Summary: HIPAA compliance on Neon is a self-serve feature on the Scale plan. Customers can accept a Business Associate Agreement (BAA) and enable PHI protection at the organization and project level via the Console, API, or CLI. Enabling HIPAA on a project is irreversible and triggers a compute restart. Breach notifications are issued within five business days.

Neon offers HIPAA compliance as a self-serve feature available to customers on the Scale plan.

Note: HIPAA support is currently available at no additional cost. When we begin charging for HIPAA support, a 15% surcharge will be added to your monthly invoice. We'll notify you in advance before this change takes effect.

We take the security and privacy of health information seriously. This guide explains how Neon supports HIPAA compliance and what it means for you as a customer. HIPAA features are available to customers who have accepted our Business Associate Agreement (BAA) through the self-serve enablement process. The BAA outlines our responsibilities for protecting Protected Health Information (PHI) and ensuring HIPAA compliance.

You can find the Business Associate Agreement (BAA) here.

HIPAA is a federal law that sets national standards for the protection of health information. It requires businesses handling PHI to implement safeguards to ensure privacy and security.

HIPAA compliance is available as a self-serve feature on supported plans. To enable HIPAA support, follow these steps:

1. Enable HIPAA for your Organization: First, you must enable HIPAA compliance at the organization level and accept the Business Associate Agreement (BAA).
2. Enable HIPAA for your projects: After HIPAA is enabled for your organization, you can create HIPAA-compliant projects or enable HIPAA for existing projects.

To enable HIPAA compliance for your organization:

1. In the Neon Console, navigate to your Organization settings.
2. Locate the HIPAA support section.
3. Enable HIPAA compliance for your organization.
4. Read and accept the Business Associate Agreement (BAA).

Once HIPAA is enabled for your organization, you can proceed to enable HIPAA compliance for your projects.

Important: Once HIPAA compliance is enabled on a project, it cannot be disabled. Enabling HIPAA will also restart all computes, temporarily interrupting database connections.

New project

For Neon project creation steps, see Create a project.

When you create a project, select the Enable HIPAA compliance for this project checkbox on the Create Project form. This option is available after HIPAA has been enabled for your organization.

Existing project

To enable HIPAA compliance for an existing Neon project:

1. In the Neon Console, navigate to your project's Settings page.
2. Locate the HIPAA support section.
3. Click Enable.

API

To create a new HIPAA-compliant Neon project via the Neon API, set audit_log_level to hipaa in the project settings object, as shown below.

curl --request POST \
     --url https://console.neon.tech/api/v2/projects \
     --header 'accept: application/json' \
     --header 'authorization: Bearer $NEON_API_KEY' \
     --header 'content-type: application/json' \
     --data '
{
  "project": {
    "settings": {
      "hipaa": true
    },
    "pg_version": 18
  }
}
'

To enable HIPAA for an existing project, set hipaa to true in the project settings object using the Update project API:

curl --request PATCH \
     --url https://console.neon.tech/api/v2/projects/YOUR_PROJECT_ID \
     --header 'accept: application/json' \
     --header 'authorization: Bearer $NEON_API_KEY' \
     --header 'content-type: application/json' \
     --data '
{
  "project": {
    "settings": {
      "hipaa": true
    }
  }
}
'

Important: Enabling HIPAA on an existing project will force a restart of all computes to apply the new setting. This will temporarily interrupt database connections.

CLI

To create a new HIPAA-compliant Neon project via the Neon CLI, use the --hipaa option with the neon projects create command, as shown below.

neon projects create --hipaa

To enable HIPAA for an existing project, use the --hipaa option with the neon projects update command, as shown below:

neon projects update my-project --hipaa

Important: Enabling HIPAA on an existing project will force a restart of all computes to apply the new setting. This will temporarily interrupt database connections.

If you have trouble enabling HIPAA, raise a Support request.

Note: For information about disabling HIPAA compliance, see Disabling HIPAA.

