It was the wallet comment in the response brief filed by the Federal Trade Commission (FTC) in the U.S. Court of Appeals for the 11th Circuit that prompted me to write this post. In its February 9, 2017 filing, the FTC argues that the likelihood of harm to individuals (patients who used LabMD’s laboratory testing services) whose information was exposed by LabMD roughly a decade ago is high because the “file was exposed to millions of users who easily could have found it – the equivalent of leaving your wallet on a crowded sidewalk.”

However, if one is to liken the LabMD file (referred to throughout the case as the “1718 File”) to a wallet and the patient information to cash or credit cards contained in that wallet, it is more accurate to describe the wallet as having been left on the kitchen counter in an unlocked New York City apartment. Millions of people could have found it, but they would have had to go looking for it, and would have had to walk through the door (or creep through a window) into a private residence to do so.

I promised to continue my discussion of LabMD’s appeal in the U.S. Court of Appeals for the 11th Circuit of the FTC’s Final Order back in January (see prior post here), planning to highlight arguments expressed in briefs filed by various amici curiae in support of LabMD.   Amici include physicians who used LabMD’s cancer testing services for their patients while LabMD was still in business, the non-profit National Federation of Independent Business, the non-profit, nonpartisan think tank TechFreedom, the U.S. Chamber of Commerce, and others. Amici make compelling legal arguments, but also emphasize several key facts that make this case both fascinating and unsettling:

The FTC has spent millions of taxpayer dollars on this case – even though there were no victims (not one has been identified in over seven years), LabMD’s data security practices were already regulated by the HHS under HIPAA, and, according to the FTC’s paid litigation expert, LabMD’s “unreasonableness” ceased no later than 2010. During the litigation, …   a whistleblower testified that the FTC’s staff … were bound up in collusion with Tiversa [the cybersecurity firm that discovered LabMD’s security vulnerability, tried to convince LabMD to purchase its remediation services, then reported LabMD to the FTC], a prototypical shakedown racket – resulting in a Congressional investigation and a devastating report issued by House Oversight Committee staff.” [Excerpt from TechFreedom’s amicus brief]

An image of Tiversa as taking advantage of the visible “counter-top wallet” emerges when reading the facts described in the November 13, 2015 Initial Decision of D. Michael Chappell, the Chief Administrative Law Judge (ALJ), a decision that would be reversed by the FTC in the summer of 2016 when it concluded that the ALJ applied the wrong legal standard for unfairness. The ALJ’s “Findings of Fact” (which are not disputed by the FTC in the reversal, notably) include the following:

“121. On or about February 25, 2008, Mr. Wallace, on behalf of Tiversa, downloaded the 1718 File from a LabMD IP address …

  1. The 1718 File was found by Mr. Wallace, and was downloaded from a peer-to-peer network, using a stand alone computer running a standard peer-to-peer client, such as LimeWire…
  2. Tiversa’s representations in its communications with LabMD … that the 1718 File was being searched for on peer-to-peer networks, and that the 1718 File had spread across peer-to-peer networks, were not true. These assertions were the “usual sales pitch” to encourage the purchase of remediation services from Tiversa… .”

The ALJ found that although the 1718 File was available for peer-to-peer sharing via use of specific search terms from June of 2007 through May of 2008, the 1718 File was actually only downloaded by Tiversa for the purpose of selling its security remediation services. The ALJ also found that there was no contention that Tiversa (or those Tiversa shared the 1718 File with, namely, a Dartmouth professor working on a study and the FTC) used the contents of the file to harm patients.

In short, while LabMD may have left its security “door” unlocked when an employee downloaded LimeWire onto a work computer, only Tiversa actually walked through that door and happened upon LabMD’s wallet on the counter-top. Had the wallet been left out in the open, in a public space (such as on a crowded sidewalk), it’s far more likely its contents would have been misappropriated.

It was nearly three years ago that I first blogged about the Federal Trade Commission’s “Wild West” data breach enforcement action brought against now-defunct medical testing company LabMD.   Back then, I was simply astounded that a federal agency (the FTC) with seemingly broad and vague standards pertaining generally to “unfair” practices of a business entity would belligerently gallop onto the scene and allege non-compliance by a company specifically subject by statute to regulation by another federal agency. The other agency, the U.S. Department of Health and Human Services (HHS), has adopted comprehensive regulations containing extremely detailed standards pertaining to data security practices of certain persons and entities holding certain types of data.

