FOS

FTC Extends Enforcement Deadline for Identity Theft Red Flags Rule

At the request of several Members of Congress, the Federal Trade Commission is further delaying enforcement of the “Red Flags” Rule through December 31, 2010, while Congress considers legislation that would affect the scope of entities covered by the Rule. Today’s announcement and the release of an Enforcement Policy Statement do not affect other federal agencies’ enforcement of the original November 1, 2008 deadline for institutions subject to their oversight to be in compliance.

“Congress needs to fix the unintended consequences of the legislation establishing the Red Flags Rule – and to fix this problem quickly. We appreciate the efforts of Congressmen Barney Frank and John Adler for getting a clarifying measure passed in the House, and hope action in the Senate will be swift,” FTC Chairman Jon Leibowitz said. “As an agency we’re charged with enforcing the law, and endless extensions delay enforcement.”

The Rule was developed under the Fair and Accurate Credit Transactions Act, in which Congress directed the FTC and other agencies to develop regulations requiring “creditors” and “financial institutions” to address the risk of identity theft. The resulting Red Flags Rule requires all such entities that have “covered accounts” to develop and implement written identity theft prevention programs to help identify, detect, and respond to patterns, practices, or specific activities – known as “red flags” – that could indicate identity theft.

The Rule became effective on January 1, 2008, with full compliance for all covered entities originally required by November 1, 2008. The Commission has issued several Enforcement Policies delaying enforcement of the Rule. Most recently, the Commission announced in October 2009 that at the request of certain Members of Congress, it was delaying enforcement of the Rule until June 1, 2010, to allow Congress time to finalize legislation that would limit the scope of business covered by the Rule. Since then, the Commission has received another request from Members of Congress for another delay in enforcement of the Rule beyond June 1, 2010.

The Commission urges Congress to act quickly to pass legislation that will resolve any questions as to which entities are covered by the Rule and obviate the need for further enforcement delays. If Congress passes legislation limiting the scope of the Red Flags Rule with an effective date earlier than December 31, 2010, the Commission will begin enforcement as of that effective date.

In the interim, FTC staff has continued to provide guidance, both through materials posted on www.ftc.gov/redflagsrule, and in speeches and participation in seminars, conferences and other training events to numerous groups. The FTC also published a compliance guide for business, and created a template that enables low risk entities to create an identity theft program with an easy-to-use online form (www.ftc.gov/bcp/edu/microsites/redflagsrule/get-started.shtm). The FTC staff also has published numerous general and industry-specific articles, released a video explaining the Rule, and continues to respond to inquiries from the public. To assist further with compliance, FTC staff has worked with a number of trade associations that have chosen to develop model policies or specialized guidance for their members.

As was the case previously, this enforcement delay is limited to the Red Flags Rule and does not extend to the rule regarding address discrepancies applicable to users of consumer reports (16 C.F.R.§641), or to the rule regarding changes of address applicable to card issuers (16 C.F.R.§681.2).

For questions regarding this Enforcement Policy, please contact Naomi Lefkovitz or Pavneet Singh, Bureau of Consumer Protection, 202-326-2252.

The Federal Trade Commission works for consumers to prevent fraudulent, deceptive, and unfair business practices and to provide information to help spot, stop, and avoid them.  To file a complaint in English or Spanish, visit the FTC’s online Complaint Assistant or call 1-877-FTC-HELP (1-877-382-4357).  The FTC enters complaints into Consumer Sentinel, a secure, online database available to more than 1,800 civil and criminal law enforcement agencies in the U.S. and abroad.  The FTC’s Web site provides free information on a variety of consumer topics.

MEDIA CONTACT:

Office of Public Affairs
202-326-2180

Insurer overhead a large percentage of medical costs.

An article published in the Philadelphia Inquirer examines the administrative burden placed on physician practices in dealing with multiple insurance companies. A spokesperson at Cardiology Consultants of Philadelphia—one of the region's largest specialty physician groups—estimates that 45 of the organization’s 350 non-physician employees do nothing but make sure payment is received for 230,000 patient visits a year. According to information from the international Organization for Economic Cooperation and Development, payments for health administration in the United States, at 7 percent of overall spending, are double the average of the 30 member countries that share economic data. A recent study by the Medical Group Management Association found that "interaction" with insurers, other than for Medicare, costs medical practices in the United States $21 billion to $31 billion each year.
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CMS Delays PECOS Compliance Date

Responding to concerns expressed by the physician community, the Centers for Medicare & Medicaid Services (CMS) has announced a delay in the implementation of PECOS Compliance.  The full announcement can be viewed by clicking on the link below. 

CMS is phasing in an effort to make sure all Medicare Enrolled physicians have been included in the PECOS system.  Physicians started to receive warnings from Medicare in October of 2009 if they were not entered in the PECOS system.  The original compliance date of January 4, 2010 has been pushed back to April 5, 2010.  Medicare is going to publish a list of all of the physicians that are currently in the PECOS system.  Physicians will want to make sure if their name does not appear on this list that they revalidate their information with their State Medicare Fiscal Intermediary so their information is included in the PECOS system.  After April 5th physicians risk their Medicare claims being denied if they are not in the PECOS system. 

