Puerto Rican insurer faces $6.8M fine for HIPAA violations

Health insurer Triple-S Management faces a fine over a security breach at the insurer’s subsidiary that is larger than any imposed for HIPAA violations by the Office for Civil Rights.

The Puerto Rico Health Insurance Administration intends to impose a $6.8 million fine on the subsidiary, Triple-S Salud.

The incident occurred on Sept. 20, 2013, when Triple-S Salud inadvertently mailed a pamphlet that included beneficiaries' Medicare health insurance claim number to 13,336 of its dual-eligible beneficiaries--individuals eligible for both Medicaid and Medicare, according to documents filed with the Securities and Exchange Commission. Triple-S immediately investigated the incident and reported it to the appropriate government agencies.

The company also released a breach notification to local media; notified all affected beneficiaries; and offered a year of identity protection and credit monitoring through a third-party provider to all affected individuals affected.

Despite the organization’s efforts, the administration says the fine represents a fine of $500 per affected individual, as well as an additional $100,000 penalty because Triple S failed to cooperate with the administration's investigation. The administration also wants Triple-S to suspend enrollment of dual-eligible beneficiaries; notify all affected individuals of their right to end their enrollment; and implement a corrective action plan to prevent future breaches.

Triple-S has until March 13 to request an administrative hearing on the fine, which could result in the maintenance or reduction of the fine.

Beth Walsh,

Editor

Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.