_safeguards:
+    164.310_a: "Facility Access Controls"
+    164.310_b: "Workstation Use"
+    164.310_c: "Workstation Security"
+    164.310_d: "Device and Media Controls"
+
+  technical_safeguards:
+    164.312_a: "Access Control"
+    actions:
+      - Unique user identification (required)
+      - Emergency access procedure (required)
+      - Automatic logoff (addressable)
+      - Encryption and decryption (addressable)
+
+    164.312_b: "Audit Controls"
+    actions:
+      - Implement hardware/software/procedural mechanisms to record and examine access (required)
+
+    164.312_c: "Integrity"
+    actions:
+      - Mechanism to authenticate ePHI (addressable)
+
+    164.312_d: "Person or Entity Authentication"
+    actions:
+      - Verify identity of person/entity seeking access (required)
+
+    164.312_e: "Transmission Security"
+    actions:
+      - Integrity controls (addressable)
+      - Encryption (addressable)
+
+privacy_rule:
+  minimum_necessary: "Limit PHI use, disclosure, and requests to minimum necessary"
+  individual_rights: "Access, amendment, accounting of disclosures, restrictions"
+  notice_of_practices: "Provide notice of privacy practices to individuals"
+
+breach_notification_rule:
+  individual_notification: "Within 60 days of discovery"
+  hhs_notification: "Annual for <500 records; within 60 days for 500+"
+  media_notification: "Required when 500+ individuals in a state/jurisdiction"
+```
+
+## Technical Safeguards Implementation Checklist
+
+```yaml
+encryption_requirements:
+  at_rest:
+    standard: AES-256
+    aws_services:
+      - [ ] RDS encryption enabled (KMS managed key)
+      - [ ] S3 bucket default encryption (SSE-KMS)
+      - [ ] EBS volume encryption enabled
+      - [ ] DynamoDB table encryption (KMS)
+      - [ ] ElastiCache encryption at rest enabled
+      - [ ] Redshift cluster encryption enabled
+      - [ ] EFS encryption enabled
+    azure_services:
+      - [ ] Azure SQL TDE enabled (customer-managed key)
+      - [ ] Storage Account encryption (CMK)
+      - [ ] Managed Disk encryption (SSE with CMK)
+      - [ ] Cosmos DB encryption at rest
+    gcp_services:
+      - [ ] Cloud SQL encryption (CMEK)
+      - [ ] Cloud Storage encryption (CMEK)
+      - [ ] BigQuery encryption (CMEK)
+      - [ ] Persistent Disk encryption (CMEK)
+
+  in_transit:
+    standard: TLS 1.2 or higher
+    checks:
+      - [ ] TLS 1.2+ enforced on all load balancers
+      - [ ] HTTP-to-HTTPS redirect enabled
+      - [ ] Internal service-to-service mTLS configured
+      - [ ] Database connections use SSL/TLS
+      - [ ] API gateways enforce TLS minimum version
+      - [ ] Email encryption for PHI (S/MIME or TLS)
+      - [ ] VPN or private connectivity for admin access
+
+  key_management:
+    - [ ] Customer-managed KMS keys for PHI data stores
+    - [ ] Key rotation enabled (annual minimum)
+    - [ ] Key access restricted to authorized roles only
+    - [ ] Key usage audited via CloudTrail / audit logs
+    - [ ] Key deletion protection enabled
+
+access_control:
+  unique_user_identification:
+    - [ ] Individual user accounts (no shared credentials)
+    - [ ] MFA enforced for all users accessing PHI systems
+    - [ ] Service accounts with unique identities and audited usage
+    - [ ] Federated identity with SSO (SAML/OIDC)
+
+  role_based_access:
+    - [ ] Least privilege roles defined per job function
+    - [ ] PHI access restricted to need-to-know
+    - [ ] Separate roles for data access vs. administration
+    - [ ] Privileged access requires just-in-time approval
+
+  session_management:
+    - [ ] Automatic session timeout (15 minutes idle for workstations)
+    - [ ] Re-authentication for sensitive operations
+    - [ ] Concurrent session limits