To read more, please click on the link below: 

Download CMS Delays PECOS Compliance - blog posting

FTC Extends Enforcement Deadline for Identity Theft Red Flags Rule

The Federal Trade Commission (FTC) is delaying enforcement of the “Red Flags” Rule until June 1, 2010.  As part of the Federal Trade Commission's (FTC's) implementation of the Fair and Accurate Credit Transactions (FACT) Act of 2003, most medical providers would have needed to comply with the "Red Flags" rule November 1, 2009. The rule requires "creditors" – which the FTC defines to include most health care providers – to establish a program to prevent identity theft in their practices.

New online tool helps medical practices meet FTC identity theft prevention program requirements.

The U.S. Federal Trade Commission (FTC) has designed an online program to help medical practices and other businesses comply with its Red Flags Rule. The "Do-It-Yourself Program for Businesses at Low Risk for Identity Theft" contains two parts: Part A consists of a series of questions to help you determine if your practice is at low risk for identity theft, and Part B guides you through the four steps required to comply with the requirement of a written identity theft prevention program. FTC has delayed the enforcement date of the Red Flags Rule to Aug. 1, 2009.
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Drugstore clinics look to expand scope of practice.

According to the Chicago Tribune, several large pharmacy companies plan to increase the range of specialized services found in their outpatient clinics to include care for "sprains and strains" and injections for chronic conditions such as osteoporosis. The retail clinic model has been supported by health insurers, employers, and consumer groups as one way to address rising numbers of the uninsured. However, some critics argue that patients with certain conditions would be better served by physicians—especially if the physician has a history with the patient. Retail clinics must operate under physician supervision but are often staffed by nurse practitioners.
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New AMA resource a one-stop shop for ePrescribing information

An online learning center launched this week by the AMA can help physicians and practice managers make informed decisions about electronic prescribing, also known as ePrescribing. With vast educational content and interactive tools, this convenient resource allows users to assess ePrescribing technology at their own pace in an impartial environment.

Aspects of the learning center include complete and unbiased coverage of ePrescribing system vendor pricing and features, calculators to estimate potential time savings and determine Medicare ePrescribing incentive payments, the latest information on federal and state programs offering ePrescribing incentives, and readiness and planning tools to help physicians map out an implementation plan.

“The AMA’s new ePrescribing learning center takes the guesswork out of the decision-making process by giving physicians all the tools they need to decide what system is best for their practice,” AMA Board Chair Joseph M. Heyman, MD, said.

Visit www.ama-assn.org/go/eprescribing to access the learning center.

Practice Management Center

American Medical Association
www.ama-assn.org/go/pmc

Stimulus packages targets $19 billion for EHRs.

Although the federal government plans to use $19 billion of the economic stimulus package to facilitate increased adoption of electronic health records (EHRs), some obstacles remain. The Los Angeles Times reports one 10-physician practice that adopted EHRs 3½ years ago has been able to eliminate tens of thousands of manila files and reduce its record-keeping staff from seven to three. The office also eliminated 2½ positions in its billing department because clerks no longer have to review handwritten notes. However, the upfront costs of implementing EHRs can be high—as much as $30,000 per physician, and interoperability across competing records systems remains low. The U.S. Department of Health and Human Services has been tasked with developing a set of standards for EHRs by the end of 2009. Watch for an in-depth article on EHRs in the April issue of AAOS Now.

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Hospitals seek to employ more physicians as smaller practices disappear.

A commentary published in Physicians News Digest states that current long-term trends favor continued growth of hospital-owned physician practices and changing compensation models. Instead of large salaries and bonuses that were not supported (and in some cases could not be supported) by productivity, compensation is refocusing on strategy and productivity. The author states that factors driving the new model from the physicians’ side include stagnation of reimbursement, a reduction in ancillary revenue, rising practice expenses, and a greater need for scale.
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An article in the Nov. 2008 issue of AAOS Now examined the issue of changing practice patterns in orthopaedic surgery.
Read "Is the private practice orthopaedist disappearing?"…

Overview of E-Prescribing Program Initiated by CMS

The BSOF has attached a series of educational documents to our Blog that provide some background and instructions on the E-prescribing program initiated by the Centers for Medicare & Medicaid Services.  The documentation includes a series of helpful documents from the AAOS as well as links to the CMS E-prescribing website. 

Here is the link to the CMS E-prescribing site:  http://www.cms.hhs.gov/EPrescribing/

As a quick reference tool, below are the appropriate codes for reporting the use of e-prescribing technology.

The current “G” codes are as follows:

• G8443 – the prescriptions generated during the patient encounter were generated using a qualified system.

• G8445 – you have a qualified system but no prescriptions were generated during the patient visit.

• G8446 – you have a qualified system, but some or all of the prescriptions during the encounter were handwritten or phoned in due to one of the following: required by state law (such as narcotics), patient request ( such as patient going away for winter), or your system is currently inoperable.

Download Nuts and Bolts of E Prescribing

Download 2009 E Prescribing Fact Sheet AAOS