HIPAA §164.308(a)(3) - Workforce Security

🔑 AUDIT-GRADE EVIDENCE • Follows AICPA SOC 2 / HHS HIPAA / PCI QSA ROC / NIST 800-53A • Report tamper-evident via SHA-256 chain

1. CONTROL IDENTIFICATION

FrameworkHIPAA Security Rule
Control ID§164.308(a)(3)
Control FamilyAdministrative Safeguards > Workforce Security
Control NameWorkforce Security
StatusIMPLEMENTED
Assessment Date2026-04-19T02:25:35.202960+00:00
AssessorTITAN AI Scanner v2.0 (CONDUCTOR + BASTION + SCOUT + COMPLY + SAGE)
Environment ScopeAzure: Pay-As-You-Go (prod) (4f29d094-1079-44c9-acb0-4d73a7a2dd34)
Report ID175d89a9a168b9ae707989a094178a6edd14d4d5a390d3a2426146f2728d90c1

2. REGULATORY TEXT

Standard: Workforce security. Implement policies and procedures to ensure that all members of its workforce have appropriate access to electronic protected health information, as provided under paragraph (a)(4) of this section, and to prevent those workforce members who do not have access under paragraph (a)(4) of this section from obtaining access to electronic protected health information.

Source: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-C/section-164.308

3. IMPLEMENTATION SPECIFICATIONS

Each implementation specification addressed separately per HIPAA §164.306(d) / NIST 800-53A assessment methodology.

164.308(a)(3)(ii)(A) ADDRESSABLE Authorization and/or Supervision IMPLEMENTED

Implement procedures for the authorization and/or supervision of workforce members who work with electronic protected health information or in locations where it might be accessed.

Evidence: #A1, #A2
164.308(a)(3)(ii)(B) ADDRESSABLE Workforce Clearance Procedure IMPLEMENTED

Implement procedures to determine that the access of a workforce member to electronic protected health information is appropriate.

Evidence: #A1, #A2
164.308(a)(3)(ii)(C) ADDRESSABLE Termination Procedures IMPLEMENTED

Implement procedures for terminating access to electronic protected health information when the employment of, or other arrangement with, a workforce member ends.

Evidence: #A1, #A2

4. EVIDENCE ARTIFACTS

Summarized with counts + exceptions + drill-down. Raw data available on request per retention policy.

#A1 Onboarding/Offboarding Workflow Audit 2026-04-19T02:25:35.202960+00:00
ITSM workflow (generic REST API): 12 new-hire tickets, 8 terminations in 90d. 100% had access-review attached.
Records: 20 Exceptions surfaced: 0 Sampling: full quarter
#A2 Orphaned Account Detection 2026-04-19T02:25:35.202960+00:00
Azure AD accounts with no owner or disabled manager: 0.
Records: 0 Exceptions surfaced: 0 Sampling: full directory

5. TESTING PROCEDURES & RESULTS

Test of Design (does the control exist?) + Test of Operating Effectiveness (does it work consistently?). Sampling per AICPA AU-C 530.

Test of Operating - Termination access removal <24h OPERATING PASS
Sample size: 8 terminations

All 8 had AAD disable within 24h.

6. FINDINGS / EXCEPTIONS

Active findings: 0 · Accepted risks (exceptions): 0 · Total: 0

Click any finding to view detail, remediation, and record an exception (risk acceptance). Exceptions are retained in the report as part of the audit trail.

No findings for this control.

7. MANAGEMENT RESPONSE

SOC 2 Type 2 and HITRUST assessors require management's written response to findings.

Management has reviewed 0 findings. No open findings for this control period. Next review cycle: quarterly.

8. AUDIT TRAIL

ScannerTITAN AI Scanner v2.0 (CONDUCTOR + BASTION + SCOUT + COMPLY + SAGE)
Scanner versionv2.0.1
Collection timestamp2026-04-19T02:25:35.202960+00:00
Retention2555 days (HIPAA 164.316(b)(2))
Report hash (SHA-256)175d89a9a168b9ae707989a094178a6edd14d4d5a390d3a2426146f2728d90c1

9. CROSS-FRAMEWORK MAPPING

This same evidence is admissible for the following related controls. Scan once, satisfy multiple frameworks.