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Public Knowledge Center > Identity Theft |
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Medical Identity Theft
In a dangerous emerging trend, referred to as "Medical Identity Theft", thieves and scam artists have discovered the ease in which they may use a victim's information to obtain healthcare and other medical benefits and services.
Recent studies have suggested that as many as 250,000 to 500,000 American consumers have already been victimized in this manner in recent years, although there is a high probability that these numbers are vastly under-estimated because the crime may easily go undetected for years. It is a serious problem and may soon be officially recognized through legislation as a separate and distinct form of Identity Theft.
In a report by Elizabeth Roop of Radiology Today, the World Privacy Forum has estimated that fraudulent medical billing resulting from medical identity theft can range from $1,000 to as high as $1 million per incident. Pam Dixon, Executive Director of the World Privacy Forum, said "We get a lot of complaints that are in the $20,000 to $150,000 range; that's very common. If someone called up and said, 'I had debt collectors knocking on my door wanting $90,000,' we wouldn't even blink."
Another Way of Looking at the Problem:
"An insurance card is like a Visa card with a $1 million spending limit." - Byron Hollis; National Anti-Fraud Director of the Blue Cross and Blue Shield Association
In addition to the obvious problems caused by fraudulent billing that may result from the healthcare services obtained in the victim's name, there is an even more disturbing, and potentially life-threatening danger - erroneous medical files. The thief's misuse of the victim's information to obtain healthcare services could result in the victim's medical files and related information entered into medical databases becoming contaminated with incorrect or mismatched information (the thief's rather than the victim's) such as an inaccurate medical history, missed or incorrect documentation of allergies to certain medications, inaccurately documented health conditions or diagnosis, and other dangerous errors that could put the victim's health in jeopardy. Victims may also suddenly and unexpectedly discover that their insurance benefits coverage has been depleted, that they no longer qualify for medical or life insurance due to erroneously reported "pre-existing" conditions, or receive a notice of cancellation or substantial increase in their insurance premiums due to inaccurately documented medical conditions.
Extremely Difficult to Correct
Errors in medical files can be very difficult to detect and correct, as victims of medical identity theft are not extended the same rights and protections as victims of financial identity theft. If your record is corrupted by inaccurate information, there is often no way to correct it. For instance, information in a hospital database may be forwarded to a doctor for review and subsequently added into his/her database. Information in the doctor's database may then be forwarded to an insurance company for billing purposes, and entered into that company's database. Information from the insurance company database may then be forwarded to the Medical Information Bureau database, used by many health care providers and insurance companies. At this point, all of these databases have become corrupted with the incorrect health information, and correcting them all is virtually impossible.
The following are four real life examples of incidents of Medical Identity Theft:
Case #1 - A woman discovered that someone using her identity to obtain medical services had caused her blood type to be changed in her medical records. Had this discovery not been made by the victim, the results of this incorrect information could have been potentially life-threatening.
Case #2 - A man discovered a medical identity thief had used his identity at five separate hospitals to receive more than $100,000 worth of medical treatments. Beyond the financial burden and challenges posed in attempting to absolve himself of the fraudulent charges, the victim also struggled with the daunting task of correcting multiple medical histories.
Case #3 - A woman's identification was stolen, and the thief later used the victim's identification at a hospital to receive medical services when giving birth. After the thief delivered the baby, test results showed that the newborn tested positive for methamphetamine. The thief was already gone when the results were returned. Because the thief had used the victim's name and information, social workers attempted to remove the victim's four children from her home. The victim's case was only resolved after she hired a lawyer and enlisted the aid of the local media. However, in a demonstration of the ongoing problems faced by victims of medical identity theft, when the victim was later herself admitted to a hospital for a kidney infection, the hospital records indicated the wrong blood type -- that of the thief's.
Case #4 - A retired schoolteacher received a surprising medical bill -- for the amputation of her right foot. The bill was surprising because the victim's right foot was perfectly intact. Despite this, the victim found proving her foot had never been amputated, and being absolved of the fraudulent medical bills, to be incredibly difficult. However, this turned out not to be the end of the victim's potential troubles. When the victim later suffered a heart attack and awoke in the hospital, the nurse asked her which medications she was taking to treat her diabetes. The victim did not have diabetes, but the woman who had stolen her identity did. This inaccuracy could have led to serious consequences because diabetes patients undergo different heart surgery procedures than patients without diabetes.
For more information regarding "Medical Identity Theft", visit the World Privacy Forum's website at: www.worldprivacyforum.org/medicalidentitytheft.html
Note: The World Privacy Forum is one of the few organizations that recognizes and actively attempts to educate the public about the dangers of Medical Identity Theft. On May 3, 2006, Pam Dixon, Executive Director of the World Privacy Forum, released an insightful report entitled "Medical Identity Theft -- The Information Crime that Can Kill You". The report is available on the WPF website. The WPF website also offers a helpful guide for victims of Medical Identity Theft.
©Copyright 2008 by Michael Barnett. All rights reserved. Unauthorized use, copying, or distribution without permission is prohibited.
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