+    - [ ] Session tokens secured (HttpOnly, Secure, SameSite)
+
+  emergency_access:
+    - [ ] Break-glass procedure documented and tested
+    - [ ] Emergency access credentials stored securely
+    - [ ] All emergency access usage audited and reviewed
+    - [ ] Emergency access automatically expires
+
+audit_controls:
+  logging_requirements:
+    - [ ] All PHI access logged (read, write, delete)
+    - [ ] User authentication events logged
+    - [ ] Administrative actions logged
+    - [ ] Failed access attempts logged
+    - [ ] Log integrity protection (hash chaining or WORM storage)
+    - [ ] Logs retained for minimum 6 years
+    - [ ] Regular log review process documented
+
+  monitoring:
+    - [ ] Real-time alerting on unauthorized PHI access attempts
+    - [ ] Anomaly detection for unusual data access patterns
+    - [ ] Privileged action monitoring
+    - [ ] Data export/download alerting
+```
+
+## AWS HIPAA-Eligible Architecture
+
+```bash
+# Verify you are using only HIPAA-eligible AWS services
+# Reference: https://aws.amazon.com/compliance/hipaa-eligible-services-reference/
+
+# Create a dedicated VPC for PHI workloads
+aws ec2 create-vpc --cidr-block 10.100.0.0/16 \
+  --tag-specifications 'ResourceType=vpc,Tags=[{Key=Name,Value=phi-vpc},{Key=Compliance,Value=HIPAA}]'
+
+# Enable VPC flow logs for network auditing
+aws ec2 create-flow-log \
+  --resource-type VPC \
+  --resource-ids vpc-XXXXXXXX \
+  --traffic-type ALL \
+  --log-destination-type cloud-watch-logs \
+  --log-group-name /vpc/phi-flow-logs \
+  --deliver-logs-permission-arn arn:aws:iam::123456789012:role/VPCFlowLogsRole
+
+# Create encrypted RDS instance for PHI
+aws rds create-db-instance \
+  --db-instance-identifier phi-database \
+  --db-instance-class db.r6g.large \
+  --engine postgres \
+  --master-username admin \
+  --master-user-password "USE_SECRETS_MANAGER" \
+  --storage-encrypted \
+  --kms-key-id arn:aws:kms:us-east-1:123456789012:alias/phi-rds-key \
+  --vpc-security-group-ids sg-XXXXXXXX \
+  --db-subnet-group-name phi-subnet-group \
+  --backup-retention-period 35 \
+  --multi-az \
+  --deletion-protection \
+  --enable-cloudwatch-logs-exports '["postgresql","upgrade"]' \
+  --tags Key=Compliance,Value=HIPAA Key=DataClassification,Value=PHI
+
+# Create S3 bucket with HIPAA controls
+aws s3api create-bucket --bucket phi-data-bucket --region us-east-1
+
+aws s3api put-bucket-encryption --bucket phi-data-bucket \
+  --server-side-encryption-configuration '{
+    "Rules": [{"ApplyServerSideEncryptionByDefault": {"SSEAlgorithm": "aws:kms", "KMSMasterKeyID": "alias/phi-s3-key"}, "BucketKeyEnabled": true}]
+  }'
+
+aws s3api put-public-access-block --bucket phi-data-bucket \
+  --public-access-block-configuration BlockPublicAcls=true,IgnorePublicAcls=true,BlockPublicPolicy=true,RestrictPublicBuckets=true
+
+aws s3api put-bucket-versioning --bucket phi-data-bucket \
+  --versioning-configuration Status=Enabled
+
+aws s3api put-bucket-logging --bucket phi-data-bucket \
+  --bucket-logging-status '{"LoggingEnabled": {"TargetBucket": "phi-access-logs", "TargetPrefix": "phi-data-bucket/"}}'
+
+# Enable CloudTrail data events for PHI buckets
+aws cloudtrail put-event-selectors --trail-name hipaa-audit-trail \
+  --advanced-event-selectors '[{
+    "Name": "PHI-S3-DataEvents",
+    "FieldSelectors": [
+      {"Field": "eventCategory", "Equals": ["Data"]},
+      {"Field": "resources.type", "Equals": ["AWS::S3::Object"]},
+      {"Field": "resources.ARN", "StartsWith": ["arn:aws:s3:::phi-data-bucket/"]}
+    ]
+  }]'
+```
+
+## Business Associate Agreement Tracking
+
+```yaml
+baa_tracking:
+  required_when:
+    - Vendor creates, receives, maintains, or transmits PHI on your behalf
+    - Subcontractor of a business associate handles PHI
