Here are the new regulations under FACTA that I have been talking about, and the reason for using the "medical dispute letter" prior to using
any of the HIPAA letter program.
http://www.hipaadvisory.com/news/newsarchi...04/0216fact.htmExcerpted passages:
New Consumer Credit Law Protects Medical Information
The Fair and Accurate Credit Transactions (FACT) Act, signed by President Bush on December 4, 2003 (Public Law 108-159), establishes
medical privacy provisions as part of consumer credit law. The bill amends the Fair Credit Reporting Act (FCRA) to include improved
medical privacy protections,in addition to new protections against identity theft. Credit bureaus and creditors will have to comply with
a number of medical privacy restrictions that ban the sharing of medical information. Title IV of the FACT Act limits the use and sharing
of medical information in the financial system and provides an updated and more expansive definition of medical information.
The legislation prohibits the furnishing of consumer reports that contain medical information about a consumers, unless the consumer
affirmatively consents to the furnishing of the report in the case of an insurance transaction, or the consumer provides specific written
consent in the case of the an employment or credit transaction. The legislation also prohibits creditors from obtaining or using medical
information in connection with any determination of the consumer's eligibility, or continued eligibility, for credit.
Section 411 under Title IV of the Act:
Revises the requirement for specific affirmative consumer consent (opt-in) regarding the use and sharing of medical information by
consumer reporting agencies for employment or insurance purposes.
States that medical information shall not be excluded from credit reports shared among affiliates unless it is prohibited by this title.
Directs the Federal banking agencies and the NCUA to prescribe regulations limiting the use of such medical information.
Section 412 under Title IV of the Act:
Requires information furnishers whose primary business is providing medical services, products, or devices to notify any credit reporting
agency to which they furnish consumer information that they are medical information furnishers, for purposes of compliance with medical
information coding requirements.
cool.gif Prohibits a consumer reporting agency from including in any consumer report the name, address, and telephone number of any medical
information furnisher except in code, unless the report is provided to an insurance company for other than property and casualty insurance
purposes.
Requires the FTC, if a furnisher of information fails to comply with requirements for the coding of trade names, to take action, including
issuance of guidelines, to ensure the furnisher's compliance with such requirements.
The regulation text of Title IV of the FACT Act follows:
HR 2622
Fair and Accurate Credit Transactions Act of 2003 (Enrolled as Agreed to or Passed by Both House and Senate)
TITLE IV--LIMITING THE USE AND SHARING OF MEDICAL INFORMATION IN THE FINANCIAL SYSTEM
SEC. 411. PROTECTION OF MEDICAL INFORMATION IN THE FINANCIAL SYSTEM.
(a) IN GENERAL- Section 604(g) of the Fair Credit Reporting Act (15 U.S.C. 1681b(g)) is amended to read as follows:
`(g) PROTECTION OF MEDICAL INFORMATION-
`(1) LIMITATION ON CONSUMER REPORTING AGENCIES- A consumer reporting agency shall not furnish for employment purposes, or in
connection with a credit or insurance transaction, a consumer report that contains medical information about a consumer, unless--
`(A) if furnished in connection with an insurance transaction, the consumer affirmatively consents to the furnishing of the report;
`(cool.gif if furnished for employment purposes or in connection with a credit transaction--
`(i) the information to be furnished is relevant to process or effect the employment or credit transaction; and
`(ii) the consumer provides specific written consent for the furnishing of the report that describes in clear and conspicuous language
the use for which the information will be furnished; or
`© the information to be furnished pertains solely to transactions, accounts, or balances relating to debts arising from the
receipt of medical services, products, or devises, where such information, other than account status or amounts, is restricted or
reported using codes that do not identify, or do not provide information sufficient to infer, the specific provider or the nature of
such services, products, or devices, as provided in section 605(a)(6). yu.gif
`(2) LIMITATION ON CREDITORS- Except as permitted pursuant to paragraph (3)© or regulations prescribed under paragraph (5)(A),
a creditor shall not obtain or use medical information pertaining to a consumer in connection with any determination of the consumer's
eligibility, or continued eligibility, for credit.
`(3) ACTIONS AUTHORIZED BY FEDERAL LAW, INSURANCE ACTIVITIES AND REGULATORY DETERMINATIONS- Section 603(d)(3) shall not be
construed so as to treat information or any communication of information as a consumer report if the information or communication is
disclosed--
`(A) in connection with the business of insurance or annuities, including the activities described in section 18B of the model Privacy of
Consumer Financial and Health Information Regulation issued by the National Association of Insurance Commissioners (as in effect on
January 1, 2003);
`(cool.gif for any purpose permitted without authorization under the Standards for Individually Identifiable Health Information promulgated
by the Department of Health and Human Services pursuant to the Health Insurance Portability and Accountability Act of 1996, or referred
to under section 1179 of such Act, or described in section 502(e) of Public Law 106-102; or
`© as otherwise determined to be necessary and appropriate, by regulation or order and subject to paragraph (6), by the Commission,
any Federal banking agency or the National Credit Union Administration (with respect to any financial institution subject to the
jurisdiction of such agency or Administration under paragraph (1), (2), or (3) of section 621(cool.gif, or the applicable State insurance
authority (with respect to any person engaged in providing insurance or annuities).
`(4) LIMITATION ON REDISCLOSURE OF MEDICAL INFORMATION- Any person that receives medical information pursuant to paragraph
(1) or (3) shall not disclose such information to any other person, except as necessary to carry out the purpose for which
the information was initially disclosed, yu.gif or as otherwise permitted by statute, regulation, or order.
`(i) MEDICAL INFORMATION- The term `medical information'--
`(1) means information or data, whether oral or recorded, in any form or medium, created by or derived from a health care provider
or the consumer, that relates to--
`(A) the past, present, or future physical, mental, or behavioral health or condition of an individual;
`(cool.gif the provision of health care to an individual; or
`© the payment for the provision of health care to an individual.
`(2) does not include the age or gender of a consumer, demographic information about the consumer, including a consumer's residence
address or e-mail address, or any other information about a consumer that does not relate to the physical, mental, or behavioral
health or condition of a consumer, wink.gif including the existence or value of any insurance policy.'.
