The Federal Trade Commission recently posted a frequently asked question designed to remind health care providers and health plans of their obligations when they become aware of medical identity theft.  The FAQ describes medical identity theft as occurring “when someone uses another person’s name or insurance information to get medical treatment, prescription drugs or surgery.  It also happens when dishonest people working in a medical setting use another person’s information to submit false bills to insurance companies.” 

The guidance states that a complaint from an individual that he or she has been billed for services he or she did not receive should trigger an investigation and, where appropriate, correction of the records and notification of the correction “to everyone who accessed the patient’s medical or billing records.”  The guidance further reminds health care providers and health plans that they may have additional obligations under the Fair Credit Reporting Act and the HIPAA breach notification and security rules. 

The FTC seems to be taking a new interest in medical identity theft.  The agency also recently published Facts for Consumers on Medical Identity Theft.

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Photo of Anna D. Kraus Anna D. Kraus

Anna Durand Kraus advises on issues relating to the complex array of laws governing the health care industry. Her background as Deputy General Counsel to the U.S. Department of Health and Human Services (“HHS”) gives her broad experience with, and valuable insight into…

Anna Durand Kraus advises on issues relating to the complex array of laws governing the health care industry. Her background as Deputy General Counsel to the U.S. Department of Health and Human Services (“HHS”) gives her broad experience with, and valuable insight into, the programs and issues within the purview of HHS, including Medicare, Medicaid, fraud and abuse, and HIPAA privacy and security. Anna is co-chair of the firm’s Health Care Industry practice group.

Anna regularly advises clients on Medicare reimbursement matters, particularly those arising under Part B and the Part D prescription drug benefit. She also has extensive experience with the Medicaid Drug Rebate program. She assists numerous pharmaceutical and device manufacturers, health care providers, pharmacy benefit managers, and other health care industry stakeholders to navigate the challenges and opportunities presented by the Affordable Care Act.

Anna is a trusted adviser on health information privacy, security and breach notification issues, including those arising under the Health Insurance Portability and Accountability Act (“HIPAA”) and the Health Information Technology for Economic and Clinical Health (“HITECH”) Act. Her background in this area dates back to the issuance of the original HIPAA privacy regulations.

Anna’s clients depend on her to guide them through compliance with the Anti-Kickback statute, the Stark regulations, and other laws preventing fraud and abuse in the health care industry. Her deep knowledge of these laws has made her an important component of the firm’s representation of pharmaceutical companies and health care organizations under federal investigation or facing allegations under the False Claims Act. In addition, clients contemplating acquisitions in the health care sector rely on her to guide due diligence efforts.