Trizetto Data Breach: PHI of 3.4 Million Individuals Exposed

It has been more than four months since TriZetto Provider Solutions discovered unauthorized access to its IT environment, and it has now been confirmed that the protected health information of 3,433,965 individuals was exposed or compromised in the incident. The data breach has recently been added to the HHS’ Office for Civil Rights breach portal, suggesting the data breach investigation and data review have been completed. At more than 3.4 million affected individuals, it ranks as one of the largest healthcare data breaches of 2025.

January 26, 2026: Trizetto Data Breach Victim Count Swells

Based on previous estimates of the scale of the Trizetto data breach, more than 700,000 individuals were thought to have been affected. It is now clear that the data breach was significantly bigger. The Oregon Attorney General has recently been informed that the personal and protected health information of 3,433,965 individuals was exposed or compromised in the incident, plus a further 304 individuals in Trizetto’s capacity as a business associate of Columbia River Health.

Attorneys General in other U.S. states have also received breach notices, although few publicly disclose the number of state residents affected. Two states that do are Texas and South Carolina. The Texas Attorney General was informed that the personal and protected health information of 171,158 Texas residents was compromised in the incident, while South Carolina was informed that 3,562 individuals in the state were affected. Other states that have been notified but have not published the number of affected individuals include California, Massachusetts, New Hampshire, and Vermont. Based on the disclosures to the Oregon, Texas, and New Hampshire Attorneys General alone, the data breach is known to have affected more than 3.6 million individuals, making it one of the largest healthcare data breaches of 2025.

Trizetto has yet to confirm whether the review of the affected data has been completed, and there is currently no Trizetto data breach listed on the HHS’ Office for Civil Rights breach portal. It is not unusual for the number of affected individuals to be increased several times as a data breach investigation and data review progress. For instance, the massive data breach at Change Healthcare in 2024 was first reported as affecting 500 individuals. The total number of affected individuals was updated to 100 million, and the final estimate provided to regulators was 192,700,000 individuals.

While the Trizetto Provider Solutions data breach is unlikely to match the scale of the Change Healthcare data breach, it should be noted that Trizetto handles more than 4 billion payment, enrollment, and claims transactions each year in its capacity as a HIPAA business associate. The data breach could therefore be substantially higher than the 3.6 million individuals currently known to have been affected.

Notification letters have started to be mailed to the affected individuals. The HIPAA Journal has been contacted by individuals who have been confused after receiving a breach notice from Trizetto, as they had no direct dealings with the company. This is a common occurrence when data breaches occur at business associates of HIPAA-covered entities. One California resident claimed the letter she received did not state the name of the healthcare provider that provided Trizetto with her data, which made her question whether the notification letter could be a scam.

January 15, 2026: TriZetto Provider Solutions Issues Data Breach Notifications to HIPAA Covered Entities (Update)

TriZetto Provider Solutions, a Cognizant-owned provider of revenue management services to physicians, hospitals, and health systems, has started notifying certain healthcare clients about a recently identified cybersecurity incident.

On October 2, 2025, suspicious activity was identified within a web portal used by some of its healthcare provider customers to access TriZetto systems. Immediate action was taken to secure the web portal and mitigate the incident, and the cybersecurity firm Mandiant was engaged to investigate the activity, review the security of the web portal application, and ensure that the incident is fully remediated. TriZetto is satisfied that the threat actor has been eradicated from its system. No further unauthorized web portal activity has been detected since October 2, 2025.

While the cybersecurity incident was only recently detected, the unauthorized access has been ongoing for a considerable period of time. The forensic investigation determined that an unauthorized third party first started accessing historical eligibility transaction reports within the TriZetto system in November 2024, almost a year before the unauthorized access was detected. The reports within its storage system contained the protected health information of patients of certain healthcare provider clients.

Between October 2, 2025, and the end of November 2025, Trizetto reviewed the data within the compromised system to determine the types of data involved and the individuals affected. Information compromised in the incident includes the names of patients and primary insureds, in combination with some or all of the following: address, date of birth, Social Security number, health insurance member number (in some cases, Medicare beneficiary number), health insurer name, information about the primary insured or beneficiary, and other demographic health and health insurance information. TriZetto said no financial information was involved.

Notifications have been issued to the affected healthcare clients, who have been provided with a list of the affected individuals and a copy of the affected data. The HIPAA Breach Notification Rule requires notifications to be issued to the affected individuals within 60 days of a HIPAA-covered entity being notified about a data breach at a business associate. Assuming the affected healthcare providers comply with that HIPAA requirement, individual notifications for the affected individuals should be mailed within 60 days.

TriZetto has offered to handle the breach notifications on behalf of the affected clients, should they determine that breach notifications are required under HIPAA. TriZetto has also offered to notify the HHS’ Office for Civil Rights, state regulators, and media outlets on behalf of its covered entity clients, and will also cover the cost of complimentary credit monitoring, fraud consultation, and identity theft restoration services.

It is currently unclear how many of its healthcare provider clients have been affected. Trizetto informed one of the affected clients that the protected health information of more than 700,000 individuals was likely compromised in the attack.

A majority of the affected covered entities are based in California and did not contract with Trizetto as a business associate. Trizetto was a subcontractor used by OCHIN, a provider of HealthIT solutions, workforce, and operational solutions to rural and community health centers. OCHIN was provided with certain patient data as required to perform its contracted services, and OCHIN subcontracted certain functions to TriZetto Provider Solutions. The incident highlights the wide-reaching effects of a cyberattack on a business associate or one of its vendors.

