Medical Identity Theft On The Rise

Category: Privacy

Your credit and bank account balance are not the only valuables that identity thieves are after. As health care costs have soared, so have incidents of “medical identity theft” in which crooks steal the credentials that enable one to obtain health care and sell them to other crooks. Here's what you need to know...

What is Medical Identity Theft?

Medical identity theft is on the rise. And sadly, it is much more difficult to guard against this type of ID theft, and much harder to clean up the havoc it can create for a victim.

The Medical Identity Theft Alliance estimates that over 2.3 million Americans have been victims of medical ID theft, and 2014 saw 500,000 more cases than the previous year. That bad news is sure to get much worse. The MITA’s latest survey was conducted in November, 2014, before the disastrous leak of 80 million patients’ personal health information from Anthem. And just yesterday, I read that an "error" on Amazon's Web Services platform exposed 1.5 million people's private medical records.

Criminals can use victims’ birth dates, Social Security Numbers, and the ID numbers found on insurance cards to obtain medical services and prescriptions at hospitals, clinics, and doctors’ offices. While medical providers today routinely scan your driver’s license, you may notice that they aren’t very diligent about verifying its authenticity.

Medical Identity Theft

A fake license that wouldn’t fool a liquor store clerk can be used to rack up thousands of dollars in health care costs very easily. Insurance cards, generally, don’t bear photos or signatures. Using stolen medical credentials, a crook may visit multiple hospitals, pharmacies, and doctors to obtain services and drugs – often narcotics.

The records of these transactions are added to victims’ health care records, and should be visible on your Explanation of Benefits letters, but bogus healthcare transactions often go undetected for months or even years.

The MITA’s survey found that the average victim did not learn of medical ID theft until three months after it happened, and 30 percent victims could not determine when their health care credentials were improperly used. Health care privacy laws force victims to be intensely involved in investigations of medical fraud.

Can't Get No Satisfaction

If you’ve ever challenged a hospital bill, you know how hard it can be to prove that you did not authorize or receive the treatment claimed. Only 10 percent of victims in MITA’s survey indicated they were “completely satisfied” with the resolutions of their cases. About 65 percent of respondents said they ended up paying an average of over $13,000 to resolve disputed claims.

Are you concerned about other forms of identity theft? Your best defense is knowledge and a proactive stance. See my articles Free Credit Reports Online and 10 TIPS: Identity Theft Protection to learn what steps you can take, both online and offline, to protect yourself.

MITA estimates that medical ID theft crimes are a $5.6 billion industry. Larry Ponemon, head of The Ponemon Institute that conducts MITA’s annual surveys, believes that “a medical record is considered more valuable than everything else" to cybercrooks. Credit cards expire and are replaced frequently, rendering them useless to fraudsters after a short time. But Social Security numbers and personal health information don’t change; a crook can use them practically forever.

There is no way to “freeze” health care credentials as one can freeze a credit card account. There are no centralized reporting agencies analogous to Experian, TransUnion, and Equifax that collect health care activity and can monitor it for suspicious patterns. Health care providers are trained to be helpful to patients, not skeptical of their identities.

In short, there are very few protections against medical ID theft and little help resolving its consequences. My 10 Tips to Avoid Identity Theft will help you safeguard your personal and financial records.

Aside from that, the most important thing you can do to guard against medical ID theft is reactive: read all of those “explanation of benefits” letters that come from your health care providers and insurance company as soon as they arrive. If you see anything suspicious, do not delay in challenging it.

Your thoughts on this topic are welcome. Post your comment or question below...

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Most recent comments on "Medical Identity Theft On The Rise"

Posted by:

22 Sep 2015

From Ontario, Canada.
Our OHIP system requires that we update our health cards every five years and get re-photographed. Health card numbers are not that of SIN numbers. The cards are optically scanned. Big improvements in ten years but expensive and not fully integrated.

Posted by:

Linda Anne Quinlan Gasper
22 Sep 2015

Bob, once again an excellent article. I know from personal experience how difficult Medical Identity Theft can be and wouldn't wish the six-years of time-consuming, sleepless nights and anxiety suffered fighting the bogus charges on anyone! I did win, but at what cost? Maybe I didn't have to pay, but having no protections in place to flag this fraud is inexcusable! I have solutions for this based on my early work in setting up a couple of databases for the federal government. Just look at how solvent social security would be if we went after, not just commercial insurance fraud, but Medicare as well! It can be done.

Posted by:

Old Man
23 Sep 2015

You identified a major point associated with medical information breaches. There is one other aspect to consider.
The information obtained can also be used to issue fake IDs and Social Security cards for illegal aliens. This has been going on for a long time, but was mostly hit-and-miss looking for valid SSANs. Medical breaches give these fraudsters more accurate information.
A major problem with this is; if an illegal alien using your SSAN dies, it goes into the computer against the SSAN, not the name. When the person actually issued the SSAN retires, or needs other benefits, they are denied because the SSAN is marked "Deceased."
An article I read a few years ago cited about 30,000 US citizens who could not collect benefits because they were legally dead (how does one prove they are alive?). The author somehow did a search on his SSAN and found about 100 other people were using it.
As the number of illegal immigrants increases, so does the need for fake IDs. Medical records are an ideal source, and the information can be used many times.

Posted by:

Monte Crooks
24 Sep 2015

Hey! How about the hundreds (thousands?) of federal staff who now, thanks to obama's careless care, have all the access necessary to "sell" your personal medical info. Beats fed retirement, huh? AND, who's gonna question and/or stop 'em?!!

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