The California Department of Managed Health Care (DMHC) has fined Kaiser Foundation Health Plan, a division of Kaiser Permanente, $200,000 for exposing the confidential health information of about 150 people.
The DMHC said the information had been available on a publicly accessible Web site for as long as four years.
A Kaiser spokeswoman referred questions about the incident to another Kaiser official, who did not respond to a request for comment.
"Patients must be assured that health plans will, at all costs, do everything possible to protect confidential information," Cindy Ehnes, director of the DMHC, said in a statement. "As we work on broadening the use of electronic medical records to improve patient care on both the state and federal levels, health plans must make security of confidential information a top priority."
An investigation by the agency found that Kaiser was responsible for the creation of a systems diagram Web site used as a testing portal by its IT staff. The site contained confidential patient information, including names, addresses, telephone numbers and lab results. According to the DMHC, Kaiser set up the site in 1999 without the prior consent of the affected patients.
DMHC said it was concerned that Kaiser allowed the Web site to languish on the Web in an accessible format and did not act to remove it until its existence was brought to the attention of federal civil rights authorities in January (see Update: Kaiser Permanente patient data exposed online) [1].
In addition, Kaiser authorities chose not to inform state regulators until after the site had been reported to the media in March, the DMHC said. Kaiser has since informed all of its affected members about the incident.
"Not only was this a grave security breach, Kaiser did not actively work to protect patients until after [it] had been caught," said Ehnes. "We're imposing this fine because we consider this act to be irresponsible and negligent at the expense of members' privacy and piece of mind."
Under California state law, a health plan can be fined if it has violated the confidentiality of medical information without first obtaining an authorization from the patient.
Berkeley, Calif., resident Elisa Cooper, a former Web coordinator at Kaiser Permanente, brought the breach to the attention of federal regulators and posted a link to the Kaiser Web site on her Web log last year. Kaiser then sued her for invasion of privacy and breach of contract. That case is still pending in Alameda County Superior Court (see Court orders blogger to stop posting Kaiser patient data) [2].
In addition, the DMHC ordered Cooper to stop posting the link to the information, which she did, said DMHC spokeswoman Lynne Randolph. "Her case is now closed."
"I'm relieved that the DMHC has formally confirmed that Kaiser was responsible for posting the systems diagrams Web site. For three months I've been fending off Kaiser's attempts to pin that site on me, and I'm still being sued by Kaiser," Cooper said in an e-mail to Computerworld.
Cooper said she fears Kaiser could drag her back and forth to court for years because she doesn't know how the legal system works and can't afford to hire a lawyer.
"The DMHC determined the systems diagrams site had been publicly accessible since 1999, and it would still be there today if I hadn't pointed it out," she said. "I just hope the next whistleblower isn't afraid to file a complaint or talk about a problem they've discovered because of what happened to me. The DMHC still has not apologized for giving the public the impression I was the one who posted the Web site."
Kaiser officials, who have been cooperating throughout the investigation, have until June 25 to present any information to dispute the state agency's findings, or the fine will be imposed, the DMHC said.
[1] http://www.computerworld.com/industrytopics/healthcare/story/0,10801,100420, 00.html
[2] http://www.computerworld.com/industrytopics/healthcare/story/0,10801,100615, 00.html