Doctors, hospitals leery of federal rules


The Wichita Eagle

Physicians and hospitals are adopting procedures to prevent patient identity theft, even as they protest their inclusion in new federal “Red Flags Rules.”

The Federal Trade Commission announced the regulations in November 2007 but has delayed their implementation three times. The rules require many businesses to establish and implement identity theft prevention programs; many have done so.

Health care providers, through the American Medical Association and other groups, say they shouldn’t be included because they aren’t “creditors”; the FTC says many are because they aren’t paid in full at the time of service.

Last week, the FTC delayed the Aug. 1 implementation until Nov. 1. The AMA says it will continue to make its case to Congress.

The Wichita Clinic, with its 160 physicians, and the Medical Practice Association at the University of Kansas School of Medicine-Wichita, with its 50, are among those that were prepared to put programs into effect but are grateful for the latest delay.

“We can always use more time,” said Donna Johnson, director of medical affairs at the Wichita Clinic.

Lorene Valentine, executive director of the KU physicians’ group, said some policies are in place while others need a bit of tweaking.

The FTC rules are designed to help businesses from auto dealers to utility companies detect “red flags” that could indicate identity theft.

Not all health care providers are considered creditors under the regulations. But those that file insurance claims for patients, then bill the patients for the what insurance doesn’t pay, or those that set up payment plans for patients are creditors, the FTC says.

Medical identity theft can occur when someone uses someone else’s name or insurance information to get medical services or to create fictitious medical records.

For health providers, Johnson said, there’s a fine line between appearing impersonal and complying with the law.

At Wichita Clinic locations, new patients or those not recognized at check-in will be asked for photo identification and told why it’s needed.

But that won’t always be possible: “It’s one thing for a bank to say, we’re not going to process your loan,” Johnson said, and another for a health care provider to ask for a photo ID from someone who shows up with a broken arm.

As hospitals already do, the clinic will verify identity later in such cases.

The Wichita Clinic uses electronic records, so a driver’s license can’t be photocopied for a paper file, she said. And adding photo scanners or cameras everywhere would be prohibitively expensive.

The Medical Practice Association has the capability of having a photo added to its electronic records but “we haven’t actually implemented that yet,” Valentine said.

She said the KU clinics are implementing some of the other procedures suggested by the AMA.

“We need to tweak just a little bit on the policies and procedures,” she said.


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