Florida Insurance Commissioner Mike Yaworsky on Tuesday ordered the suspension of Mirra Health Care LLC’s certificate of authority after the Office of Insurance Regulation found the company delegated claims-processing work to unlicensed offshore entities in India and the Philippines that were given access to sensitive claims and enrollment data for more than 23,000 Florida Medicare Advantage enrollees.
The order, signed March 23, said the company’s business practices posed an imminent threat to the public health, safety and welfare of Florida residents. According to the order, Mirra Health performs core administrative functions for three Florida domestic health maintenance organizations — Secur, Solis and Ultimate — including member enrollment, claims adjudication and payment, utilization management, and grievance and appeals processing.
OIR said those services affect 23,119 enrollees, the majority of whom participate in chronic condition, dual-eligible and institutional special needs plans serving medically vulnerable populations.
State regulators said Mirra Health delegated claims-processing and related duties to four unlicensed offshore entities: Data Marshall, BluOne India, HOM India Private Limited and Saibervet. The order said Mirra Health did so without obtaining the advance written approval required under its contracts with the Florida HMOs and without notifying the HMOs or their enrollees. OIR also said Mirra Health failed to provide all requested contracts during the examination, including a contract with Data Marshall.
The order further found that Mirra Health’s administrative service agreements with the Florida HMOs did not include language required by section 641.234(3), Florida Statutes, allowing contracts to be canceled by order of the Office of Insurance Regulation. Regulators said some offshore contracts also lacked expiration dates, creating what the order described as ongoing unauthorized exposure of sensitive data to entities beyond the state’s regulatory reach.
“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,” Yaworsky said. “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.”
Under the order, the suspension takes effect on the 31st day after execution and may remain in place for up to one year unless modified or rescinded. Mirra Health may continue servicing existing agreements during the first 30 days to minimize disruption to consumer claims handling, but it cannot enter new Florida administrator agreements.
