Medical Identity Theft Can Be Hazardous to Your Health
dan tynan on Sep 19 2008 at 6:53 am | Filed under: Identity Theft, Privacy, Womans Health Mag
When your medical identity is stolen, you may experience pain both fiscal and physical. Here’s how to avoid becoming a victim and recover quickly if you do.
A version of this story appears in the October issue of Women’s Health, which you can find online here, along with a strangely tongue-in-cheek photo (pun intended). What follows is the slightly longer version I submitted originally, with more sources and links. — D.T.
(image courtesy of kiiitv.com)
When Maija Lamberts found a health care credit card in her mailbox last February — one she’d never requested – she realized almost immediately she was the victim of identity theft. But her nightmare was only just beginning.
A call to the health care company revealed that someone had used Lamberts’ credit to buy $24,000 worth of plastic surgery – breast implants, tummy tuck, and full liposuction. Two weeks later the suspect was arrested during a follow-up visit to the surgeon’s office.
The health care heist was part of a larger scam that netted the thief roughly $60,000 in cash and services – and Lamberts a world of hurt. Since then the 39-year-old pharmaceutical sales rep has spent months trying to restore her credit and her good name. She’s been ignored by the police in her San Francisco Bay Area town, grilled by credit card detectives convinced she was in on the crime, and seen her perfect credit score plummet, putting her finances in jeopardy.
“I caught the crime really quickly, yet it still devastated my entire financial life,” she says. “I’ve never been scared of losing my house before. My security has been yanked out from underneath me.”
Lamberts is one of an estimated 250,000 victims of medical identity theft each year, according to the Federal Trade Commission. It’s a crime that can stick you with huge bills, max out your coverage so it’s not available when you need it, or cause insurers to cancel your policy. Even worse: Because a thief’s medical history can become mixed up with your own, your doctor may not know who he or she is really treating.
“Imagine showing up incapacitated in an emergency room and the doctor has to consult your medical records to know how to treat you,” says Byron Hollis, managing director for BlueCross/BlueShield’s anti-fraud department. “If your records say you have diabetes but you don’t, and he prescribes insulin, it could have devastating medical consequences.”
[ More after the jump ]
Inside Jobs
Medical identity theft can happen in a variety of ways. Your might lose your purse with your health insurance card inside. A benefits letter from your insurer could be stolen from your mailbox, or a thief can overhear you reciting your Social Security number to the receptionist at your doctor’s office. An email pretending to be from your insurance company might really a “phishing” scam that lures you to a fake Web site so thieves can steal your account information. In the vast majority of cases, the victims never know what hit them.
Wendy Jackson of West Salt Lake City found out her identity was compromised when she went to collect her paycheck and found $256.52 missing. When the 47-year-old support technician contacted the collection agency that garnished her wages, they told her it was for a “medical bill” but refused to identify how or where the charges were incurred. Jackson, who says she’s been robbed three times in the past year, believes thieves stole her Social Security number from papers in her bedroom and used it to obtain medical treatment.
Your medical records could also be exposed in a data spill. According to the Privacy Rights Clearinghouse, more than 80 medical data breaches have occurred since 2005, putting millions of patient records at risk.
Worse, employees at physicians’ offices may sell your identity for cash. In 2006 Isis Machado, a former desk clerk at the Cleveland Clinic in Weston, Florida, stole more than 1100 patient records from the clinic and used them to file $2.8 million in bogus Medicare claims. In May 2007 Machado and her cousin, Fernando Ferrer, were convicted of identity theft, conspiracy, and computer fraud.
“The more common form of medical identity theft is insiders at clinics, hospitals, and other facilities stealing lists of patients and reselling them for huge profits,” notes James Quiggle, spokesperson for the Coalition Against Insurance Fraud. “That’s where the big money is.”
A Dirty Bill of Health
If getting your medical identity stolen is bad, recovering from it is even worse. Unlike financial data, there’s no medical equivalent of a credit bureau where all your information is stored. Victims must not only prove they didn’t receive the medical treatment – and thus aren’t liable for the bills – they must also track down where the bad data has gone, so it doesn’t result in a misdiagnosis or denial of claims later.
“The biggest issue with medical identity theft is that your information travels to so many different places,” says Susan Trost, a certified identity theft risk management specialist in Castle Rock, Colorado. “Erroneous information on your medical record may have gone to your insurance company, pharmacies, third-party payers, even research databases. Trying to figure out what information was disclosed and to whom is a nightmare.”
If you tell a health care provider you believe your records are mixed up with someone else’s, they may refuse to show them to you for fear of violating the thief’s privacy under the Health Insurance Portability and Accountability Act (HIPAA), says Heather Wells, a recovery advocate at ID Experts in Beaverton, Oregon.
“Once you say you’re a victim of identity theft, it’s almost impossible to get access to your health records,” she says. “The whole system shuts down.”
Kirk Nahra, a partner with Wiley Rein in Washington, DC, and an expert on health care privacy, says that isn’t how HIPAA is supposed to work. But, he adds, doctors and their staff may get confused and nervous when confronted, and it’s always easier to say no than yes.
Preventative Medicine
Katrina Brooke of Seattle got burned by a medical ID thief four years ago, when a stranger used her then-newborn baby’s identity to obtain a prescription for OxyContin. Now the 42-year-old Brooke and her husband are fiercely protective of their information. The never give out their children’s Social Security Numbers or birth certificates. The Brookes check their credit reports at least twice a year. They shred all documents containing account numbers and never leave bills or letters in their mailbox.
“We were lucky because we caught it early,” she says. “The hospital hadn’t submitted the forms for my son’s birth certificate or his social security card, so there wasn’t a number for them to take. But we worry to this day that our information is still out there.”
The time to start fighting medical identity theft is before it happens, says Trost. You should closely monitor any “Explanation of Benefits” you receive, ask insurers for a summary of benefits at least once a year, and question anything that looks suspicious. You should be stingy with key information like SSNs, date of birth, and mother’s maiden name – and never give them out to anyone who calls you first. And you should treat your insurance card like a credit card with a $1 million+ limit – because, ultimately, that’s what it is.
If You’ve Been a Victim of Medical ID Theft
Obtain your medical history. But don’t tell health care providers you suspect identity theft until after you’ve seen it, or they may not show it to you. Request an “accounting of disclosures” to find out who else your providers shared information with, and contact your insurer(s) to ask for a summary of benefits. For more information on what to do, visit the World Privacy Forum’s Medical ID Theft page.
Call the cops. The odds of catching your thief are next to nil, but you’ll need a copy of your police report to contest charges with banks and other creditors. File a report with the FTC too; they maintain a database of identity theft crimes and will pursue the worst offenders.
Request copies of your credit report. These are free for victims of fraud. Be sure to place a fraud alert on your credit that notifies you when anyone tries to create new accounts in your name. Visit www.annualcreditreport.com for more info.
Whatever the media feeds us is bunch of bs, universal healthcare is good