Third-Party AI Risk: Diligence on an AI vendor that touches PHI

NIST AI RMF GOVERN 6.1 is the outcome on third-party AI risk. It is short to read and easy to underestimate, because satisfying it means producing evidence rather than holding an intention.

What the framework says

Policies and procedures are in place that address AI risks associated with third-party entities, including risks of infringement of a third-party’s intellectual property or other rights.

That is the text of NIST AI RMF GOVERN 6.1. Read it closely: it describes an outcome to achieve, not a product to buy, which is why two practices of the same size can satisfy it in different ways and both be right.

If the vendor creates, receives, maintains or transmits PHI for you, it is a business associate: a business associate agreement meeting 45 CFR 164.504(e) and 164.314(a) is required before PHI is shared (164.502(e), 164.308(b)), and the Security Rule binds the vendor directly.

What this looks like in practice

In an assessment, NIST AI RMF GOVERN 6.1 is not one question. It resolves into several, and each one is really asking for different evidence. These are among the questions asked about it:

• Do policies and procedures address AI risks from third parties, vendors, data suppliers and model providers, across acquisition and use?
• Do the organization's third-party AI policies address the risk of infringing others' intellectual property or other rights through AI data, models or outputs?
• Does the organization vet and oversee suppliers of AI models, data, tools and services, so that what it buys fits its responsible AI approach and supplier risks are monitored over time?

Ownership usually sits with procurement, though the evidence is often produced by someone else, which is where the trail breaks. A control that works but has no owner tends to stop working the month the person who quietly maintained it changes roles.

Who this applies to

NIST AI RMF is voluntary rather than binding, and that changes how it should be used. Adopting it does not create a legal obligation, and declining it is not a violation. It earns its place when a customer contract names it, when it gives structure to AI governance work you already owe under a law or a contract, or when a recognized practice is worth having on record. Treat it as a way of organizing that work, not as a second regime.

Building it, in order

The sequence below is the order that produces evidence as a by-product rather than as a separate documentation exercise:

1. Add AI-specific risk questions to third-party due diligence.
2. Require contract terms on data use, model changes, incident notification and audit rights.
3. Assess third-party AI before purchase and at renewal.
4. Identify the intellectual property and other rights exposures from training data, models and generated outputs.
5. Require licensing review and contractual warranties or indemnities where appropriate.
6. Define how outputs are checked before commercial use.

Where else this maps

The questions behind NIST AI RMF GOVERN 6.1 also map to ISO/IEC 42001 A.10.3, which is voluntary guidance and standards rather than law; following it does not by itself establish compliance with any law. That matters for scoping: the same evidence can be written once and referenced from each, rather than rewritten per framework.

Evidence an assessor asks for

For this outcome the evidence types that satisfy it are policy and procedure. The distinction matters more than it looks: a policy states what you intend to do, a procedure states how, and a record proves it happened on a date. Auditors ask for all three, and a practice that has written the first two often has nothing for the third.

Date every document and keep the superseded versions. The framework sets no retention period, so this is our recommendation rather than a requirement: keep each version for as long as the system it describes is in use and for a period after it is retired, because a question about a past decision is answered from the version that was in force when it was made.

Where this usually goes wrong

The usual gap is a control that exists in practice and nowhere in writing. Someone does the work, reliably, and it has never been written down, so the organization cannot demonstrate it and cannot notice when it stops. The fix is not more control, it is a dated record and a named owner.

What to do about it

• Produce the evidence, not the intention. For NIST AI RMF GOVERN 6.1 that means a signed, dated policy with a named owner and a review date and a step-by-step procedure someone unfamiliar with the task could follow. If the only evidence is that someone knows how this works, you have a practice and not a record.
• Put a name on it. Procurement should be recorded as the owner. Where the work is done by someone else, say so in the document: the split between who owns it and who performs it is where the trail usually breaks. A control with no owner stops working the month the person who quietly maintained it changes roles, and nobody notices.
• Set a review cadence and keep the evidence of each review. An annual date with a dated output is a common floor; what fails an assessment is a control implemented once and never re-checked against a changed environment.
• Do not treat this as a legal obligation. It is a voluntary framework. Adopt it where a customer contract or a regulator's guidance names it, or where it gives structure to AI governance work you owe for other reasons, and say in your own documentation which of those reasons applies.

Work backward from the evidence. Decide what evidence would prove third-party AI risk to someone who does not already trust you, then build the control that produces it. Programs built in that order tend to stay current, because the evidence goes stale visibly.

Related outcomes

• External AI Feedback: Collecting feedback from clinicians and patients
• AI System Context: Documenting the context a model will operate in
• Organizational AI Risk Culture: Building a culture that reports AI failures

References

• GOVERN 6.1, in NIST AI Risk Management Framework 1.0 (NIST AI 100-1). This is a voluntary framework, not a legal requirement. The quoted statement is NIST's own, from the Core tables of NIST AI 100-1.
• Crosswalk references in this post are the mappings in our question bank, and are not verified against the published text of those standards.
• This post describes what a framework outcome asks for and what evidence documents it. It is not legal advice, and your counsel owns the conclusion. State law may impose additional obligations of its own.