I had some HIPAA stuff on my Navy mainframe but fortunately, I didn't have to process it beyond just assuring that the system had room for the file to come in and the DB team knew as soon as possible that it was available for their consumption. I still had to take yearly HIPAA training, but it was available online and we were considered as doing legit work under the contract, so got paid for our time. Which was usually less than an hour once per year. I could read the file because at that time we were not encrypting the data. I don't know what they do now because about a year after I retired, the mainframe was decommissioned and everything went to web-based interfaces on a UNIX-flavored box plus ORACLE on another UNIX box. The interface app that ran on my mainframe yielded to the web. But it lasted for 30 years with very good uptime availability and it kept up with the work to be done, so the software costs weren't totally wasted. (Unlike DIMHRS.)