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.htm

Excerpted 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.

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;
`( 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).

`(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);
`( 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(, 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, 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;
`( 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, including the existence or value of any insurance policy.'.

Does the underlined text mean that medical credit report entries with $0 balance must be removed?

OK Whyhchat, I admit I am not the brightest in the bunch, so I need to ask a question that I do not understand about. I read through what you listed above. Are you saying that the credit bureus(Exp,Eq,Trans) are not supposed to be listing the name of the medical provider on your report, that it should only say: Medical? Every last medical collection I have on my reports, does list the name of the medical facility. Please correct me if I am wrong and if I am not wrong,how do I handle this?

I have been fighting to get,let's just say MANY medical collections removed from my reports, cause I do not believe I owe any money to these medical facilities. I gave each one a copy of my medicare and medicaid card, they said that they would file and that was that, I never heard from them again, that is until I pulled my credit report for the first time in years, back in June 05.
If I had recieve any bills or even a call, I would have been on top of it to find out why the medical facility had not filed my insurance. No medicare/medicaid does not pay as much as a conventional insurance plan or a cash patient, yet it is substantially more than they will get now, for failing to file.

Each of these collections are out of SOL, if that matters. Also ALL of the medical collections are out of Floridam too.

If you can offer me some advice as to what steps I might take next, I would appreciate it. When I first got my report back in June I did dispute the accts as unknown to me. When they came back verified, I sent of a DV, to see if maybe they had crossed me up with someone with a simular name, since there are only about 5000 people in Florida alone, with the same first and last name as mine. The collection agencies have either ignored my DV(s) or they have sent me a billing printout from the OC.


Thanks IN Advance,

A " not mine" dispute is, IMO, virtually useless as all the CRA does is have a computer match up of the spelling of your name with it's existing data from the creditor.

Send the CRA's the medical dispute letter from my website,(linked within the HIPAA letter program)

Ya know.. when I sent them the medical dispute letter I received a letter back saying they don't provide the info on the accounts and I'll have to get that from the CA.

I think this should be pinned......

Thanks for the info WhyChat

( Thanks for the " pin " Cotter)

It doesn't matter WHAT their first automated response is, if you haven't received a COMPLETE verification OR a COMPLETE deletion within the time frame, 35 days from their receipt of your letter, 50 days if it was a free report, ( track the certified # on line and print out the delivery data for your "paper trail")then you file a complaint on line with the FTC and redispute with a copy of your filed complaint.

The name & address of the original creditor for medical accounts MAY appear on your credit report if the CRA is sending the report to the consumer himself/herself. Only if they are sending it to other businesses who have PP do they have to code the account as "Medical".

No problemo

The only thing I would like to ask people is that if they have a specific question regarding the new laws and how they pertain in general then please post it here, if you have a question that is more involved and more specific to your personal situation, then I do ask you start a separate topic. This will keep the information in this thread neater and more on topic.

Thanks.

Ok i am writing Medical Dispute letter now. Who Do I report To Ftc The Cra Or Oc. thanks in advance

Could that be construed that Medical accounts can not be provided/included on a credit report that is being made/pulled for A job and/or credit decision unless it is for a Medical Credit decision or has permission signed for a job consumer report by the consumer?

In other words are not allowed to show up on any credit report except the Consumers Own report or one pulled in conjunction for Medical services and/or without express permission?

BG

BlueGhost has your research been able to answer this question, as I am extremly interested as well? When I come across the answer I will post it, unless WhyChat beats me to it.

According to my reading, they cant even state the account as medical?

That seems to be the whole purpose of this, not to disclose anything medical.

For goodness sake, anyone who understands this stuff and has used it, please give us a plain english translation.

Thanks
Steve

LOL, I know what you mean, it is rather confusing, I have just sent off the letters, not sure if I did it the right way though....

Did you send letters to the CRA requesting information that is in WhyChat's medical dispute letter?

If these provider were Medicaid providers, you should not owe them anything, unless the services were non-covered by the Medicaid plan.

Thats pretty much the idea......

Okay I just joined the site today, but I have been reading the site for the past couple of weeks and I can tell you that my eyes are about to bleed. I will take newbie bashing if it helps me get answers. I have decent credit lets say an average of 660 or so (never a late payment, seveal mortgages, cars, cc, etc) but it is taking a huge hit from three medical bills that I have that went to collections. They were actually from my daughter, that my X toook to the emergency room gave her new home address and then proceded to throw them in the trash. I never new they existed until recently. I called the CA's and explained the situation and they told me to bad. I even offered to pay them if they would remove them but no dice. I have read a lot of Why Chats post and even visited his website and read the Hippa forms etc but I have to tell you I am completely lost. I did file online disputes for the 2nd time, still awaiting the results of the second dispute, the first yielded "we have found the items belong to you" I even called the original HC provider and they said they only show one bill that is past due and it was for $107.00 not the $172 that the CA is asking for. Also there are disputes for $37 and 60$ which I did pay and they said it was coming off my CR but that was six month ago and no dice. So now that I have filed disputes, what is next? Do I send the HIPPA letter with the amount in question to the original HC provider? Letters to the CA, the CRA? I need a little help as I am somewhat lost. Sorry about the length......Thanks


Cam

I believe I have found a post that has answered quite a few of my questions but any help is still greatlly appreciated.

