CalCPA ProtectPlus

On June 1, 2010, the Federal Trade Commission (FTC) will begin to enforce a nationwide identity protection law that  hospitals, doctors’ offices and other health care providers need to adhere to. They will be required to develop and implement written policies and procedures that will help identify warning signs or “red flags” that could lead to identity theft of their patients.

The FTC conducted a survey that found that close to 5% of identity theft victims have experienced some form of medical identity theft. The victims could find their benefits exhausted or they may face potentially life-threatening consequences due to inaccuracies in their medical records.

The following is a list provided by the FTC that gives a few warning signs or “red flags” that may be relevant to health care providers:

• Suspicious documents. Has a new patient given you identification documents that look altered or forged? Is the photograph or physical description on the ID inconsistent with what the patient looks like? Did the patient give you other documentation inconsistent with what he or she has told you — for example, an inconsistent date of birth or a chronic medical condition not mentioned elsewhere? Under the Red Flags Rule, you may need to ask for additional information from that patient. 
• Suspicious personally identifying information. If a patient gives you information that doesn’t match what you’ve learned from other sources, it may be a red flag of identity theft. For example, if the patient gives you a home address, birth date, or Social Security number that doesn’t match information on file or from the insurer, fraud could be afoot.  
• Suspicious activities. Is mail returned repeatedly as undeliverable, even though the patient still shows up for appointments? Does a patient complain about receiving a bill for a service that he or she didn’t get? Is there an inconsistency between a physical examination or medical history reported by the patient and the treatment records? These questionable activities may be red flags of identity theft. 
• Notices from victims of identity theft, law enforcement authorities, insurers, or others suggesting possible identity theft. Have you received word about identity theft from another source? Cooperation is key. Heed warnings from others that identity theft may be ongoing.

We should welcome this new rule for health care providers since it is an added measure to protect our identity and to prevent unauthorized individuals from gaining access to our health insurance information and personal medical history. It will help our health care providers to identify red flags in advance and they will  be better equipped to spot suspicious patterns. Overall, we can be assured that our identity is better secured and that the proper steps will be taken to prevent a red flag from escalating into a terrible case of identity theft against us. 

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