What is Medical Identity Theft?
Criminals Can Steal Medical Records and Make False Claims
Identity thieves can get your personal medical records in a variety of ways and the consequences can be lethal. All they need is your Social Security number to obtain prescription medication or have important surgical procedures. The Federal Trade Commission reported that in 2005 medical identity theft constituted three percent of all cases, i.e. 249,000 people out of 8.3 million who had their identities stolen. Privacy advocates are worried that number will skyrocket because medical files are increasingly stored on computers.
Patients who have not had any medical assistance will have a hard time convincing health care providers otherwise. It could take months if not years.
Being Billed for Surgery that Didn't Happen
In 2004 Lind Weaver, a resident of Palm Coast, Florida received a nasty shock when she opened a bill from a hospital charging her for a foot amputation. Trying to make the hospital's billing department understand she had both of her feet didn't work, so she had to go there herself and show the chief administrator that no such operation took place.
The following year she was hospitalized for a hysterectomy but realized the identity thief had added some medical conditions to her personal records – conditions she did not have, like diabetes.
What Can Happen to Patients?
- They can be given the wrong kind of blood during a transfusion, a potentially fatal consequence if there is an accident.
- Patients can be seriously misdiagnosed.
- They can be prescribed the wrong kind of medication, even something they are allergic to.
- Patients could be put on the operating table and get the wrong kind of surgery.
Not only this, but there is no direct way to challenge false medical records or inaccurate reports unlike financial identity theft. Unsuspecting people can open their mailboxes and be staring at some rather expensive bills for medical procedures they never had – bills that could be impossible to pay.
How is Medical Identity Theft Committed?
Not every case involves a thief needing help from a doctor. Inside jobs do occur, when organized crime groups work in tandem with shady clerks who sell medical records. As hard as it might be to believe, the perpetrator could be a doctor who is looking to supplement his/her income. Some identity thieves resort to plain, old-fashioned dumpster diving and trolling around residential areas looking for unopened mail.
Victims of Medical Identity Theft Will Find it Hard to Get Help
The Federal Health Insurance Portability and Accountability Act (HIPAA) of 1996 require health care providers to give patients access to medical records and copies of privacy practices. However, if an impostor is messing around with somebody's records the act allows insurance companies and providers ninety days to respond to a case. If they feel nothing is amiss, they do nothing. Moreover, the HIPAA act doesn't force providers to remove incorrect medical data. In fact, it is preserved to make a paper trail. Negative information can bounce around in the system and put victims in trouble for years.
What is Being Done to Prevent Medical Identity Theft?
Hospitals are now taking steps to make it harder for identity thieves to create this kind of damage. Computers are being reprogrammed so that employees have just enough information to do their jobs and others are requiring patients to show picture identification when requesting treatment.
What You Can Do to Protect Yourself from Medical Identity Theft
Protect your documents! Keep your health insurance information private and never reveal anything over the phone to somebody you don't know. You should also carefully review the insurance comany explanation of benefits (EOB) statements that come in the mail. It's an itemized list of the services you have received and what your insurance plan has paid for. If something looks suspicious, call them to make sure they have the right address since identity thieves will add all kinds of conditions that don't apply to you to complicate things.
Sources:
Diagnosis: Identity Theft BusinessWeek Magazine, January 8, 2007
Medical Identity Theft Turns Patients into Victims by Michelle Andrews, U.S. News and World Report, February 29, 2008
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