Blue Cross and Blue Shield of North Carolina

In response to member telephone complaints, the covered entity (CE), Blue Cross Blue Shield of North Carolina, investigated and determined that on September 26, 2018, the CE mistakenly sent low income subsidy (LIS) letters to the wrong members due to an employee’s failure to follow established quality review procedures. Each letter contained the name and Blue Cross NC ID number for another member. Following the incident, the CE sanctioned the responsible staff member by coaching her and tasking her with creating a new process for sending the LIS letters. As a result of OCR’s investigation, the CE updated its policies and procedures by adopting the new process for mailing out the LIS letters. The CE also provided breach notification to HHS, affected individuals, and the media.