BehindTheMedspeak: Medical Identity Theft

I'd never heard about it until Shawn Lea sent me a link to Eileen Ambrose's Baltimore Sun column of May 15, which follows.

Watch out for medical identity theft

Report estimates that up to 500,000 consumers have been victimized so far

We shred our papers and delete anything "phishy" to prevent thieves from posing as us and stealing our money.

Now there's a new twist to watch out for -- medical identity theft.

This is when thieves use your name or insurance information to get medical treatment.

Or, they might use it to buy prescription drugs or get reimbursed by insurance companies for services you never received.

That's not the worst of it.

False entries on health care records mean you could end up being treated based on someone else's medical history, says Pam Dixon, executive director of the World Privacy Forum.

Dixon's group last week issued a report on this crime, roughly estimating that it has ensnared 250,000 to 500,000 consumers so far.

Often, the perpetrators are professional thieves selling pills or medical supplies online.

Sometimes, it's the doctor.

A Massachusetts psychiatrist, for instance, filed false insurance claims for patients and non-patients alike, saying they were being treated for drug addiction or depression, Dixon says.

The chance of finding out about the theft is slim, and the discovery might not occur until long after the crime.

Often it's a call from a bill collector that alerts victims.

That happened to a Colorado man who was dogged by a collection agency to pay $44,000 for surgery someone else received under his name, the report says.

Some uncover the theft when an insurer won't pay a bill because a thief's claims put them over their insurance limit.

The psychiatrist's fraud was uncovered when a victim was denied a job because of the fake mental diagnosis, Dixon says.

Clifton Gaus, president of Health Professor Inc. in California, says medical identity theft is an emerging problem, but states are unlikely to take action to protect consumers until it's known how pervasive the crime is.

What can you do?

Ask your insurer each year for a list of benefits paid on your behalf, Dixon says.

This helps uncover cases where a thief changes your billing address.

Request an "accounting of disclosures" annually, she says.

Here, insurance and health care providers are required under federal law to tell you who accessed your records in certain cases.

This can help you spot any data breaches, Dixon says.

Also under federal law, you have a right to look at your medical file, although you might be charged a fee for a copy.

If you see errors, you're entitled to ask that the record be amended. This isn't the same as deleting wrong information. Amending a record, Dixon says, means you can place a paper in the file that disputes the wrong information.

(Seinfeld fans might recall Elaine's failed attempt to steal her medical file to erase negative information, and then having to jump from doctor to doctor searching for one that didn't know her record. She ended up seeking treatment from a vet.)

Sometimes in real life, a sympathetic doctor will remove false items from patients' records, Dixon says.

But even this isn't foolproof.

Wrong information might be on other paperwork that continues to be circulated among doctors, hospitals and insurers, she says.

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[via Shawn Lea and everythingandnothing]