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Practice Management It's a FACTA Life...Identify Theft Happens

It's a FACTA Life...Identify Theft Happens

Identity Theft Happens
Back in October, my debit card went to China without me and whooped it up at what VISA called a "Drinking and Dancing Establishment".  Wells Fargo decided that while my card was being used to complete a "card present" transaction, it was simultaneously being used at the local organic grocer.  They figured I was at the grocery store because of my spending profile, and that the other lifestyle was likely not me. How did they get through not one, but three transactions totalling over $2700 with a "card present" transaction? Not sure, but these days, one can take the number off a magnetic strip and simply make a new card. For this and other reasons, FACTA is now a necessity.

By August 1, 2009*, virtually all health care providers (including hospitals and physicians) throughout the United States will be required to comply with new privacy and security requirements to prevent identity theft. These new requirements are referred to as the Identity Theft Red Flags Rule (the "Rule") and it applies to any "Creditor" who maintains "Covered Accounts," as those terms are defined in the Rule.

For free templates and model policies

Applicability of the Rule

The American Medical Association ("AMA") and other associations including Medical Group Management Association, (MGMA) have recently corresponded with the FTC arguing, among other things, that the agency's interpretation that the Rule applies to physicians is overly broad. The definition of the term "Creditor" and whether health care providers fall under such a definition is at issue. The Rule defines the term "Creditor" as having the same meaning as in the FCRA, which was derived directly from the definition of "Creditor" in the Equal Credit Opportunity Act ("ECOA"). The ECOA defines the term to include, "any person who regularly extends, renews, or continues credit; any person who regularly arranges for the extension, renewal, or continuation of credit; or any assignee of an original creditor who participates in the decision to extend, renew, or continue credit." The term "Credit" is defined in the ECOA as, "the right granted by a creditor to a debtor to defer payment of debt or to incur debts and defer its payment or to purchase property or services and defer payments therefor."

The FTC maintains that anyone who defers payment for services provided beyond the date of service is a Creditor and a health care provider that bills a patient after having provided medical services clearly fits that definition. Makes perfect sense to me.

The second key definition of the Rule is "Covered Accounts." A "Covered Account" is defined as (i) an, "account that a ... creditor offers or maintains, primarily for personal, family, or household purposes, that involves or is designed to permit multiple payments or transactions, such as a credit card account, mortgage loan, automobile loan, margin account, cell phone account, utility account, checking account, or savings account, and (ii) any other account that the ... creditor offers or maintains for which there is a reasonably foreseeable risk to customers or to the safety and soundness of the ... creditor from identity theft, including financial, operational, compliance, reputation or litigation risks."

Five Things To Do Now
  1. The Rule requires Creditors to develop and implement an Identity Theft Prevention Program ("Program") that identifies, detects, and responds to activities that could indicate identity theft. These Red Flag activities may include, for example, unusual account activity, fraud alerts on a consumer report, or attempted use of suspicious account application documents.
  2. The second element is the development and implementation of policies and procedures designed to detect Red Flags.
  3. The third element of the Rule requires the Program have appropriate responses to prevent and mitigate the crime.
  4. The fourth element is the development and implementation of policies and procedures to reassess and update the Program periodically. A Creditor should review the Program to determine if the list of Red Flags included in need to be amended as a result of changing risks of identity theft.
  5. Finally, the Program must be managed by a Creditor's board of directors or senior employee, include appropriate staff training, and provide for oversight of any service providers with whom the Creditor contracts.
It's not really hard to do and I have developed a sample compliance plan and monitoring templates.  For access to copies of these, click below:
Sample Policy and Procedure
Sample Monitoring Report
Sample Medical Group Identity Theft Program Desription

Although compliance with the Rule was technically mandatory as of November 1, 2008, the FTC has granted entities subject to its jurisdiction a six-month forbearance period (ending on May 1, 2009) before it will begin enforcement of the Rule. The FTC also recently announced that effective February 9, 2009, its civil monetary penalties for violations of the FCRA, including the Rule, have increased to $3,500 per violation.
 

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