• Protected Health Information (PHI): Any identifiable health-related data.
• Covered Entity: Healthcare providers, plans, or clearinghouses that handle PHI.
• Business Associate: A service provider (like Neon) that handles PHI on behalf of a Covered Entity.
• Breach: Unauthorized access, use, or disclosure of PHI.
• Security Rule: Safeguards to protect electronic PHI.
• Privacy Rule: Rules governing how PHI is used and disclosed.

1. Use and disclosure of PHI

   • We only use PHI to provide our agreed-upon services and to meet legal obligations.
   • PHI is disclosed only as required by law or with proper authorization.

2. Safeguards

   • Administrative: Policies and training to ensure compliance.
   • Physical: Secure access controls to data storage areas.
   • Technical: Encryption and access controls for electronic PHI.

3. Incident reporting

   • We promptly report any unauthorized use or disclosure of PHI.
   • Breach notifications are provided within 30 days as per HIPAA requirements.

4. Subcontractors and agents

   • Any third parties we work with are required to adhere to the same data protection standards.
   • We provide transparency by listing our subcontractors at https://neon.com/hipaa-contractors and notifying customers of any changes if you sign up to notifications here.

5. Customer responsibilities

   • Customers must ensure that PHI is only stored in data rows as intended for sensitive data and should never be included in metadata, column names, table names, schema descriptions, or system-generated logs such as audit trails, query logs, or error logs.
   • Customers have the responsibility to configure a session timeout.
   • Customers need to avoid including PHI in support tickets or metadata fields.

6. PHI access and amendments

   • Customers can request access to audit logs by raising a Support request.
   • Any updates or corrections to PHI need to be carried out by the customer.

• Transparency: You can request details about how your PHI is being used.
• Security: Our technical safeguards are designed to prevent unauthorized access.
• Data Control: You retain ownership of your data; we are custodians ensuring its protection.

Audit events may not be logged if database endpoints experience exceptionally heavy load, as we prioritize database availability over capturing log events.

Neon maintains a comprehensive audit trail to support HIPAA compliance. This includes the following categories of logged events:

1. Neon Console and API audit logs: Captures user actions in the Neon Console and via the Neon API.
2. Postgres audit logs: Logged using the pgAudit extension (pgaudit) for Postgres.

Self-serve access to HIPAA audit logs is currently not supported. Access to audit logs can be requested by raising a Support request.

Neon logs operations performed via the Neon Console interface and the Neon API. Examples of logged operations may include these, among other operations:

• Project management: creating, deleting, listing projects
• Branch management: creating, deleting, listing branches
• Compute management: starting and stopping of compute instances
• Database and role management: creating or deleting databases and roles

To protect sensitive information, Neon filters data in audit logs using the following approach:

• Sensitive fields (such as connection_uri and password) are excluded from logs wherever possible.
• GET requests: Only query parameters are logged; response payloads are not recorded.
• Mutation requests (PATCH, PUT, POST, DELETE): Request and response bodies are logged with sensitive fields redacted.

The following example shows how a List project branches operation is captured in Neon's audit logs. The table provides a description of the log record's parts.

Audit log record:

fb7c2e2f-cb09-4405-b543-dbe1b88614b6 2025-05-25 10:18:45.340 +0000 `{ "changes": [], "sync_id": 57949 }` e640c32c-0387-4fc2-8ca5-f823f7ebc4b6 GET `{}` /projects/misty-breeze-49601234/branches a92b3088-7f92-4871-bf91-0aac64edc4b6 b8c58a4b-0a33-4d54-987e-4155e95a64b6 2025-05-24 15:42:39.088 +0000 misty-breeze-49601234 keycloak 200 `{}` ListProjectBranches 0

Field descriptions:

When HIPAA audit logging is enabled for a Neon project, Neon configures pgAudit with the following settings by default:

This configuration enables logging for all major classes of SQL activity while excluding less relevant statements in the misc category. Specifically, it includes:

• READ: SELECT statements and COPY commands that read from tables or views.
• WRITE: INSERT, UPDATE, DELETE, TRUNCATE, and COPY commands that write to tables.
• FUNCTION: Function calls and DO blocks.
• ROLE: Role and permission changes, including GRANT, REVOKE, CREATE ROLE, ALTER ROLE, and DROP ROLE.
• DDL: Schema and object changes like CREATE TABLE, ALTER INDEX, DROP VIEW (all DDL operations not included in the ROLE class).
• MISC_SET: Miscellaneous SET commands, for example SET ROLE.