Has anyone seriously read the privacy notice you get from the med provider. I sat down with a copy, and at least in my state, you have to sign a new release EVERY YEAR. That may be an additional point to push, that any release previously signed has expired. And it can't hurt to send a letter to the provider REVOKING consent for release of information. Under HIPAA, you have the right to revoke consent and then the provider can only release your info (without consent) in specific situations. You have to read your state medical privacy laws to see what those purposes consist of but they generally seem to include reporting suspected abuse, contacting an insurance provider, general statics for research purposes, etc. I'm betting most states do not all contact for payment purposes, except insurance company, without consent of the patient or parent. I sent letters CMRRR to our last providers and have paid part of our bills off. Not a one of the CAs has been notified of the payments and the accounts came off our credit reports quite easily. When I sent my parents, I did include a paragraph referencing that I had revoked consent and gave them the date they received the letter and the CMRRR #.

The wording on every form I have signed said I can write and revoke consent but they do not have to comply. What good is writing, then?

Please give advice...

I sent a request for Validation to a local collection agency when I found their TL on my credit report.

Here is the response I get. Please note they leave out 5 © of the FDCPA which expressly states that if the consumer does not reply in the 30 day period, it is not an admission of liability.



I have an idea where I go here. I tell them that the letter is basically a refusal to verify, yada yada.

Any suggestions? I am about to start writing.

If you have revoked consent in writing and have prrof they were notified (CMRRR) then it might give you a little more leverage if you need to file a complaint against the provider. Also, if you notice, at least in my state, it states that consent is valid for 1 yr. I know, here in VA, that my dr is REQUIRED to have us sign a new privacy statement every year. The statements expire after 1 yr and they have to have a current statement on file.

Depending on state law, the wording may be slightly different. On the forms I signed fo rmy previous providers, it stated we could revoke consent and said nothing about they could choose to ignore our request.

Also, consider it this way, the privacy notice may say they can refuse to honor your request but if you revoke consent by CMRRR, a complaint of HIPAA violation would carry more weight. It costs providers time and money to show they did not violate HIPAA, plus the number of complaints are logged. I believe most providers want to stay away fomr being accused of violating privacy and will gladly ignore the CA if you pay them directly.

Anybody have advice on how I should proceed after reading their reply to my validation request?

I have a ton of medical bills and I don't even know how to get out from under them anymore. Everytime I think I can another one comes and then an annoying collection is slapped on me. I just paid off a couple and bammm there is more.

ATTENTION MEDICAID and MEDICARE RECIPIENTS:

I have done court research for two major information companies that sell the info to Equifax, Experian, and Transunion. I have seen some interesting lawsuits filed by collectors against medicare/medicaid recipients.

Additionally, I have had an awesome lawyer whom I have used regarding the health care needs of a child who passed away. We used medicaid for his needs.

I learned this, it is ILLEGAL for medicare/medicaid recipients to be "balance billed" by the medical provider. This is a common practice. Why? One could suppose that it is because of assumptions that medicaid recipients are not smart enough to know better or challenge it. Two, because seniors tend to be very conscientious about paying ALL of their bills--legitimate or not.

Here's the thing: If you are a medicare or medicaid recipient who has received a medical service for which the provider agreed to accept medicaid or medicare, they CANNOT bill you (providing they have the medicare/medicaid card/information. If they do bill you, they are violating federal law--report them to the insurance commissioner and the AG's office.

Further, the lawyer, firm, collection bureau who files a court action against you in order to collect on "balance billing" is also violating the law. Report them to the BAR and AG's office as well.

What happens if the medical providers are reported/investigated is potentially a withdrawal of the agreement for them to be medicare/medicaid providers--this is big business, they don't want that to happen.

I have been a victim of this very thing. I have been successful each time I challenged, but I still have more to challenge and it is time consuming.

Because I was additionally doing research, I suggested to my lawyer a class-action suit against one of the hospitals in our area notorius for this crap. The cases I read in one court house broke my heart as far as what happened to some individuals who lost their court cases but they had no idea they were illegal suits. Apparently, the judge had no idea they were medicare/medicaid recipients and of course the plaintiffs had no intention of mentioning that.

