payer-agent-audit 0.1.4__tar.gz

payer_agent_audit-0.1.4/CHANGELOG.md

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+# Changelog
+
+All notable changes to this project are documented here. The format follows
+[Keep a Changelog](https://keepachangelog.com/en/1.1.0/), and this project
+adheres to [Semantic Versioning](https://semver.org/spec/v2.0.0.html).
+
+## [0.1.4] — 2026-06-27
+
+First distribution to PyPI via Trusted Publishing (packaging/release only, no code changes).
+
+## [0.1.3] — 2026-06-09
+
+Frontier-autonomy README section + 'for reviewers & safety teams' note; links the framework and the non-financial agent-coordination demo. Medical-necessity scope disclaimer unchanged. No source changes.
+
+## [0.1.2] — 2026-06-09
+
+Documentation release: README upgraded to the conversion standard (buyer-first hook, live CI/release badges, inline trust boundary, family block). Medical-necessity scope disclaimer unchanged. No source changes.
+
+## [0.1.1] — 2026-06-06
+
+Documentation and metadata patch (no code/behavior change).
+
+### Changed
+- Backfilled the Zenodo DOI (concept `10.5281/zenodo.20564377`) into
+  `CITATION.cff`, the README badge, and `DOI-PLAN.md`; added `.zenodo.json`
+  for native, reliable Zenodo metadata.
+- Scrubbed internal build-process references from public files (planning notes,
+  section markers) and strengthened `scripts/no_internal_notes_lint.py` to catch
+  that class.
+- Litigation golden-corpus entry restated using the complaint's own words.
+
+## [0.1.0] — 2026-06-05
+
+Initial release. Module (a) health-payer (aligned to the NAIC Model Bulletin framework).
+
+### Added
+
+- **Five corrected-spec primitives** (`governance/`):
+  - Autonomy-ladder level-gate requiring independent attestation (rejects
+    self-attestation, stale, and evidence-less claims); labeled advisory.
+  - Sovereign veto — un-self-clearable; mandatory `Authorizer` in production
+    mode; `operator_id` bound to an authenticated principal; documented durable
+    state store.
+  - Hash-chain audit ledger — verifier branches the genesis seed so both
+    deployer-keyed hardened chains and legacy chains verify; production mode
+    requires an external witness anchor; in-place tamper detected on load and
+    on verify.
+  - DEFCON state machine — immediate escalation, transition-direction guard on
+    de-escalation (no one-call `HALT`/`SHUTDOWN → NORMAL`).
+  - Effective-challenge harness — enforces challenger ≠ primary; records an
+    operator independence attestation to the chain.
+- **Module (a) health-payer controls** (`payer/`): funding-type obligation
+  routing (CMS / ERISA / state DOI / ACA), UM-timeliness check,
+  clinician-of-record-on-denial enforcement, appeal/IRO pathway control.
+- **CLI** (`payer-audit`): `info`, `verify`, `obligations`.
+- **Identity-guard hardening**: a shared NFKC + zero-width normalizer
+  (`_normalize.py`) so the self-attestation (P1), self-clear (P2), and ERISA
+  reviewer-independence guards cannot be defeated by Unicode-confusable or
+  zero-width disguises of an id.
+- **PEP 561**: ships a `py.typed` marker so adopters consume the strict types.
+- **Audit-chain participation**: DEFCON transitions and the promotion gate now
+  optionally emit to the audit chain, so every governance primitive can be
+  ledgered.
+- **Tests**: unit + contract, property-based (thousands of generated cases),
+  golden corpus of public matters of record (primary-source URLs), the five
+  AL-PROBES under `tests/adversarial/`, a payer-not-FDA-SaMD boundary scan, and
+  a mutation pass (`scripts/mutation_check.py`). **100% line coverage, 100%
+  mutation kill** (gate floor ≥90%).
+- **Docs**: README, ARCHITECTURE (trust-boundary diagram), LIMITATIONS
+  (payer-not-FDA-SaMD boundary), DISCLAIMER, FAILURE-MODES, NEGATIVE-USE-CASES,
+  ASSURANCE-CATALOG, NOTICE, LICENSE, LICENSING, TRADEMARK, CITATION.cff, DOI-PLAN.
+
+### Notes
+
+- Reference IP for adoption — not a deployed control. Makes no
+  medical-necessity or clinical determination.
+- Module (b) P&C / Life-&-Annuity is on the roadmap and not yet shipped.
+- Zero runtime dependencies.