Excluded:

• MISC: Low-impact commands such as DISCARD, FETCH, CHECKPOINT, VACUUM, and SET.

Note: In some cases, audit logs may include SQL statements that contain plain-text passwords (for example, in a CREATE ROLE ... LOGIN PASSWORD command). This is due to limitations in the Postgres pgaudit extension, which may log full statements without redacting sensitive values.

This behavior is a known issue. We recommend avoiding the inclusion of raw credentials in SQL statements where possible.

For more details, see the pgAudit documentation.

• Logs are written using the standard PostgreSQL logging facility.
• Logs are sent to a dedicated Neon audit collector endpoint and securely stored.
• Each log entry includes metadata such as the timestamp of the activity, the Neon compute ID (endpoint_id), Neon project ID (project_id), the Postgres role, the database accessed, and the method of access (for example, neon-internal-sql-editor), etc. See the following log record example and field descriptions:

The following example shows how a simple SQL command (CREATE SCHEMA IF NOT EXISTS healthcare) is captured in Neon's audit logs. The table provides a description of the log record's parts.

Query:

CREATE SCHEMA IF NOT EXISTS healthcare;

Audit log record:

2025-05-05 20:23:01.277	 <134>May 6 00:23:01 vm-compute-shy-waterfall-w2cn1o3t-b6vmn young-recipe-29421150/ep-calm-da 2025-05-06 00:23:01.277 GMT,neondb_owner,neondb,1405,10.6.42.155:13702,68195665.57d,1,CREATE SCHEMA, 2025-05-06 00:23:01 GMT,16/2,767,00000,SESSION,1,1,DDL,CREATE SCHEMA,,,CREATE SCHEMA IF NOT EXISTS healthcare,<not logged>,,,,,,,,,neon-internal-sql-editor

Field descriptions:

The pgaudit extension is preloaded on HIPAA-enabled Neon projects. For extension version information, see Supported Postgres extensions.

The following features are not currently HIPAA-compliant and should not be used in projects containing HIPAA-protected data:

• Managed Better Auth – Uses an authentication provider that is not covered under Neon's HIPAA compliance.
• Data API – Hosted outside Neon's HIPAA-compliant infrastructure.

If a security breach occurs, Neon will:

1. Notify you within five business days of becoming aware of the incident.
2. Provide detailed information about the breach.
3. Take corrective actions to prevent future occurrences.

Once HIPAA compliance is enabled for a Neon project, it cannot be disabled.

You can delete a HIPAA-compliant project using the same self-serve flow as any other Neon project—in the Console (Settings → Delete), via the Neon API, or with the Neon CLI. Deleting a project is permanent and removes all computes, branches, databases, and roles in that project.

Important: Before deleting a HIPAA project, export any audit logs or data you may need. Neon retains audit logs for the duration specified in your Business Associate Agreement (BAA).

For step-by-step instructions, see Delete a project.

If you want to disable HIPAA for your Neon organization entirely, you need to submit a support request. This can only be done after all HIPAA-enabled projects have been deleted.

Yes, upon termination of services, we will securely delete or return your PHI.

We conduct regular internal audits and provide training to our employees to ensure adherence to HIPAA requirements.

Contact our security team immediately at security@neon.tech.

For any questions regarding our HIPAA compliance or to report an issue, please raise a Support request.

This guide provides a high-level overview of Neon's HIPAA compliance efforts. For more details, please refer to your Business Associate Agreement (BAA) or contact us directly via our support channels.

• Overview
• Security reporting
• Compliance
• Acceptable Use Policy
• AI use in Neon

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