KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Regulations Seek To Crack Down On Medical ID Theft

New regulations seek to crack down on a little known form of identity theft -- medical identity theft, according to Kaiser Health News. "Armed with as little as a stolen name, Social Security number and date of birth, an imposter can walk into a doctor's office or hospital and receive services billed to the victim or the insurance provider. Although few statistics are available, the Federal Trade Commission reports that medical identity theft accounts for 1.3 percent to 3 percent of all identity theft crime -- about 250,000 cases each year."

A new FTC regulation, the 'Red Flags Rule,' is set to take effect on August 1 to address at least part of the problem. "The rule would require physicians' offices and hospitals, among other businesses, to create new protocols to spot the 'red flags' of identity theft. These could include detecting fake or altered IDs, inconsistencies in a patient's medical records or fraud alerts from consumer reporting agencies. Doctors are not only required to implement procedures ... that allow them to detect these warning signs effectively but also to spell out what they'll do when they find something fishy. ... But medical provider groups, including the American Medical Association, insist the rule is misguided. Their reasoning, in part, comes down to the actual language of the law." The statute states that businesses that regularly extend or renew credit are required to implement the new protocols. This category includes auto dealers, lawyers, utility companies and any physician's office or hospital that accepts insurance or allows a payment plan (Gold, 7/24).

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