payer_agent_audit-0.1.4/CITATION.cff

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+cff-version: 1.2.0
+message: "If you use this framework, please cite it as below."
+type: software
+title: "payer-agent-audit: Governance patterns for autonomous AI agents in health-insurance / payer operations"
+authors:
+  - family-names: Bhaduri
+    given-names: Kunjar
+    affiliation: North Texas Capital Investments
+repository-code: "https://github.com/linus10x/payer-agent-audit"
+url: "https://github.com/linus10x/payer-agent-audit"
+abstract: >-
+  Reference governance patterns, schemas, and runnable implementations for
+  audit-ready autonomous AI agents in health-insurance / payer operations
+  (utilization management, prior authorization, and claims/appeals support),
+  aligned to the NAIC Model Bulletin framework. Ships five primitives built to a corrected
+  specification — an autonomy-ladder level-gate requiring independent
+  attestation, an un-self-clearable sovereign veto with a mandatory
+  production-mode authorizer, a tamper-detecting hash-chain ledger
+  (within-trust-boundary) whose verifier branches the genesis seed and whose
+  production mode requires an external witness anchor, a DEFCON state machine
+  with a transition-direction guard, and an effective-challenge harness that
+  enforces challenger-not-equal-primary and records an operator independence
+  attestation. Module (a) health-payer adds funding-type-aware obligation
+  routing (CMS vs ERISA vs state DOI vs ACA) and three controls: UM timeliness,
+  clinician-of-record-on-denial, and appeal/IRO pathway. The framework makes no
+  medical-necessity or clinical determination — a payer coverage decision is a
+  benefit adjudication under insurance law, distinct from FDA medical-device
+  regulation. Maps to reference regulatory anchors including the NAIC Model
+  Bulletin on insurer use of AI, CMS-0057-F, ERISA 29 CFR 2560.503-1, and ACA
+  45 CFR 147.136. Zero runtime dependencies. Independent research; no employer
+  or client IP or confidential material.
+keywords:
+  - ai-governance
+  - autonomous-agents
+  - health-insurance
+  - payer
+  - utilization-management
+  - prior-authorization
+  - naic
+  - erisa
+  - cms
+  - audit-trail
+license:
+  - MIT
+  - Apache-2.0
+version: "0.1.4"
+date-released: "2026-06-27"
+# The concept DOI resolves to the latest version and is the preferred citeable
+# handle; each tagged release also mints its own version-specific DOI.
+doi: "10.5281/zenodo.20564377"

payer_agent_audit-0.1.4/LICENSE

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+payer-agent-audit is dual-licensed under either of:
+
+    * Apache License, Version 2.0   (see LICENSE-APACHE or http://www.apache.org/licenses/LICENSE-2.0)
+    * MIT license                   (see LICENSE-MIT   or http://opensource.org/licenses/MIT)
+
+at your option.
+
+SPDX-License-Identifier: MIT OR Apache-2.0
+
+Dual-licensing preserves the MIT downstream-citation graph used by the sibling
+Autonomy Ladder libraries while supplying the express patent grant (Apache 2.0
+§3) that Tier-1 regulated-industry legal review typically requires before
+authorizing inbound supply-chain inclusion. Adopters elect at integration time;
+election does not require notice to the maintainer.
+
+For the trademark posture (governed separately from this code license per
+Apache 2.0 §6 and standard MIT practice), see docs/TRADEMARK.md.
+
+For contribution license terms, see LICENSING.md.

payer_agent_audit-0.1.4/LICENSE-APACHE

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+
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+   Copyright 2026 Kunjar Bhaduri
+
+   Licensed under the Apache License, Version 2.0 (the "License");
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payer_agent_audit-0.1.4/LICENSE-MIT

