Trust by Design
A Governance Framework for Enterprise AI in Regulated Health Plans
How compliance-native AI gives Medicare Advantage, Medicaid and dual-eligible plans the confidence to automate their highest-stakes regulatory work, and to defend it under audit.
- The AI principles, governance model and security architecture behind Inovaare’s platform
- How AI-assisted actions stay explainable, traceable and defensible to an auditor
- Mapping to HIPAA, HITRUST, ISO/IEC 27001, ISO/IEC 42001 and the NIST AI RMF
“Trust is the precondition for value. In compliance, AI earns its place only when every action it takes can be explained, traced and defended.”
From the whitepaper
A governance framework, in full
The paper details how Inovaare governs the AI embedded in its compliance platform, and maps it to recognized standards.
The Trust Imperative
Why AI governance is now a buying decision — adoption is outpacing trust, and regulators are watching AI in payer operations.
Compliance-Native, Trust-First AI
Governance as architecture, not a wrapper applied afterward — with human accountability that is non-negotiable.
Our AI Principles
Human oversight, security and privacy by design, transparency, accountability, fairness, compliance and continuous improvement.
The AI Governance Model
Five layers of accountability, from executive oversight to continuous monitoring and improvement.
Security & Privacy by Design
The AI security architecture, key controls, and privacy commitments including customer data ownership and no public model training.
Governing the Full AI Lifecycle
Nine stages from planning through continuous improvement, underpinned by governance and controls at every step.
Risk Management & Monitoring
A structured process to identify, assess, mitigate and continuously monitor AI risk across the lifecycle.
Standards & Regulatory Alignment
HIPAA, HITRUST, ISO/IEC 27001, ISO/IEC 42001 and the NIST AI Risk Management Framework — and why they matter.
Written for the people who have to defend it
AI adoption in a regulated function is a shared responsibility. This paper speaks to the stakeholders who evaluate, secure and stand behind it.
Compliance & Audit Leaders
CCOs and audit directors who need AI-assisted outputs that are explainable, traceable and defensible when a regulator or auditor asks.
IT & Security Teams
CIOs, CTOs and information-security teams evaluating architecture, controls and documentation — zero trust, encryption, tenant isolation and secure APIs.
Operations Leaders
COOs and VPs of Operations applying AI to program audits, universe management, ODAG, CDAG, FDR oversight, corrective action tracking and appeals & grievances.
Built on widely accepted foundations
Inovaare aligns its governance framework with recognized security, privacy and AI governance standards.
| Standard / Framework | Scope | Alignment status |
|---|---|---|
| HIPAA | Privacy and security of protected health information | Supported |
| HITRUST CSF | Certifiable security and privacy control framework for healthcare | Certified |
| ISO/IEC 27001 | Information security management system | Certified |
| ISO/IEC 42001 | AI management system (world’s first certifiable AIMS) | In progress |
| NIST AI RMF | Voluntary framework to govern, map, measure and manage AI risk | Aligned |
Certifications, standards alignment and framework status reflect the position at time of publication and are subject to change; statements regarding frameworks in progress reflect present intent and are not guarantees of future certification.