Compliance  ›  HIPAA  ·  45 CFR Part 164, Subpart C

HIPAA Requires Retrievable Exact Copies of ePHI. Does That Include the ePHI in ServiceNow?

The Security Rule’s contingency plan standard, 45 CFR §164.308(a)(7), requires a data backup plan, a disaster recovery plan and an emergency mode operation plan for electronic protected health information. HRSD cases, patient-facing CSM records and clinical workflow data put ePHI inside ServiceNow. Rezilient Restore gives covered entities and business associates a backup control for that data they can document and test.

§164.308(a)(7) contingency planExact, retrievable copies of ePHISix-year documentation retention

What HIPAA requires

Backup Is a Required Implementation Specification

The Security Rule applies to covered entities and their business associates. §164.308(a)(7) is the contingency plan standard. Three of its five implementation specifications are marked Required; the other two are Addressable, which means implemented or justified in writing.

§164.308(a)(7)(ii)(A)

Data backup plan (Required)

“Establish and implement procedures to create and maintain retrievable exact copies of electronic protected health information.”

§164.308(a)(7)(ii)(B)

Disaster recovery plan (Required)

“Establish (and implement as needed) procedures to restore any loss of data.”

§164.308(a)(7)(ii)(C)

Emergency mode (Required)

Procedures “to enable continuation of critical business processes” and “for protection of the security of electronic protected health information while operating in emergency mode”.

§164.308(a)(7)(ii)(D)

Testing (Addressable)

“Implement procedures for periodic testing and revision of contingency plans.”

6 yearsRetention of Security Rule documentation from creation or the date it was last in effect, whichever is later.§164.316(b)(2)(i)
3 of 5Contingency plan specifications marked Required: data backup, disaster recovery, emergency mode.§164.308(a)(7)
14 daysServiceNow’s native backup window, engineered for platform disaster recovery.ServiceNow platform documentation

What regulators have enforced

Regulators have announced 58 public actions and settlements that cite HIPAA against 39 organizations we have confirmed as ServiceNow customers, about $264 million in total (2008 to 2026). These are evidence of regulatory exposure, not a claim that ServiceNow data was involved.

Source: Rezilient review of public regulator records and reputable press, as of 31 October 2026. Each action is traced to its regulator or press source. Our count includes HHS OCR and state attorney general actions. For scale, HHS OCR reports 152 cases with a settlement or civil money penalty, $144,878,972 in total, as of 31 October 2024 (OCR cases only; page reviewed 21 November 2024).

Why ServiceNow is in scope

ServiceNow Protects the Platform. You Answer for the ePHI Inside It.

Health systems and payers run more on ServiceNow than IT tickets. HR Service Delivery holds employee health and leave cases. Customer Service Management holds member and patient interactions. Clinical and revenue-cycle workflows carry attachments and notes. Wherever those records identify a person and describe their care or coverage, they are ePHI, and §164.308(a)(7) applies to them.

The Security Rule starts from a risk analysis: an “accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability” of ePHI. Availability is the word that pulls backup into scope. A business associate agreement with the platform vendor does not satisfy it; the covered entity still has to show the copies exist and can be restored.

ServiceNow does its part well. Its native backup is engineered for infrastructure disaster recovery: weekly fulls kept for 14 days, restored at the level of the whole instance. It was not designed to restore a single case that an integration overwrote, or to hold a copy for the six years your documentation must cover.

How Rezilient Restore helps

Each Requirement, Mapped to a Capability

Rezilient Restore is compliance-grade backup and recovery built for ServiceNow. It runs inside the ServiceNow experience and keeps your data in immutable storage off the platform.

HIPAA requirement
Rezilient Restore capability
§164.308(a)(7)(ii)(A)

Create and maintain retrievable exact copies of ePHI.

Continuous, full-fidelity capture. Every change to protected tables is captured with its relationships, attachments and history intact, and stored immutably off the platform.

§164.308(a)(7)(ii)(B)

Procedures to restore any loss of data.

Restore exactly what was lost. Record, field or table restore, without rolling back the instance and every other team’s work.

§164.308(a)(7)(ii)(C)

Continue critical processes and protect ePHI in emergency mode.

An independent copy outside the blast radius. If the instance is compromised, the copy and the restore path are outside the attacker’s reach.

§164.308(a)(7)(ii)(D)

Periodic testing and revision of contingency plans.

Restore tests you can actually run. A surgical restore in a non-production instance, with the result exported as evidence.

§164.308(a)(7)(ii)(E)

Assess the relative criticality of applications and data.

Coverage you can see. The Coverage Gaps dashboard shows which tables, attachments and applications are in or out of the backup set.

§164.316(b)(2)(i)

Retain required documentation for six years.

Retention set to the rule. Per-table retention so ePHI and its documentation are kept for the period HIPAA names, not the platform’s 14 days.

Requirement text is summarized from the primary source; quoted language is verbatim. The cross-framework view, with every regime on one page, is in the white paper.

Four questions OCR could ask

Put §164.308(a)(7) Next to the 14-Day Window

Exact copies

Where is the retrievable exact copy of the ePHI in ServiceNow, and who controls it?

Restore

When did you last restore ePHI from that copy, and how long did it take?

Emergency mode

If the instance is unavailable or compromised, can you still reach a protected copy?

Documentation

Can you produce six years of contingency plan documentation and test records on request?

How it works

From Connect To Compliance Evidence

Live in under one business day, starting in a non-production instance.

01

Connect

Rezilient is a ServiceNow-native app. Connect your instance, link storage, and go live in a day.

02

Capture

Every change recorded continuously across selected tables, including ITSM, CMDB, HRSD, CSM and GRC.

03

Restore

Surgical recovery at record, field or table level, without rolling back the instance.

04

Prove

Chain-of-custody exports. Audit-ready evidence on demand.

Questions

What Teams Ask Us About HIPAA

Does Rezilient Restore make us HIPAA compliant?

No product does that on its own. The Security Rule covers administrative, physical and technical safeguards, from risk analysis and workforce training to access controls and audit logs. Rezilient Restore supports the contingency plan standard and the documentation retention requirement for the ePHI in ServiceNow.

We are a business associate, not a covered entity. Does this apply?

Yes. Since the HITECH Act, business associates are directly liable for Security Rule compliance, including §164.308(a)(7).

Isn’t ServiceNow’s native backup enough?

It is the right tool for infrastructure disaster recovery, which is what it was built for. The contingency plan standard also asks for retrievable exact copies you maintain, procedures to restore any loss, and periodic testing. A 14-day, full-instance backup managed by the platform makes those hard to document.

How long do we have to keep ePHI backups?

HIPAA does not set a backup retention period. It requires six years of Security Rule documentation under §164.316(b)(2)(i), and medical record retention is set by state law and other federal rules. Rezilient Restore sets retention per table so each record class keeps the period your policy names.

Does Rezilient need a business associate agreement?

If Rezilient Restore stores ePHI on your behalf, yes. Backup data is encrypted in transit and at rest, with keys held only by you or ServiceNow, so Rezilient can never read it. Our team will walk through the BAA with your privacy officer.

Run a Real Restore Test in 30 Days

The Rezilient Restore trial runs in your non-production instance, with no commitment. You finish with a tested restore and the evidence to show for it.

Back Up Now. Restore Anytime. Always Rezilient.