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+MIT License
+
+Copyright (c) 2026 Kunjar Bhaduri
+
+Permission is hereby granted, free of charge, to any person obtaining a copy
+of this software and associated documentation files (the "Software"), to deal
+in the Software without restriction, including without limitation the rights
+to use, copy, modify, merge, publish, distribute, sublicense, and/or sell
+copies of the Software, and to permit persons to whom the Software is
+furnished to do so, subject to the following conditions:
+
+The above copyright notice and this permission notice shall be included in all
+copies or substantial portions of the Software.
+
+THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR
+IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY,
+FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE
+AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER
+LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM,
+OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE
+SOFTWARE.

payer_agent_audit-0.1.4/LICENSING.md

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+# Licensing
+
+`payer-agent-audit` is dual-licensed under either of:
+
+- **Apache License, Version 2.0** — [LICENSE-APACHE](LICENSE-APACHE) · [apache.org/licenses/LICENSE-2.0](http://www.apache.org/licenses/LICENSE-2.0)
+- **MIT license** — [LICENSE-MIT](LICENSE-MIT) · [opensource.org/licenses/MIT](http://opensource.org/licenses/MIT)
+
+at the election of the adopter. Election does not require notice to the maintainer.
+
+`SPDX-License-Identifier: MIT OR Apache-2.0`
+
+## Why dual
+
+- **Preserves the MIT citation graph** used by the sibling Autonomy Ladder libraries, so prior-adopter attribution does not break.
+- **Supplies the express patent grant** (Apache 2.0 §3) that Tier-1 regulated-industry legal review routinely requires before authorizing open-source software into a regulated supply chain; MIT does not supply it.
+- **Costs nothing at zero external contributors** and is reversible by a future maintainer (deprecating one arm is a SemVer-minor change; a unilateral re-license away from MIT is not).
+
+## Adopter election
+
+Adopters cite the elected license in their NOTICE, third-party-license inventory, or equivalent. Any of these forms satisfies the requirement under both licenses:
+
+```
+payer-agent-audit (Apache-2.0): https://github.com/linus10x/payer-agent-audit
+payer-agent-audit (MIT): https://github.com/linus10x/payer-agent-audit
+payer-agent-audit (MIT OR Apache-2.0): https://github.com/linus10x/payer-agent-audit
+```
+
+## Contributing under both licenses
+
+Unless you explicitly state otherwise, any contribution intentionally submitted for inclusion in the project by you, as defined in the Apache License 2.0, shall be dual-licensed as above without any additional terms or conditions.

payer_agent_audit-0.1.4/MANIFEST.in

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+include LICENSE LICENSE-MIT LICENSE-APACHE NOTICE LICENSING.md
+include README.md CHANGELOG.md CITATION.cff
+include src/payer_agent_audit/py.typed
+recursive-include examples *.py
+recursive-include docs *.md
+recursive-include tests *.py

payer_agent_audit-0.1.4/NOTICE

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+payer-agent-audit
+Copyright 2026 Kunjar Bhaduri / North Texas Capital Investments (NTCI)
+
+This product includes software developed by Kunjar Bhaduri and contributors.
+
+This is an independent research work authored by Kunjar Bhaduri through North
+Texas Capital Investments. It was developed independently, outside the scope of
+any employment, on the author's own time and resources, without use of any
+employer's or client's confidential, proprietary, or trade-secret information
+and without any employer or client equipment, systems, or facilities. It does
+not incorporate any employer or client intellectual property, is not a work
+made for hire for any employer or client, and does not represent the views of
+any employer or client. All regulatory content is drawn from public primary
+sources cited in the repository.
+
+Licensed under either of the Apache License, Version 2.0 (LICENSE-APACHE) or
+the MIT license (LICENSE-MIT) at the election of the adopter.
+
+"Autonomy Ladder" and "ALO" are trademarks of NTCI Consulting, LLC (post-formation).
+Trademark use is governed by docs/TRADEMARK.md and is independent of the source-code
+license per Apache License 2.0 §6.