This contribution gives an overview of various access control strategies in use in healthcare scenarios and shows how a variety of policies can be modeled based on a single security policy model for usage control, UCON. The core of this contribution consists of the specialization of the Sectet -Framework for Model Driven Security for complex healthcare scenarios based on UCON. The resulting Domain Architecture comprises a Domain Specific Language for the modeling of policies with advanced security requirements, a target architecture for the enforcement of these policies and model-to-code transformations.