The FTC Act governs business practices, in general, and has no implementing regulations, whereas HIPAA specifically governs Covered Entities and Business Associates and their Uses and Disclosures of Protected Health Information (or “PHI”) (capitalized terms that are all specifically defined by regulation). The HIPAA rulemaking process has resulted in hundreds of pages of agency interpretation published within the last 10-15 years, and HHS continuously posts guidance documents and compliance tools on its website. Perhaps I was naively submerged in my health care world, but I had no idea back then that a Covered Entity or Business Associate could have HIPAA-compliant data security practices that could be found to violate the FTC Act and result in a legal battle that would last the better part of a decade.

I’ve spent decades analyzing regulations that specifically pertain to the health care industry, so the realization that the FTC was throwing its regulation-less lasso around the necks of unsuspecting health care companies was both unsettling and disorienting. As I followed the developments in the FTC’s case against LabMD over the past few years (see additional blogs here, here, here and here), I felt like I was moving from the Wild West into Westworld, as the FTC’s arguments (and facts coming to light during the administrative hearings) became more and more surreal.

Finally, though, reality and reason have arrived on the scene as the LabMD saga plays out in the U.S. Court of Appeals for the 11th Circuit. The 11th Circuit issued a temporary stay of the FTC’s Final Order (which reversed the highly-unusual decision against the FTC by the Administrative Law Judge presiding over the administrative action) against LabMD.

The Court summarized the facts as developed in the voluminous record, portraying LabMD as having simply held its ground against the appalling, extortion-like tactics of the company that infiltrated LabMD’s data system. It was that company, Tiversa, that convinced the FTC to pursue LabMD in the first place. According to the Court, Tiversa’s CEO told one of its employees to make sure LabMD was “at the top of the list” of company names turned over to the FTC in the hopes that FTC investigations would pressure the companies into buying Tiversa’s services. As explained by the Court :

In 2008, Tiversa … a data security company, notified LabMD that it had a copy of the [allegedly breached data] file. Tiversa employed forensic analysts to search peer-to-peer networks specifically for files that were likely to contain sensitive personal information in an effort to “monetize” those files through targeted sales of Tiversa’s data security services to companies it was able to infiltrate. Tiversa tried to get LabMD’s business this way. Tiversa repeatedly asked LabMD to buy its breach detection services, and falsely claimed that copies of the 1718 file were being searched for and downloaded on peer-to-peer networks.”

As if the facts behind the FTC’s action weren’t shocking enough, the FTC’s Final Order imposed bizarrely stringent and comprehensive data security measures against LabMD, a now-defunct company, even though its only remaining data resides on an unplugged, disconnected computer stored in a locked room.

The Court, though, stayed the Final Order, finding even though the FTC’s interpretation of the FTC Act is entitled to deference,

LabMD … made a strong showing that the FTC’s factual findings and legal interpretations may not be reasonable… [unlike the FTC,] we do not read the word “likely” to include something that has a low likelihood. We do not believe an interpretation [like the FTC’s] that does this is reasonable.”

I was still happily reveling in the refreshingly simple logic of the Court’s words when I read the brief filed in the 11th Circuit by LabMD counsel Douglas Meal and Michelle Visser of Ropes & Gray LLP. Finally, the legal rationale for and clear articulation of the unease I felt nearly three years ago:   Congress (through HIPAA) granted HHS the authority to regulate the data security practices of medical companies like LabMD using and disclosing PHI, and the FTC’s assertion of authority over such companies is “repugnant” to Congress’s grant to HHS.

Continuation of discussion of 11th Circuit case and filings by amicus curiae in support of LabMD to be posted as Part 2.

Readers of this blog know that we have been tracking the FTC’s recent data security enforcement activities with a particular focus on the FTC v. LabMD case.  As reported by Cause of Action, a nonprofit organization involved in the defense of LabMD, the LabMD trial was put on hold on May 30, 2014 until June 12, 2014 because the House Oversight Committee is investigating Tiversa Holding Co, the cybersecurity firm that found the patient data leading to the FTC’s investigation.  The unofficial transcript from the May 30th trial proceeding is available via the Cause of Action report.

While we don’t yet know how the LabMD case will end or whether the FTC will eventually decide to defer to the Department of Health and Human Services (“HHS”) and its detailed HIPAA requirements for data privacy and security, businesses involved with protected health information (PHI) might want to consider including a paragraph on the FTC’s data security enforcement activities in disclosure statements provided to investors or other third parties (such as those viewing website privacy statements).  A statement to be included in a private placement memorandum might provide as follows:

Section 5 of the Federal Trade Commission Act (“FTC Act”) prohibits unfair or deceptive acts or practice in or affecting commerce. The FTC has taken the position that unfair practices include those related to the use or protection of a consumer’s personal information, and has taken enforcement action against businesses based on its determination that the businesses had unfair practices relating to deficient data security measures.  The FTC has taken such enforcement action against businesses, such as [COMPANY], that must protect data in accordance with HIPAA, even where no HIPAA violation has been alleged and no HIPAA penalties have been imposed. Management of [COMPANY] has no reason to believe that [COMPANY] will not comply with Section 5 of the FTC Act; however, the failure to do so could result in the expenditure of significant sums incurred in responding to an administrative complaint and navigating the consent order process, and COMPANY could face the imposition of civil penalties, bans on certain activities, and requirements for corrective actions, including reporting, audit and compliance requirements for periods of up to twenty years.    