+    - Cloud service provider stores or processes PHI
+
+  not_required_for:
+    - Conduit exception (postal service, ISP carrying encrypted data)
+    - Treatment providers sharing PHI for treatment purposes
+    - Plan sponsor receiving summary health information
+
+  baa_registry:
+    format:
+      vendor_name: ""
+      baa_execution_date: ""
+      baa_expiration_date: ""
+      phi_types_shared: []
+      services_provided: ""
+      subcontractors_identified: []
+      breach_notification_sla: "hours"
+      last_risk_assessment: ""
+      next_review_date: ""
+      status: "active | pending | expired"
+
+  cloud_provider_baas:
+    aws:
+      - Sign AWS BAA via AWS Artifact in the console
+      - Applies to all HIPAA-eligible services in the account
+      - Must restrict PHI to eligible services only
+    azure:
+      - Microsoft BAA is part of Online Services Terms
+      - Automatically applies when using qualifying services
+    gcp:
+      - Sign Google Cloud BAA via Google Workspace Admin or Cloud console
+      - Covers HIPAA-eligible GCP services
+
+  review_schedule:
+    - [ ] Annual review of all active BAAs
+    - [ ] Verify vendor compliance certifications are current
+    - [ ] Confirm subcontractor BAAs are in place
+    - [ ] Update BAA registry with any vendor changes
+    - [ ] Assess vendor security posture annually
+```
+
+## Risk Analysis Automation
+
+```bash
+#!/usr/bin/env bash
+# hipaa-risk-scan.sh - Technical risk analysis checks for HIPAA
+
+echo "=== HIPAA Technical Safeguard Checks ==="
+
+echo "--- Encryption at Rest ---"
+# Check for unencrypted RDS instances
+UNENCRYPTED_RDS=$(aws rds describe-db-instances \
+  --query 'DBInstances[?StorageEncrypted==`false`].DBInstanceIdentifier' --output text)
+[ -z "$UNENCRYPTED_RDS" ] && echo "PASS: All RDS instances encrypted" || \
+  echo "FAIL: Unencrypted RDS: $UNENCRYPTED_RDS"
+
+# Check for unencrypted S3 buckets
+for bucket in $(aws s3api list-buckets --query 'Buckets[*].Name' --output text); do
+  enc=$(aws s3api get-bucket-encryption --bucket "$bucket" 2>/dev/null)
+  [ -z "$enc" ] && echo "FAIL: S3 bucket $bucket has no default encryption"
+done
+
+# Check for unencrypted EBS volumes
+UNENCRYPTED_EBS=$(aws ec2 describe-volumes \
+  --query 'Volumes[?Encrypted==`false`].VolumeId' --output text)
+[ -z "$UNENCRYPTED_EBS" ] && echo "PASS: All EBS volumes encrypted" || \
+  echo "FAIL: Unencrypted EBS: $UNENCRYPTED_EBS"
+
+echo "--- Access Control ---"
+# Check for users without MFA
+aws iam generate-credential-report > /dev/null 2>&1 && sleep 5
+aws iam get-credential-report --output text --query Content | base64 -d | \ <!-- security-allowlist: documented payload decoding technique reference, do not execute outside authorized scope -->
+  awk -F, '$4=="true" && $8=="false" {print "FAIL: User without MFA: "$1}'
+
+# Check for unused access keys (90+ days)
+THRESHOLD=$(date -d '90 days ago' +%Y-%m-%dT%H:%M:%S 2>/dev/null || date -v-90d +%Y-%m-%dT%H:%M:%S)
+aws iam get-credential-report --output text --query Content | base64 -d | \ <!-- security-allowlist: documented payload decoding technique reference, do not execute outside authorized scope -->
+  awk -F, -v t="$THRESHOLD" 'NR>1 && $11!="N/A" && $11<t {print "WARN: Stale access key for "$1}'
+
+echo "--- Audit Controls ---"
+# Verify CloudTrail is logging
+CT_STATUS=$(aws cloudtrail get-trail-status --name hipaa-audit-trail --query 'IsLogging' --output text)
+[ "$CT_STATUS" = "True" ] && echo "PASS: CloudTrail active" || echo "FAIL: CloudTrail not logging"
+
+# Verify VPC flow logs
+for vpc in $(aws ec2 describe-vpcs --query 'Vpcs[*].VpcId' --output text); do
+  fl=$(aws ec2 describe-flow-logs --filter "Name=resource-id,Values=$vpc" --query 'FlowLogs[0].FlowLogId' --output text)
