164.312(c)(1) Integrity (Standard)
Implement policies and procedures to protect ePHI from improper alteration or destruction. NIST recommends integrity controls including checksums, signed records, and tamper detection.
Source: HIPAA Security Rule, 164.312(c)(1). The statement above is our statement of the clause, read from the published text and cited so you can check it against the official text, not the instrument verbatim. Open HIPAA Security Rule in the compliance library.
Applies to covered entities and business associates. An addressable specification can be met by a documented, reasonable alternative.
These are the artefacts auditors commonly ask for on this requirement, our guidance rather than text from the standard. Your assessor decides what is sufficient in your context, and asks for samples across the period when a report covers one.
system holds itEvidence a system already holds
none for this control
periodic reviewEvidence produced at each review
none for this control
governing documentDocuments that govern the control
- Integrity control standard · Policy repository / GRC workspace
- Database integrity controls · Document repository
- File integrity monitoring (FIM) deployment · Policy repository / GRC workspace
- Backup integrity verification · Policy repository / GRC workspace
First move
Common gaps auditors find
- No FIM on critical ePHI stores
- Database triggers not monitored
- Tampering detection only via backups
Do this for your whole sheet
Paste the rows you run your controls from and get this mapping for every control at once, with the periodic-review ones flagged and a first move per row. No account for the first run.
Build my evidence sheet164.312(b) Audit Controls (Standard) · 164.312(c)(2) Mechanism to Authenticate ePHI (Addressable)