Healthcare and the FTC “Red Flags”

The “Address Discrepancy Rules” and Medical Compliance Rules

[By Staff Reporters]Red Flag Rules

Healthcare executives and CFOs are looking for help to better understand and comply with the Red Flag and Address Discrepancy Rules from the Federal Trade Commission (FTC). The Rules were issued to curb identity theft in the United States, and require companies including most hospitals, to submit their written program to identify and manage ‘red flag’ accounts – originally – by November 1, 2008.

Core Elements

The core elements of the Red Flag Rules are identification, detection and response to patterns, practices, or specific activities – known as “red flags”. They include the two key issues. 

1. Identification/Detection:

Inconsistencies of addresses constitute a ‘red flag’ to the registrar and organization.

2. Response:

When a ‘red flag’ is found, predetermined workflows within workflow solutions guide the registration process and financial relationship with patients, including those identified as a red flag patient, using validated patient information.

FTC Grants a Delay

However, the Federal Trade Commission just suspended enforcement of the new “Red Flags Rule” until May 1, 2009, to give creditors and financial institutions additional time in which to develop and implement written identity theft prevention programs. This recent announcement, and the release of an Enforcement Policy Statement, does not affect other federal agencies’ enforcement of the original November 1, 2008 deadline for institutions subject to their oversight to be in compliance.

Assessment

info: FTC Media Contact: Office of Public Affairs [202-326-2180]

Conclusion

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Pondering the Health Insurance Overhaul

Mandates Include All Patients and Pre-Existing Conditions

Staff Reporters

According to the New York Times, November 20, 2008, the health insurance industry would support a health care overhaul requiring insurers to accept all customers, regardless of illness or disability, if Congress requires all Americans to have coverage.  

Industry Trade Groups

In separate actions, the two trade groups, America’s Health Insurance Plans and the Blue Cross and Blue Shield Association, announced their support for guaranteed coverage for people with pre-existing medical conditions, in conjunction with an enforceable mandate for individual coverage.

Assessment

In the absence of such a mandate, insurers said, many people will wait until they become sick before they buy insurance. Members of Congress said that they wanted to pass legislation next year to expand coverage and rein in health care costs, while the new position taken by the insurance industry could ease the way for passage of such legislation.

View Video [“Future of American Healthcare” by Uwe Reinhardt; PhD]: http://vodpod.com/watch/852139-uwe-reinhardt-future-of-american-healthcare-who-will-manage-the-system?pod=drdemmba

Conclusion

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