Commissioner Mike Yaworsky Orders Immediate Suspension for Mirra Health for Shipping Sensitive Claims & Enrollment Data to Unlicensed Entities in India & Philippines

TALLAHASSEE, Fla.-Florida Insurance Commissioner Mike Yaworsky is ordering an immediate suspension of a Florida health administrator for delegating claims processing services to unlicensed offshore entities in India and the Philippines. Mirra Health Care, LLC maintains contracts with Florida domestic health maintenance organizations to perform core administrative services that directly impact over 23,000 Florida Medicare Advantage enrollees-the substantial majority of whom have chronic and institutional special needs. By providing these unlicensed offshore entities access to sensitive claims and enrollment data, Mirra Health is violating Florida's Insurance Code and threatening the safety and welfare of Florida residents. Additionally, when OIR examined Mirra Health to investigate the matter, the company failed to produce all contracts, further violating Florida law.

Commissioner Mike Yaworsky said, "Mirra Health's business practices are extremely reckless, especially when it comes to exposing the sensitive health information of vulnerable Florida residents. I am ordering an immediate suspension of the company's certificate of authority, as the company's actions are not competent or trustworthy. The Office of Insurance Regulation will continue to aggressively investigate this matter and stand up for the more than 23,000 enrollees impacted by this careless behavior."

Mirra Health delegated services without advanced written approval or notification to the Florida HMOs, as required by contract. The exposed sensitive health information pertains to C-SNP, D-SNP and I-SNP participants. C-SNP enrolls special needs individuals with severe or disabling chronic conditions; D-SNP enrolls individuals who are federally entitled to both Medicare and Medicaid due to conditions; and I-SNP enrolls individuals who need services provided in a long-term care skilled nursing facility, an intermediate care facility for individuals with intellectual disabilities.

OIR's final order states: "Mirra Health's business practices have created-and continue to create-ongoing, unauthorized exposure of sensitive claims and enrollment data to foreign entities beyond the Office's regulatory reach and without any contractual mechanism for immediate termination, thereby depriving the Office and the Florida HMOs of the ability to protect these vulnerable residents."

To view the final order, click here.