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Government Turns Prevention Efforts to Patients

Dom Nicastro, for HealthLeaders Media, October 21, 2009

The FTC will enforce its medical identity theft Red Flags Rule beginning November 1.

Now, the government is turning its anti-theft and fraud attention to consumers.

HHS released tips and information last Thursday to help seniors and Medicare beneficiaries "deter, detect and defend" against medical identity theft. The new tips and a brochure were produced by the HHS Office of the Inspector General (OIG) and are available now at www.StopMedicareFraud.gov and www.oig.hhs.gov/fraud/idtheft.

"When criminals steal from Medicare, they are stealing from all of us," HHS Secretary Kathleen Sebelius said in a press release. "That's why fighting Medicare fraud is one of the Obama Administration's top priorities. Preventing medical identify theft is an important part of our work to stop Medicare fraud, and these tools will give seniors important information about how to deter, detect and defend against ID theft and fraud."

In May, Attorney General Eric Holder and Sebelius announced the creation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), to combat Medicare fraud. The HEAT team includes senior officials from DOJ and HHS. HEAT team efforts feature the expansion of joint DOJ-HHS Medicare Fraud Strike Force.

Some of the tips offered last week by the government are:

  • Guard your Medicare and Social Security Numbers. Treat them like you would treat your credit cards.
  • Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. If it's free, they don't need your number.
  • Do not let anyone borrow or pay to use your Medicare ID card or your identity. It's illegal, and it's not worth it.
  • Don't ever give out your Medicare Health Insurance Claim Number (on your Medicare card) except to your physician or other Medicare provider.
  • Don't allow anyone, except appropriate medical professionals, to review your medical records or recommend services.
  • Don't contact your physician to request a service that you do not need.

The Red Flags Rule requires organizations considered as "creditors" to implement programs to identify, detect, and respond to patterns, practices, or specific activities that could indicate identity theft. That regulation falls under the Fair and Accurate Credit Transactions Act of 2003 (FACTA).

Providers should consider these tips in order to comply with the FTC's rule.


Dom Nicastro is a contributing writer. He edits the Medical Records Briefings newsletter and manages the HIPAA Update Blog.

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