Managed Care Contracting & Provider Payment

Bill Passed by House that Would Exempt Small Business from Red Flag Rules– Including Health Care Practices with 20 or Fewer Employees

On October 20^th, the House of Representatives passed a bill to amend the provisions of the Fair Credit Reporting Act to exempt small businesses including medical practices with 20 or fewer employees. 

Quick Post: FTC Delays Enforcement of Red Flag Rules Until August 1st

The FTC announced yesterday that it will once again delay enforcement of its controversial Red Flag Rules ... this time until August 1st.  They also plan to provide additional guidance for "low risk" creditors in the form of a template.

Provider Readiness for May 1st Red Flag Rule Enforcement Deadline

According to a study conducted by IdentityForce and published last week:

Only 17.5% of hospitals surveyed reported they were in compliance with the Red Flag Rules.

Approximately 53% were in the process of designing and implementing their compliance programs.

Approximately 24% were still evaluating their options.

IdentityForce is a company that offers Red Flag, identity theft and Identity misuse prevention and compliance tools.

A link to the report is: Here

Link to post noting delayed enforcement date: Here

The Red Flag Compliance Train is coming down the Track and Payors are Asleep at the Switch.

Now, as we all know, the deadline for enforcement of the Red Flag Rules is looming … May 1^st.  Providers are struggling to implement red flag compliance policies.  It’s another big PROVIDER compliance panic.

In Face of Physician Protest over Red Flag Rules FTC Stresses Flexibility

Quick post:  Here is a link to an article in today's AMA News on the continued controversy over including physicians in the definition of "creditors" under the red flag rules.  The AMA promises guidance on compliance with the Red Flag Rules by April 10th.  Medicine slams FTC over forcing physicians to police identity theft

Price Estimates and Informed Consumers

I received a call from a hospital describing an increasingly common scenario:  a potential patient calls asking for the price of an outpatient CT scan; either because he is uninsured or is covered by insurance with a deductible.  The caller had already called several other providers and this hospital’s price was higher.  Even if the caller was covered by a high deductible plan (and was therefore entitled to pay the insurer’s negotiated rate) the hospital’s charge for the scan was still higher than the competitors’ prices – especially outpatient scanning sites.

The hospital wanted to know whether it could match their “competitor’s” price for the MRI.