Providers now have until Aug. 1 to step up their identity theft safeguards.

May 1 has come and gone -- and some healthcare providers haven't yet prepared for the government’s Red Flags Rule, which was supposed to go into effect by then. However, the Centers for Medicare & Medicaid Services has made the rule effective on Aug. 1.

On April 30, the Federal Trade Commission, which oversees the government’s implementation of the Red Flags Rule, announced the time extension and also noted that “for entities that have a low risk of identity theft, such as businesses that know their customers personally, the Commission will soon release a template to help them comply with the law.”

Background: Under the Red Flags Rule, certain businesses -- including healthcare providers who bill patients after the services are completed are considered “creditors,” thus required to spot and heed the red flags that can be signs of identity theft, the FTC said.

The rule requires practices to develop a program that addresses identity theft prevention techniques, as well as tools to detect and deal with any identity theft incidents that may occur.

Many medical practices were unclear about how the rule affected them, and once they realized they fell under the rule’s purview, many were slow to implement programs. The three-months extension allows those practices extra time to get their programs together.

“Given the ongoing debate about whether Congress wrote this provision too broadly, delaying enforcement of the Red Flags Rule will allow industries and associations to share guidance with their members, provide low-risk entities an opportunity to use the template in developing their programs, and give Congress time to consider the issue further”" said FTC Chairman Jon Leibowitz in an April 30 statement.

“Considering that you have to write the plan, get it approved by your practice’s board of director, make potential edits, and then share it with your staff, August 1 is not that far away,” advises Allison Larro, Esq., an Atlanta attorney.

In other news…

• Medicare providers can expect to use a new HIPAA 5010 form by 2010. The Centers for Medicare & Medicaid Services is prepping for ICD-10 diagnosis codes and advises providers that they “must be ready to submit claims electronically using the X12 version of 5010” effective Jan. 1, 2010.

CMS published the final rule for implementing the 5010 transaction standard on Jan. 15. The big news regarding the 5010 is that it will allow providers to report ICD-10 codes, which take effect on Oct. 1, 2013. However, the new HIPAA 5010 form has other uses as well. For example, the new form “distinguishes between principal diagnosis, admitting diagnosis, external cause of injury, and patient reason for visit codes,” an MLN Matters article notes.

CMS hopes to use this data to monitor mortality rates for some illnesses, outcomes for specific treatment options, and hospital stay durations for some conditions. The new form also offers an indicator on institutional claims for “present on admission” conditions.

Meanwhile, providers need to ask their software vendors whether their billing systems are HIPAA 5010-ready. “This will be bigger than the Y2K changes,” says Barbara J. Cobuzzi, senior coder and auditor for The Coding Network, and president of CRN Healthcare Solutions.

To read the MLN Matters article, visit www.cms.hhs.gov/MLNMattersArticles/downloads/SE0904.pdf .

            • Stay up-to-date on the swine flu at http:cdc.gov/h1n1flu/. As of May 12, 2009, the Centers for Disease Control and Prevention confirmed 3,009 cases of the swing flu on this Web site, which it updates daily. These cases span 45 states and have been responsible for three deaths in the United States.

The CDC has also increased its testing by developing a PCR diagnostic kit to detect the H1N1 virus. The agency has distributed tests kits to all states, as well as internationally.

• A new team of people is gearing up to work on health reform. Department of Health and Human Services Secretary Kathleen Sebelius announced on May 11 the newly appointed staff of the HHS Office of Health Reform, which will coordinate closely with the White House Office of Health Reform. An April 8 Executive Order created both offices to make healthcare reform top priority.

“The HHS Office of Health Reform and the White House Office of Health Reform will work in tandem to advance legislation and take immediate actions to cut costs, assure quality and affordable healthcare for all Americans, and guarantee Americans can choose their doctor and health plan,” Sebelius said in a statement. See the HHS Newsroom Web site for a full list of the team members and their responsibilities.