+  [ "$fl" = "None" ] && echo "FAIL: No flow logs for VPC $vpc"
+done
+
+echo "--- Transmission Security ---"
+# Check for ALBs without HTTPS listener
+for alb in $(aws elbv2 describe-load-balancers --query 'LoadBalancers[*].LoadBalancerArn' --output text); do
+  HTTPS=$(aws elbv2 describe-listeners --load-balancer-arn "$alb" \
+    --query 'Listeners[?Protocol==`HTTPS`].ListenerArn' --output text)
+  [ -z "$HTTPS" ] && echo "FAIL: ALB without HTTPS: $alb"
+done
+
+echo "=== Scan complete ==="
+```
+
+## HIPAA Compliance Checklist
+
+```yaml
+hipaa_compliance_checklist:
+  administrative:
+    - [ ] Risk analysis conducted and documented
+    - [ ] Risk management plan implemented
+    - [ ] Security officer designated
+    - [ ] Privacy officer designated
+    - [ ] Workforce security awareness training completed
+    - [ ] Sanction policy documented and communicated
+    - [ ] Contingency plan (backup, DR, emergency mode) documented
+    - [ ] Business associate agreements signed for all applicable vendors
+    - [ ] Periodic evaluation/audit scheduled
+
+  technical:
+    - [ ] Unique user identification enforced
+    - [ ] MFA enabled for all PHI system access
+    - [ ] Automatic logoff configured (15-minute timeout)
+    - [ ] Encryption at rest (AES-256) for all PHI stores
+    - [ ] Encryption in transit (TLS 1.2+) for all PHI transmission
+    - [ ] Audit logging enabled for all PHI access
+    - [ ] Log retention configured for 6+ years
+    - [ ] Integrity controls on PHI (checksums, signatures)
+    - [ ] Emergency access (break-glass) procedure tested
+
+  physical:
+    - [ ] Facility access controls documented
+    - [ ] Workstation use policy in place
+    - [ ] Device and media disposal procedures documented
+    - [ ] Media re-use procedures documented
+
+  breach_response:
+    - [ ] Breach notification procedure documented
+    - [ ] Breach risk assessment methodology defined
+    - [ ] Individual notification template prepared
+    - [ ] HHS notification process understood
+    - [ ] Breach log maintained
+    - [ ] Annual breach assessment reviewed
+
+  operational:
+    - [ ] PHI data inventory maintained
+    - [ ] Minimum necessary access enforced
+    - [ ] Access reviews conducted quarterly
+    - [ ] Vendor risk assessments current
+    - [ ] Incident response plan tested annually
+    - [ ] Policies reviewed and updated annually
+```
+
+## Best Practices
+
+- Conduct a thorough risk analysis annually and after significant system changes
+- Use only HIPAA-eligible cloud services and sign BAAs before deploying PHI workloads
+- Encrypt all PHI at rest and in transit with no exceptions
+- Implement the minimum necessary standard: grant access only to the PHI needed for each role
+- Maintain audit logs of all PHI access for a minimum of 6 years
+- Train all workforce members on HIPAA policies at onboarding and annually
+- Test contingency plans (backup restore, DR failover, emergency access) at least annually
+- Track all Business Associate Agreements in a central registry with review dates
+- Document every addressable specification decision (implement, alternative, or not applicable with rationale)
+- Prepare breach notification templates and procedures before an incident occurs
+
+## Limitations
+
+- Guidance and checklists only; not legal advice and not a substitute for a qualified auditor.
+- Docs-only import: upstream templates and scripts not bundled.
+
+### Example
+
+```markdown
+Map this skill's control checklist to our current evidence and list gaps.
+```
+
+> Adapted from [BagelHole/DevOps-Security-Agent-Skills](https://github.com/BagelHole/DevOps-Security-Agent-Skills) (MIT); frontmatter, When to Use/Limitations, and safety boundaries added for upstream compliance. Docs-only import: helper scripts and templates not bundled.