Medical identity theft is the act of using someone else’s identity to obtain medical services, prescription medications and/or goods. This theft often includes fraudulent billing.
A Medical Record is a perpetual record that contains identifiable medical information, and is intended for use in decision making relevant to a patient’s health coverage, diagnosis and treatment. It contains a written account of a patient’s examination and treatment with medical history, patient complaints, physician’s findings, lab results, procedure results, medications, and other therapeutic measures. When stored on an information system it is often referred to as an Electronic Medical Record (EMR) or Electronic Health Record (EHR).
According to a research sponsored by the Medical Identity Fraud Alliance (MIFA), the increasing costs of resolving the problem of medical fraud influenced the Affordable Care Act to address medical identity theft. “Sixty-five percent of medical identity theft victims in our study had to pay an average of $13,500 to resolve the crime” and “victims learn about the theft of their credentials more than three months following the crime and 30 percent do not know when they became a victim” according to the Fifth Annual Study on Medical Identity Theft. In addition, only 3 percent of an average healthcare organization’s IT budget were being used for data protection.
One of the most striking results from the research was the answers to the following questions:
- How did the medical identity theft happen? The number of people increased from 4 percent from 2012 to 12 percent in 2014 who provided their personal information to a fake email or spoofed website. With the amount of information online and in the news on how to prevent identity theft, it is still surprising that we as a society are not changing the culture by building awareness within your organization from policies/procedures to education.
- How did the medical identity theft happen? Healthcare provider or insurer-experienced a data breach increased from 6 percent in 2012 to 10 percent in 2014. It is RISC’s position that this is probably due to increased awareness, however, thereby an increased number of complaints filed. Greater deployment of security technologies, and increased security training quite often result in statistical jumps like these as more events are recognized, not necessarily occurring.
- How did the medical identity theft incident affect your reputation? 89 percent said that embarrassment due to disclosure of sensitive personal health condition affected them while loss of career opportunities was identified by a surprising 19 percent.
- How did you resolve the medical identity theft? In 2012, a shocking 45 percent reported to paying the healthcare provider for services that the thief incurred. Last year, only 24 percent of those who experienced medical identity theft carefully reviewed their credit reports and only 15 percent said their contacted the credit bureaus to fix errors in their credit report.
A good example of dealing with medical identity theft begins from page five of an article from the Attorney General Kamala D. Harris of California which mentions prevention, detection and mitigation (California Department of Justice, 2013 October).
If you find your organization has experienced a security incident or suspects a data breach, know that there is help available. If you are a consumer who suspects medical identity theft, there is a great deal of help available to you. As taxpayers, we should all be concerned about this issue even if we do not personally experience it at work or as healthcare consumers!
References
California Dep. Of Justice. (2013, October). Medical identity theft: Recommendations for the age of electronic medical records. Retrieved from http://medidfraud.org/wp-content/uploads/2014/07/Medical-ID-Theft-Recommendations-FINAL.pdf
Fifth Annual Study on Medical Identity Theft. (2015, February). Retrieved from http://medidfraud.org/wp-content/uploads/2015/02/2014_Medical_ID_Theft_Study1.pdf
RISC Management and Consulting 