A voluntary, early-stage proposal for AI voice agent behavior in healthcare payer–provider calls.
Not a standard. Not a certification. Built by one person based on time spent in payer operations.
Website: nhid-clinical.org
| Layer | Standard | Role |
|---|---|---|
| 0 | NPI Gap | The problem — no existing diagram addresses cross-org NPI authorization |
| 1 | STIR/SHAKEN (RFC 8224) | Carrier number authentication — A/B/C attestation |
| 2 | NHID-Clinical v1.3 | Behavioral disclosure baseline — 4 controls, 5 CTS tests |
| 3 | NHID-Auth v2 (Ed25519 + DPoP) | Delegation chain + call-nonce binding (v2 roadmap) |
| 4 | FHIR AuditEvent R4 / IHE BALP | Healthcare-native audit logging |
| 5 | OpenTelemetry spans | SIEM / enterprise observability export |
| Regulatory Driver | Specific Requirement | NHID-Clinical Control |
|---|---|---|
| CMS-0057-F | FHIR API, 72hr turnaround, 5yr retention | FHIR AuditEvent + ATR-01 |
| MACPAC May 2026 | AI transparency, human review | EIT-01 + ATR-01 |
| DOJ FCA 2026 | Explainability + audit trail | LOG + CTS evidence |
| State AI Laws | Inspectable, auditable AI decisions | IDG-01 + DBC-01 |
| NIST CAISI 2026 | Cross-org agent identity | NHID-Auth v2 |
Full regulatory alignment matrix →
| Code | Built With |
|---|---|
schema/ |
Canonical event schema (JSON Schema Draft 2020-12) |
src/ |
Policy engine + cryptographic identity layer (pure Python) |
tests/ |
Conformance suite (YAML) + failure harness (pytest) + trace generator |
traces/ |
10 pre-generated failure traces |
git clone https://github.com/NHID-Clinical/NHID-Clinical.git
cd NHID-Clinical
pip install -r requirements.txt
python -m pytest tests/ -vExpected output: 173 passed, 18 skipped in ~1.4s.
Submitted to NIST docket NIST-2025-0035 · Comment ID: NIST-2025-0035-0026
v1.3 closes the disclosure gap. v2 closes the authorization gap — Ed25519 delegation chains, scope attenuation, revocation, call-bound nonces. Targeting Q3 2026. Full roadmap →
Community · Discord · contact@nhid-clinical.org
CC BY 4.0 · Brianna Baynard · nhid-clinical.org