The Red Flag Rule applies broadly to financial institutions, credit grantors, and some others, including some health care providers. A health care provider comes under the Red Flag rule if the provider: 1) meets the definition of creditor under the Fair Credit Reporting Act (15 U.S.C. 1681a(r)(5)). A health care provider comes under the Address Discrepancy Rule if they: 1) use consumer credit reports.
A health care provider that qualifies as a creditor that offers or maintains covered accounts must develop and implement a written Identity Theft Prevention Program. The purpose of the program is to detect, prevent, and mitigate identity theft in connection with new or existing covered accounts. The Program must be appropriate to the size and complexity of the creditor and the nature and scope of its activities. A large hospital will need a more robust program than a two-doctor office.
The Address Discrepancy rule requires a user of a consumer report (credit report) to develop and implement reasonable policies and procedures to enable the user to deal with an address discrepancy. These requirements are narrower than the Red Flag rule for creditors. However, applicability of the address discrepancy requirement may affect a broader class of health care provider (and health insurers) than the Red Flag rule.
The Red Flag rule represents an important opportunity for the health care sector to protect consumers and patients from the impacts of medical and other forms of identity theft.
Robert Gellman is a privacy and information policy consultant based in Washington, DC.
Pam Dixon is the executive director of the World Privacy Forum.