Lawsuit Pushes Red Flags Rule Back — Again

Amidst an AMA lawsuit, the FTC appears to take a wait-and-see approach.

After a year’s worth of extensions of the Red Flags Rule, medical practices were ready to buckle down and ensure that their plans were in place, because the rule was set to take effect on June 1.

However, just days shy of that deadline, the Federal Trade Commission (FTC) announced that it would be delaying enforcement until Dec. 31, 2010, “at the request of several Members of Congress,” according to a May 28 FTC news release.

Under the Red Flags Rule, “certain businesses and organizations — including many doctor’s offices, hospitals, and other health care providers — are required to spot and heed the red flags that often can be the telltale signs of identity theft,” according to an article on the Federal Trade Commission’s Web site.

To comply with the Red Flags Rule, covered entities are expected to create a written red flags program to prevent and detect potential identity theft cases.

According to the FTC, the rule applies to businesses that qualify as creditors or financial institutions, and the FTC’s broad definition indicates that it applies to many medical practices. “Health care providers are creditors if they bill consumers after their services are completed,” the FTC Web site says. “Health care providers that accept insurance are considered creditors if the consumer ultimately is responsible for the medical fees.”

However, simply “accepting credit cards as a form of payment does not make you a creditor under the rule.”

Congress requested the delay in part to “pass legislation that will resolve any questions as to which entities are covered by the Rule,” the FTC press release indicated. “Congress needs to fix the unintended consequences of the legislation establishing the Red Flags Rule — and to...

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Medicare: 21% Cut Continues to Loom, With May 31 Deadline Nearing

CMS instructs MACs to hold claims for ten business days while Congress mulls bill.

Impending cuts to your Medicare pay have been a familiar story this year, but hopefully you won’t face a 21-percent payment drop while you’re trying to enjoy your summer.

Last month, Congress voted to extend freezing the conversion factor at 2009 levels so Part B practices wouldn’t have to face a 21 percent cut to the conversion factor, which was supposed to go into effect on April 1. Once the president signed the extension into law, it meant that practices didn’t have to worry about the Medicare cuts until June 1, in hopes that the government would find a more permanent solution to the pay cut crisis before the conversion factor freeze expires on May 31.

New Bill Could Put Off Cuts

The House Ways and Means Committee published the text of H.R. 4213, “The American Jobs and Closing Tax Loopholes Act of 2010,” on its website on May 20. The bill would increase your payments through the end of this year, according to the text listed on the Committee’s Web site, which states, “In lieu of the update to the single conversion factor … that would otherwise apply for 2010 for the period beginning on June 1, 2010, and ending on December 31, 2010, the update to the single conversion factor shall be 1.3 percent.” The bill also includes provisions that would ensure that additional cuts don’t take place through 2013.

The American College of Physicians posted support for the bill on its website, but the AMA expressed disappointment. “An intervention to delay a looming Medicare physician payment cut will provide temporary stability for seniors and their physicians, but the AMA is deeply disappointed that Congress will once again fail to permanently correct the...

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