HIPAA compliance on Claude: BAA, HIPAA readiness and ZDR

1.Who processes the data, and the two arrangements

Regulations such as HIPAA first ask who processes the data. On the Claude API (api.anthropic.com), Claude Platform on AWS and Claude in Microsoft Foundry, Anthropic is the data processor. On Amazon Bedrock and Google Cloud's Agent Platform, the cloud provider is the processor, so the controls you need are in that provider's compliance documentation, not Anthropic's.

Where Anthropic is the processor, it offers two arrangements, and picking one is the main compliance decision for a regulated workload. Without either arrangement, Anthropic's standard commercial retention applies. Anthropic still commits that retained data is never used for model training without your express permission, and that conversation content is not retained by default. The exception is Covered Models, which require 30-day retention.

Zero data retention (ZDR) is about storage. Anthropic does not keep prompts or responses at rest once the API response has been returned. You request ZDR from the sales team, and it is enabled per organization. A new organization under the same account does not inherit it.

HIPAA readiness is about protecting protected health information (PHI) for as long as it exists. Instead of deleting data immediately, it applies encryption, access controls and audit logging. The two arrangements do not stack. An organization that handles PHI uses HIPAA readiness.

The row about non-eligible features matters more than it looks. Features marked "No" for ZDR are usually stateful: they store jobs, files or container state, so they cannot be zero-retention. ZDR does not stop you from calling them. It only tells you that the feature's own retention policy now applies to that data. HIPAA readiness does the opposite and refuses the request.

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2.Enabling HIPAA readiness and what the API enforces

There are two ways to set up HIPAA readiness. Most organizations enable it themselves in the Claude Console with Anthropic's standard Business Associate Agreement (BAA). An organization that needs a negotiated or custom BAA, or cannot use self-serve, works with the Anthropic sales team, and Anthropic executes the BAA and turns on readiness.

The self-serve path starts in Claude Console > Settings > Privacy. Organization admins with the HIPAA management permission see a HIPAA compliance card there. You download the BAA and the HIPAA Implementation Guide. Each step unlocks only after you have downloaded the previous document. An authorized legal representative then accepts the agreement, and the enablement is tied to the exact BAA version that was downloaded.

Two things happen when the agreement is accepted. The controls take effect immediately. The configuration is also permanent: no administrator can turn HIPAA readiness off afterwards. From then on, the API checks every request against the feature eligibility table. Your signed BAA is still the official source of truth, but the API stops accidental use of features the BAA does not cover.

{
  "type": "error",
  "error": {
    "type": "invalid_request_error",
    "message": "The requested features are not available for HIPAA-regulated organizations without Zero Data Retention: code_execution."
  }
}

The message lists the features it found. The fix is to remove them and retry. The words "without Zero Data Retention" are the API's own wording and do not mean you should add ZDR. One exception: client-side tools whose Details column says they are not blocked are accepted, but they are still outside HIPAA readiness.

You also need to know where PHI may appear. PHI is normally found in message content, attached files such as images and PDFs, and file names or metadata linked to that content. Workspace names, user information, billing data and support tickets are not expected to hold PHI. The JSON schemas used by structured outputs, or by tools with strict: true, are an easy place to slip. The API compiles these schemas into grammars and caches them separately from message content, and the cached copies do not get PHI protection. Property names, enum values, const values and pattern regular expressions must not contain patient-specific data.

Some surfaces are outside HIPAA readiness altogether. Processing PHI through the Claude Console is not covered, although you can enable readiness from its settings. Readiness is not available on Claude Platform on AWS or Microsoft Foundry. Beta features are generally excluded unless the eligibility table lists them.

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3.Which products the BAA covers, and Covered Models

A BAA covers only the single organization that accepted it, and it does not cover every product equally. On Claude Enterprise, nothing is covered by default. The Primary Owner has to activate HIPAA compliance under "Data and privacy" and accept the BAA. After that, Chat, Projects, Artifacts, Voice, Web Search, Research, Skills, and file creation and code execution (without network access) are Eligible Services under BAA versions accepted after 12/2/25. Connectors, Enterprise Search and Claude in Chrome can be used, but any data they send to third parties is not covered. Cowork is not an Eligible Service in any configuration.

Claude Code reaches BAA coverage by a different route from the API. It is not covered under HIPAA readiness. It is an Eligible Service only when ZDR is enabled, through the CLI (via a first-party API org or Enterprise OAuth) or desktop local mode. Remote and web modes do not work with ZDR, so they are not covered.

That route collides with Covered Models such as Claude Fable 5. These models need 30-day retention on every platform where they are offered, so a ZDR organization or workspace cannot call them. A HIPAA-ready API organization runs with standard retention, so it can call them. HIPAA readiness and ZDR cannot both be enabled on one first-party API organization. A team that needs both HIPAA-ready API use and ZDR for Claude Code needs separate organization IDs. Anthropic's BAA does not apply to services bought through a third-party cloud provider.

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Exam traps

Each one states something that sounds right. Open it to see what is actually true.

1. 1.For PHI, the safest setup is HIPAA readiness plus ZDR on the same API organization.Why is that wrong?

   HIPAA readiness alone is the arrangement for PHI. The two cannot be enabled together on one first-party API organization, so a team that needs both must use separate organizations.

   Covered in Who processes the data, and the two arrangements

2. 2.An admin can turn HIPAA readiness off later if the feature restrictions get in the way.Why is that wrong?

   Enablement is permanent, and no administrator can disable it.

   Covered in Enabling HIPAA readiness and what the API enforces

3. 3.Claude Code inside a HIPAA-ready API organization is covered by the BAA.Why is that wrong?

   HIPAA readiness does not cover Claude Code. Claude Code is BAA-covered only with ZDR enabled, and ZDR blocks Covered Models.

   Covered in Which products the BAA covers, and Covered Models