Businesses subject to HIPAA may also want to consider including a statement related to applicable state privacy and security standards or requirements, specifying those that are more stringent than the HIPAA standards and requirements.

As a regulatory lawyer, I frequently find myself parsing words and phrases crafted by legislators and agencies that, all too often, are frustratingly vague or contradictory when applied to a particular real-world and perhaps unanticipated (at the time of drafting) scenario.  So when an agency crafting guidance for a regulated industry has advisors on hand who have first-hand knowledge and expertise about particular real-world occurrences, such as data security breaches, it would seem that agency would be in an ideal position to create relevant, clear, and sufficiently detailed guidance that the affected industry could use to prevent certain occurrences and achieve compliance with the agency’s requirements.

As described in prior posts on this blog, the Federal Trade Commission (FTC) has brought numerous enforcement actions against businesses based on its decision that the businesses’ data security practices were “deceptive” or “unfair” under Section 5 of the FTC Act.  When I last checked the FTC’s website, there were 54 cases listed under the “Privacy and Security” topic and “Data Security” subtopic, one of which is the LabMD case filed on August 29, 2013.  Blog readers may have “discerned” (as do smart businesses when reviewing these cases and trying to figure out what the FTC’s data security “standards” might be) that I am intrigued with the LabMD case.  My intrigue arises, in part, from the stark contrast between the FTC and the Department of Health and Human Services (HHS) and the way these agencies identify data security standards applicable to regulated entities.  Of course, HHS’s standards apply specifically to the subset of data that is protected health information (PHI) – precisely the type of data involved in the LabMD case – but that hasn’t stopped the FTC from insisting that its own “standards” also apply to covered entities and business associates regulated by HIPAA.

The latest development in the LabMD case is particularly intriguing.  On May 1, 2014, FTC Chief Administrative Law Judge D. Michael Chappell granted LabMD’s motion to compel deposition testimony as to “what data security standards, if any, have been published by the FTC or the Bureau [of Consumer Protection], upon which … [FTC] Counsel intends to rely at trial to demonstrate that … [LabMD’s] data security practices were not reasonable and appropriate.”  The FTC had fought to prevent this testimony, arguing that the “FTC’s “data security standards” are not relevant to” the factual question of whether LabMD’s data security procedures were “unreasonable” in light of the FTC’s standards.

The FTC does publish a “Guide for Business” on “Protecting Personal Information” on its website.  This “Guide” is very basic (15 pages in total, with lots of pictures), and includes bullet points with tips such as “Don’t store sensitive consumer data on any computer with an Internet connection unless it’s essential for conducting your business.”  The “Guide” does not reference HIPAA, and does not come close to the breadth and depth of the HIPAA regulations (and other HHS published materials) in terms of setting forth the agency’s data security standards.

LabMD’s Answer and Defenses to the FTC’s Complaint was filed on September 17, 2013.  In that document, LabMD admits to having been contacted in May of 2008 by a third party, Tiversa, claiming that it had obtained an “insurance aging report” containing information about approximately 9,300 patients.  Tiversa, a privately-held company that provides “intelligence services to corporations, government agencies and individuals based on patented technologies” and can “locate exposed files … and assist in remediation and risk mitigation,” boasts an impressive advisory board.  According to Tiversa’s website, advisory board member Dr. Larry Ponemon “has extensive knowledge of regulatory frameworks for managing privacy and data security including … health care,” and “was appointed to the Advisory Committee for Online Access & Security” for the FTC.

Perhaps the FTC might consult with Dr. Ponemon in crafting data security standards applicable to the health care industry, since Tiversa apparently identified LabMD’s data security breach in the first place.  If (as published by the Ponemon Institute in its “Fourth Annual Benchmark Study on Patient Privacy and Data Security”) criminal attacks on health care systems have risen 100% since the Ponemon Institute’s first study conducted in 2010, the health care industry remains vulnerable despite efforts to comply with HIPAA and/or discern the FTC’s data privacy standards.  Bringing Dr. Ponemon’s real-world experience to bear in crafting clear and useful FTC data privacy standards (that hopefully complement, not contradict, already-applicable HIPAA standards) might actually help protect PHI from both criminal attack and discovery by “intelligence service” companies like Tiversa.