The HIPAA Journal is tracking breach reports, and confirmed data breaches are listed in the table below when each affected entity reports the breach to state attorneys general, the HHS’ Office for Civil Rights, makes a media announcement, or has contacted the HIPAA Journal directly. The list below is not exhaustive.

Affected Entity State Nature of Relationship Affected Individuals
Asian Americans for Community Involvement California TriZetto was a subcontractor of business associate OCHIN 521
Axis Community Health California TriZetto was a subcontractor of business associate OCHIN 3,579
Baltimore City Health Department Maryland TriZetto was a subcontractor of business associate OCHIN 2,597
Bay Area Community Health California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Benton County Health Oregon Business associate 1,476
Best Care Oregon Business associate 1,650
CE-Edinger Medical Group California Unknown Unconfirmed
Chattanooga C.A.R.E.S. d/b/a Cempa Community Care Tennessee TriZetto was a subcontractor of business associate OCHIN 1,341
Columbia River Health Oregon Business associate 304
Deschutes County Health Services Oregon Business associate 1,305
Friends of Family Health Center California TriZetto was a subcontractor of business associate OCHIN 2,256
Gardner Health Services California Business associate 6,197
Harmony Health Medical Clinic and Family Resource Center California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Indian Health Center of Santa Clara Valley California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Ko-Kwel Wellness Center Oregon TriZetto was a subcontractor of business associate OCHIN 543
La Clinica de la Raza California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
La Pine Community Healthcare Center Oregon Business associate 1,190
Lifelong Medical Care California Business associate 70,000
Lynn Community Health Massachusetts TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Mendocino Community Health Clinic California TriZetto was a subcontractor of business associate OCHIN 3,538
Mission Neighborhood Health Center California TriZetto was a subcontractor of business associate OCHIN 3,741
Native American Health Center California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
OLE Health (dba CommuniCare + OLE) California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
One Community Health California TriZetto was a subcontractor of business associate OCHIN 4,309
Open Door Community Health Centers California TriZetto was a subcontractor of business associate OCHIN 6,633
Pafford Medical Services (Pafford EMS) Arkansas Business associate 1,000
Petaluma Health Center California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Planned Parenthood Northern California California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Share Ourselves California Business associate 2,864
San Francisco Community Health Center California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Riverland Community Health Minnesota Business associate 940
Santa Barbara County Health Department California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Santa Cruz Community Health California TriZetto was a subcontractor of business associate OCHIN 1,487
Santa Rosa Community Health Centers California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Terry Reilly Health Services (Community Health Clinics Inc.) Idaho TriZetto was a subcontractor of business associate OCHIN 5,421
Tiburcio Vasquez Health Center California TriZetto was a subcontractor of business associate OCHIN Unconfirmed
Utah Valley Pediatrics Utah TriZetto was a subcontractor of business associate OCHIN 9,958
Valley Family Care California Business associate OCHIN 4,300
Variety Care Oklahoma Business associate 17,163
Winters Healthcare California TriZetto was a subcontractor of business associate OCHIN Unconfirmed

This post was first published on December 11, 2025, and it will continue to be updated as further information about the TriZetto data breach is released. 

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Mystic Valley Elder Services Agrees to Settle Class Action Data Breach Lawsuit for $520,000

The Malden, Massachusetts-based Mystic Valley Elder Services has agreed to pay $520,000 to settle a consolidated class action lawsuit stemming from an April 5, 2024, data breach. Unauthorized individuals gained access to the network of Mystic Valley Elder Services and potentially obtained the names, dates of birth, passport numbers, financial account numbers, payment card numbers, online credentials, taxpayer identification numbers, Social Security numbers, driver’s license numbers, health insurance information, and medical information of more than 89,600 individuals.

Five class action complaints were filed in response to the data breach, which were consolidated in the Middlesex County Superior Court in Massachusetts. The consolidated class action lawsuit – In re Mystic Valley Elder Services Inc. – alleged that the data breach occurred as a result of cybersecurity failures, Mystic Valley Elder Services failed to detect the unauthorized activity in a timely manner, and did not send timely notifications to the affected individuals, who did not learn about the data breach until 6 months later.

The lawsuit asserted claims of negligence, breach of implied contract, breach of fiduciary duty, unjust enrichment, and violations of the Massachusetts Consumer Protection Act. The lawsuit sought injunctive relief, including an order from the court prohibiting the transmission of sensitive data via unencrypted email, storing protected health information in email accounts, and requiring a host of security measures to be implemented to ensure the privacy and security of patient data. Mystic Valley Elder Services denies all liability and wrongdoing.

While the lawsuit sought a jury trial; however, following mediation, all parties agreed to a settlement to avoid the cost, time, and uncertainty of a trial and related appeals. The settlement fund will be used to cover attorneys’ fees and expenses, settlement administration and notice costs, and service awards for the class representatives. The remainder of the settlement will be used to pay benefits to the class members.

Class members may claim a pro rata cash payment, estimated to be approximately $75 per class member. A claim may also be submitted for reimbursement of documented, unreimbursed losses due to the data breach, up to a maximum of $5,000 per class member. The settlement also includes two years of credit monitoring and identity theft protection services. The final fairness hearing has been scheduled for February 17, 2026. Claims must be submitted by February 9, 2026.

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