Theft of medical ID hurtful

Changes in records can remain undetected for years

June 10, 2008|By Pamela Yip | Pamela Yip,The Dallas Morning News

DALLAS - When someone steals your identity, obtains loans in your name and then stiffs the lenders, the effects on your credit report can be devastating.

It can take weeks, months or sometimes years - as well as plenty of frustration - to restore your good name.

But there's another kind of identity theft that not only can ruin your financial health - it can also endanger your life: medical identity theft.

Medical ID theft occurs when a thief uses someone's personal information - such as health insurance information - without the individual's consent to obtain medical services or goods, or to make false claims for medical services or goods.

Getting stuck with the bill for a medical procedure you never had is bad enough, but medical identity theft also has far more serious implications.

"Unlike purely financial forms of identity theft, medical identity theft may also harm its victims by creating false entries in their health records at hospitals, doctors' offices, pharmacies and insurance companies," said Pam Dixon, executive director of the World Privacy Forum, a nonprofit privacy-rights organization in Cardiff by the Sea, Calif.

Changes made to victims' medical files and histories can remain for years and may not ever be corrected, or even discovered, which can have deadly consequences.

"Victims of medical identity theft may receive the wrong medical treatment, find their health insurance exhausted and could become uninsurable for both life and health insurance coverage," Dixon said. "They may fail physical exams for employment due to the presence of diseases in their health record that do not belong to them."

Of the 8.3 million Americans who were victims of identity theft in 2005, 3 percent, or 249,000, said someone had obtained medical treatment and services using their personal information, according to the Federal Trade Commission's 2006 Identity Theft Survey Report, the most recent.

Now that medical ID theft is recognized as a type of identity theft, it is being reported more often, said Linda Foley, co-executive director of the Identity Theft Resource Center in San Diego.

Elaine Anderson, senior vice president of compliance at Texas Health Resources, has seen evidence of that.

"Over the last three to four years, this has been something that's been coming to my attention more frequently," Anderson said. "We've taken it really seriously. Identity theft has become a real problem for our society."

The most common way for consumers to discover that their personal information has been hijacked for medical services is when they receive a bill for a procedure they never received.

If this happens to you, contact the hospital, clinic or doctor that sent the bill and inform them of the error. Also contact your health insurance company because the health care provider may have already billed the insurer.

To help prevent medical identity theft, carefully study the "explanation of benefits" document that your health insurance company sends you detailing health services you obtained and their reimbursements.

Check to see that the dates and types of services match your records. If you spot anything suspicious - whether you owe money or not - call your insurer and health care provider immediately.

Guard your health insurance card as you would a credit card.

If you're checking in for an appointment and are asked for your Social Security number, address and other personal information, make sure no one is lingering suspiciously near you.

The medical environment is a unique setting in which ID theft can take place.

When you are hospitalized, all types of employees can have access to your personal data. That includes employees in the billing department, nurses, doctors and lab technicians.

Hospital officials said they've taken steps to ensure that workers have access to different degrees of your personal information on a need-to-know basis only.

"A secretary or someone at the welcome station doesn't have the same access as the person at the registration station," Anderson said.

Likewise, doctors and nurses have access to a person's medical information.

When medical ID theft does occur, the priority is to correct a patient's medical record, so Anderson said Texas Health Resources notifies the health insurance company, doctors and all others that have access to the patient's information.

The process is all the more important, given the move toward electronic storage and sharing of patient information.

The health insurance industry said that although several bills pending in Congress propose new data security requirements, insurers must remain vigilant about protecting patient health records.

"Consumers must have confidence that the information in their PHRs [personal health records] will not be misused or inappropriately disclosed," said America's Health Insurance Plans, which represents health insurers, and the BlueCross BlueShield Association.

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