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 has a multi-disciplinary practice advising clients 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…

Anna Durand Kraus has a multi-disciplinary practice advising clients 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 health information privacy. Ms. Kraus regularly advises clients on Medicare reimbursement matters, the Medicaid Drug Rebate program, health information privacy issues (including under HIPAA and the HITECH Act), and the challenges and opportunities presented by the Affordable Care Act.