Saturday, February 22, 2014

Great! Now It's Medical Identity Theft!

Photo: Dr. advising patient on puzzling medical records.

Just frickin' terrific! It's bad enough we have to worry about hackers getting into TARGET and stealing credit card numbers, and terrorists designing new shoe bombs, now - in addition to standard identity theft - we have to worry about medical identity theft!  According to a recent piece in The WaPo by Christie Aschwanden, none of us with any kind of medical insurance can relax. Indeed, according to the article, "an estimated  1.84 million people were victims of medical identity theft in 2013, according to the Poneman Institute". This is absolutely ridiculous.

Sadly, victims usually don't know a damned thing until it's too late. That means their credit score takes a dive or worse, a collection agency comes after them full bore for unpaid medical bills. This, according to Jim Quiggle, Director of Communications for the Coalition Against Insurance Fraud.. While it's true most of the cost of medical ID theft is borne by the health care industry and government, the Poneman Institute estimates that 36 percent of victims in 2013 incurred out of pocket costs for services actually provided to impostors.  The average cost for the victims, including legal fees and ID protection services- amounted to $18, 660 and in a few cases exceeded $100,000.

Astoundingly, too many of us don't even know or understand how we're helping the medical ID thieves.  Some of the common methods used by medical ID crooks include:

1) The crook(s) persuade the victim to divulge his medical ID number, whatever it is - either for a policy like COBRA, Medicare or standard private insurance.  The strategies can be highly sophisticated, including inviting seniors to special "fairs"  - where their BP is taken, they're given complementary nutritional supplements - and then asked to see their medical insurance cards.

2) The crooks outright pay for the medical insurance number.

This one is hard to fathom, but according to Jennifer Trussell - who investigates medical identity theft for the Dept. of Health & Human Services' Office of the Inspector General- there are actually cases where criminal rings target senior centers or homeless shelters and offer people fifty bucks each for their Medicare number. According to Ms. Trussell: "That information is sold over and over again."

Though victims voluntarily share their numbers they've  no clue of the impact or how their Medicare account is being "maxed out" by thieves", including making false claims against the policy.

3) In some cases, employees of medical offices, or health care providers perpetrate the insurance fraud. In one case cited by Trussell, and Iowa chiropractor lifted the names and dates of birth from more than 200 patients to collect fraudulent Medicare payments. In another incident, a Baltimore pharmacy owner and employees were indicted for submitting bogus claims for prescription refills.

4) Perhaps rivaling (2) for stupidity, victims actually allow a family member or even acquaintance to use their medical insurance card to obtain coverage - according to the Poneman Institute.  These "Robin Hood" crimes (more like "Good Samaritan" crimes, to me) make up 30 percent of medical identity crimes.

While giving your insurance number to someone in need might seem like the "human" and decent thing to do, it's also a crime. You could definitely suffer serious consequences if the visits rack up bills that go unpaid or result in incorrect additions to your medical records.

Further, if an impostor's blood type or medical condition gets added to your record you could end up receiving inappropriate or even life-threatening treatment.

Alas, electronic medical records -which have been a boon to efficiency - have also made medical records easier to steal.  Thus, any clerk with malicious intent can load patient information onto a thumb drive and sell it to cronies or crime rings.

There are some basic ways to protect yourself:

- Never give your medical information, credentials to anyone but those with a legitimate reason for seeing this information, i.e. the billing person at your doctor's office.

-  Treat with suspicion anyone who asks for your medical insurance information without a good reason, and never EVER give the info to telemarketers.

- Check your medical records in timely fashion to make sure nothing suspicious appears. Medicare patients need to check their CMS Medicare Summary forms when they arrive. Make sure the treatments listed correspond to the dates and providers, as well as locations. If you see any discrepancy then complete the attached form questioning the filings, services.

- Think twice before sharing detailed medical info on social media. This is almost as bad as posting your address and  when you will be away on vacation.  An impostor could use this information to obtain services that might not raise red flags with your insurer. One example is if you tweet about your diabetes diagnosis. Next thing you know you're getting diabetes test strips you didn't order and which are billed to your insurance company.

- If you find your medical information has indeed been stolen or compromised the first step is a call to the police. The next is to the FTC or Federal Trade Commission at the identity theft hotline: 877- ID THEFT (877- 438 - 4338) or report the problem online at:

For any Medicare or Medicaid -related crimes report them at:

or call: 800- 447- 8477.

Be alert, be aware and don't let medical ID theft happen in the first place.

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