I believe that our consumer protection laws should be amended to include a provision that a collection agency/law firm collecting for medical bills should be required to inform the court if the respondent was a medicare or medicaid recipient.

Hope this info is helpful to someone.

Disclaimer: I am not a lawyer, this is not legal advice.

Medicare and Medicaid are two separate and unique programs.

Your post is mostly inaccurate.

MEDICARE is a FEDERALLY administered program designed for seniors/Retirees with no financial restraints as to eligibility. Recipients must pay the SSA for Medicare part A and part B, separately. A recipient may only have Part A or Part B

MEDICAID is Federal program which is administered on a STATE by STATE basis to provide health benefits to indigent people who qualify financially and have no insurance coverage or inadequate insurance coverage. Some members may be billed a copay or even a premium. Some states have plans which will help families pay the premium for a private plan like BC but offer no additional coverage.

Medicare recipients MAY be billed the appropriate amounts as set forth in the Medicare EOMB, including their 20% coinsurance, yearly deductibles and services deemed non covered by Medicare.

The only amount the provider has to write off is the DISALLOWED amount as stated by Medicare.

MediCAID recipients may also be billed in certain circumstances as well. There are many types of coverage in each state, including plans where there is a set amount a patient MUST spend out of pocket before coverage kicks in and limited plans which only cover prenatal or emergency services, as well as services which are over and above plan limits (such as if Medicaid only allows for 50 diapers per month for a bedbound patient and you need 60, you can be billed for the extra 10 in some states) or non covered by Medicaid. Also, if you fail to advise the Provider that you have Medicaid and they miss filing limit because of this YOU are responsible for the bill.

Your use of the term "Balance billing" is vague at best, since there are instances in which patients MAY be billed the balance after insurance or even the entire balance. In some cases for Medicare, the patient may be liable for the entire billed amount, such as in the case of NON ASSIGNED claims (in this case, the patient would be sent the payment and would then be liable for the entire amount to the provider)

While I understand your concern for the subject, you can not lump the two programs together. They are two separate and unique entities which have their own rules and regulations, and for Medicaid this varies by state. They are not one in the same, nor do all Medicare recipients have Medicaid, and vice versa, though some may.

Additionally, this thread is for the discussion of HIPAA and FACTA and how they relate to each other. Please *only* post in this thread if you would like to discuss that issue or have questions of a general nature relating to HIPAA and FACTA. If you have a question or comment relating to your own specific situation, please start a new thread.

Thanks

I have a CA on my CR that is reporting for a medical bill. I DVed the CA and they sent me the actual medical bill including what the charges are for. Is this not a violation, and if it is what can I do about it?

I contacted my HC provider regarding a bill that went into collections. I then found WHYCHAT's hipaa letter program and was reading it and trying to reference the information in the letter to the actual law. I can't find anything that says since there is no business purpose they can't contact the CA anymore and they must remove. the only information I found in Hipaa regarding my request for them not to disclose my PIH to the CA after payment is the following-

http://www.hipaadvisory.com/Regs/finalprivacy/522.htm
http://privacy.med.miami.edu/glossary/xd_consent.htm

Thoughts?

You are confusing two separate issues.

I have used the portions of the HIPAA rules that you cited in my new link on MedFico in a letter of redaction of permission.

http://whychat.5u.com/medfico.html

There is of course, NOTHING in any HIPAA rules that deals with how an OC should act if they have no longer any permissible purpose in communicating private medical data when there is no longer any permitted purpose. That would be like requiring expungement of all medical records that HAD been transmitted to a Dr. after that Dr. is no longer involved in treating the patient.

The purpose of the HIPAA letter program is to prevent FURTHER communication after the account is paid and there is no longer any business purpose.

One can not redact prior disseminated data, but one can make sure that the CA is NOT permitted to verify to a CRA the validity of an account that has been disputed.

hey everyone , im new to this site and dont understand alot of what im reading. my first question would be is " where do i start " ? i h ave medical bills on my report that i dont recall and i dont know who or where to start writing . some of these bills are 4 and 6 years old . sorry also new to computer . what is ca , cra ect. ? someone please help . thank you.

Good Info here....

I can not connect to the link to get the Pre-Hipaa and Hippa letters...is there anyway other way to get them...I have cleared history..cleared cookies...used another browser..no fixing it...

So obviously when I see it it says who the medical office is, but how do you really know what others are seeing? I just got a letter from Home Depot saying they were lowering my credit line because of my TU report and I know for a fact they are only a few medical bills. What did they really see?? Mmmm makes me wonder...

Bump & Subscribe

Hello everyone

Newbie here reading all the great advice on Hipaa so I thought I would give it a try. I tried calling to get the address of the Original Creditor and they are out of business or as the guy on the telephone said in transition. What do I do now?

Thanks in Advance

Does this process work for an Ambulance bill? I have all the OC information.