Triple-S Management Corporation (“TRIPLE-S”), on behalf of its wholly owned subsidiaries, Triple-S Salud Inc., Triple-C Inc. and Triple-S Advantage Inc. , formerly known as American Health Medicare Inc., has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR). TRIPLE-S will pay $3.5 million and will adopt a robust corrective action plan to correct deficiencies in its HIPAA compliance program, an effort it has already begun.

“OCR remains committed to strong enforcement of the HIPAA Rules,” said OCR Director Jocelyn Samuels. “This case sends an important message for HIPAA Covered Entities not only about compliance with the requirements of the Security Rule, including risk analysis, but compliance with the requirements of the Privacy Rule, including those addressing business associate agreements and the minimum necessary use of protected health information.”

TRIPLE-S is an insurance holding company based in San Juan, Puerto Rico, which offers a wide range of insurance products and services to residents of Puerto Rico through its subsidiaries. TRIPLE-S has fully cooperated with HHS in investigating this case and has agreed to put in place a comprehensive HIPAA compliance program as a condition for settlement.

After receiving multiple breach notifications from TRIPLE-S involving unsecured protected health information (PHI), OCR initiated investigations to ascertain the entities’ compliance with HIPAA Rules. OCR’s investigations indicated widespread non-compliance throughout the various subsidiaries of Triple-S, including:

  • Failure to implement appropriate administrative, physical, and technical safeguards to protect the privacy of its beneficiaries’ PHI;
  • Impermissible disclosure of its beneficiaries’ PHI to an outside vendor with which it did not have an appropriate business associate agreement;
  • Use or Disclosure of more PHI than was necessary to carry out mailings;
  • Failure to conduct an accurate and thorough risk analysis that incorporates all IT equipment, applications, and data systems utilizing ePHI; and
  • Failure to implement security measures sufficient to reduce the risks and vulnerabilities to its ePHI to a reasonable and appropriate level.

The settlement requires TRIPLE-S to establish a comprehensive compliance program designed to protect the security, confidentiality, and integrity of the personal information it collects from its beneficiaries, that includes:

  • A risk analysis and a risk management plan;
  • A process to evaluate and address any environmental or operational changes that affect the security of the ePHI it holds;
  • Policies and procedures to facilitate compliance with requirements of the HIPAA Rules; and
  • A training program covering the requirements of the Privacy, Security, and Breach Notification Rules, intended to be used for all members of the workforce and business associates providing services on TRIPLE-S premises.

Triple-S, with the help of OCR through its technical assistance, had already begun to take extensive corrective action, as required by the Corrective Action Plan, and will continue to work with OCR to come into compliance with HIPAA.

“Triple-S is committed to protecting the privacy and security of its beneficiaries’ health information and implementing the Corrective Action Plan entered into with OCR,” said President and CEO of Triple-S Management Corporation, Ramon M. Ruiz. “We are pleased with the agreement and regard it as an opportunity to strengthen our privacy policies. We have appreciated OCR’s technical assistance to date, and look forward to our collaboration in the future.”

The Resolution Agreement and Corrective Action Plan can be found on the OCR website at: http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/TRIPLES/index.html

For more information on how to conduct a HIPAA Risk Analysis according to OCR best practices, consider these resources:

Clearwater Compliance

Clearwater Compliance helps healthcare organizations ensure patient safety and improve the quality of care by safeguarding the confidentiality, integrity and availability of protected health information (PHI).

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