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What is Medical Identity Theft?

Medical Identity Theft Concerns on the Rise

As medical providers seek to move from cumbersome paper records to smaller and easier to file and trace electronic records, the concern over medical identity theft is escalating.

The sheer size of files limits the amount of paper medical records that are likely to be stolen. But several thousand electronic records can fit on a portable hard drive, which is only the size of a cell phone. The stolen records then can be used by the fraudster or sold on the black market to people who 'need' them.

That could lead to many more cases like the one in which a Houston man who had never had any health issues received a bill for thousands of dollars of emergency medical services, as reported in the New York Times. A fraudster had used the man’s identity for the fraudster’s emergency medical needs.

Medical identity theft is dangerous not only from a financial perspective as in the case above, but from a medical one as well. If someone has successfully stolen a person’s identity and received treatment, the record can become part of a patient's permanent medical record.

For example, a patient could be unconscious after an accident. The emergency room reads that during a previous admission the 'patient' indicated he or she is not allergic to the medication the doctor believes will be most beneficial for the unconscious patient. Relying on the prior medical record, the doctor administers that drug which – in reality – the patient is severely allergic to.

According to a 2008 Identity Theft Resource Center survey, some of the reasons that medical identity theft is particularly damaging to victims include:

  • Roughly a third of victims of medical ID theft surveyed had someone else's medical information or medical history on their medical record, increasing the possibility of patients being treated incorrectly because of incorrect medical records.

  • More than 10 percent of victims of medical ID theft surveyed were denied health or life insurance for unexplained reasons.

  • More than two-thirds of victims surveyed receive a bill for medical services that were provided to an imposter. 

ModernHealthcare.com reported recently that officials at Massachusetts General Hospital had seen a noticeable spike in attempted medical identity theft. This follows the trend of other health care organizations. For example, in June of 2008 the University of Utah Hospital announced the personal information of 2.2 million patients had been stolen.

The World Privacy Forum estimates that there are more than 250,000 cases of medical identity theft each year. The World Privacy Forum, which published an extensive report on medical identity theft in 2006 (a new report is due out later this year), acknowledges that medical identity theft is a crime that can cause great harm to its victims. Yet despite the profound risk it carries, it is the least studied and most poorly documented of the cluster of identity theft crimes.

The World Privacy Forum recommends the following steps for people to protect themselves against medical identity theft:

  • Closely monitor any "Explanation of Benefits" sent by a public or private health insurer

  • Pro-actively request a listing of benefits from your health insurers

  • Request a copy of current medical files from each health care provider

If any of those reports indicates that a person has been a victim of medical identity theft, the World Privacy Forum recommends take the following actions:

  • File a police report

  • Correct erroneous and false information in the file

  • Keep an eye on reports from each of the three credit reporting bureaus

  • Request an accounting of disclosures

Key Terms To Understanding Card Skimming Card Skimming:

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Based in Colorado, Rob Douglas is an identity theft expert and has been fighting against fraud and cyber crime for more than a decade. He is the editor of www.IdentityTheft.info and a speaker at identity theft conferences across the USA.

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