Triple-S Salud Inc., the dominant health insurer in Puerto Rico, expects to be fined $6.78 million for a breach of protected health information.

In a Feb. 18 filing with the Securities and Exchange Commission, parent corporation Triple-S Management Corp. said the Puerto Rico Health Insurance Administration notified Triple-S Salud of its intent to fine the company and impose administrative sanctions. The expected disciplinary action is being taken at the territory level of government and is not related to oversight activity at the HHS Office for Civil Rights, which has enforcement jurisdiction over the HIPAA privacy and security rules.

The expected fine, however, is much higher than any fine that HHS/OCR has levied on an organization. Further, the Puerto Rico government also is suspending new enrollments of Dual Eligible Medicare beneficiaries “and the obligation to notify affected individuals of their right to disenroll,” according to the SEC filing.

The punishment is surprising because the breach involved is relatively minor; resulting from the mailing in September 2013 of a pamphlet to 13,336 dual-eligible beneficiaries that inadvertently displayed the beneficiary Medicare number. The insurer notes it followed appropriate breach reporting and remediation procedures and is offering affected members a year of credit and identity protection services.

However, this is not the first major breach for Triple-S. In September 2010, the company learned of multiple instances of unauthorized access to a database by employees of a competitor, resulting in breaches affecting more than 400,000 members. The intrusions occurred between Sept. 9-15 as the competitors’ employees downloaded protected health information on individuals covered by Triple-S. Following this incident, the Puerto Rico government fined Triple-S $100,000.

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