Medical Identity Fraud Alliance Members Making Inroads to Detect, Prevent and Mitigate Identity Fraud

Washington, DC, September 22, 2015 – The Medical Identity Fraud Alliance (MIFA) released a study to better understand what investments are being made in the healthcare industry to detect, prevent and mitigate medical identity theft and fraud. The 2015 Healthcare Industry Investments to Fight Medical Identity Fraud surveyed MIFA members and industry contacts in various areas of investments, including strategic priorities, personnel and IT spending, budget allocations, investments in workforce training and other business areas that impact the privacy and security of Protected Health Information (PHI).

The study shows the healthcare industry is making significant technology investments but also places a high priority on employing the right personnel expertise. 72 percent of respondents placed a premium on personnel talent. Nearly half of the respondents are prioritizing resources for fraud detection systems over prevention and mitigation investments.

“Members of MIFA are making significant investments in protecting PHI to reduce the risk of medical identity theft and medical fraud. I wish other organizations would do the same,” states Rick Kam, president of ID Experts, a MIFA founding member. Nearly half of the respondents indicated they are experiencing an upward trend for overall financial investments. In addition to personnel and IT resource allocations, nearly half of respondents are also placing training, education and awareness programs either first or second as a strategic priority.

The study indicates many companies are taking a broad enterprise-wide approach to how they prioritize and invest in resources to detect, prevent and mitigate medical identity fraud, which is an approach MIFA endorses.

“With this study, MIFA has taken a major step in helping us appreciate the extent and type of investments dedicated to the protection of sensitive healthcare information for people throughout the United States,” states Don Rebovich, Center for Identity Management and Information Protection at Utica College, a MIFA strategic partner. “Study findings are encouraging in that they demonstrate a pattern of increasing investments in strategies to control medical identity theft and fraud. Further, the study enlightens us on areas where we will need to be more vigilant in the future; areas like enhancing prevention methods. In its entirety, Healthcare Industry Investments to Fight Medical Identity Fraud makes a valuable contribution to understanding how we can best contain medical identity fraud.”

The paper is available here.

About the Medical Identity Fraud Alliance (MIFA)
MIFA is an industry trade association of healthcare providers, payers and service provider stakeholders, working to help its members better protect consumers from medical identity theft and fraud, through research, public-private collaboration and information sharing. Members provide leadership to: mobilize the healthcare ecosystem; cooperate to leverage collective intellectual capita; research to adequately understand the problem and guide solution building; and educate consumers, industry and government on medical identity theft and fraud issues. For more information visit http://medidfraud.org/.

About the Study
The study included 98 respondents from throughout the healthcare industry, including both MIFA members and other companies. Not all questions were answered by all respondents. The report should not be construed as industry standards or best practices due to its limited sample size in relation to the healthcare industry as a whole.

Media Contact:
Ann Patterson
Medical Identity Fraud Alliance
703-407-0958
[email protected]

Occurrence of medical identity theft incidents doubled in the last five years; Consumers left facing more than $20 billion in out-of-pocket costs

WASHINGTON, Feb. 23, 2015 /PRNewswire/ — The Medical Identity Fraud Alliance (MIFA), a public/private partnership committed to strengthening healthcare by reducing medical identity fraud, today released its annual study on the impact of medical identity theft.

The Fifth Annual Study on Medical Identity Theft, found the number of patients affected by medical identity theft increased nearly 22 percent in the last year, an increase of nearly half a million victims since 2013. In the five years since the survey began, the number of medical identity theft incidents has nearly doubled to more than two million victims. The study was released with support from Kaiser Permanente, ID Experts, Experian Data Breach Resolution and Identity Finder, LLC, and conducted by the Ponemon Institute.

“Over the past five years, we’ve seen medical identity theft steadily rising with no signs of slowing,” said Dr. Larry Ponemon, chairman and founder of the Ponemon Institute. “Our research shows more than two million Americans were victims of medical identity theft in 2014, nearly a quarter more than the number of people impacted last year.”

Medical identity theft is a national healthcare issue with potential to cause life-threatening and hefty financial consequences for consumers. According to the Fifth Annual Study on Medical Identity Theft, 65 percent of victims surveyed paid more than $13,000 out-of-pocket costs to resolve the crime.

“2015 will be a year of increased attention to the pervasiveness and damaging effects of medical identity theft. As we’ve already seen this year, the healthcare industry is and will continue to be a major target for hackers,” said Ann Patterson, senior vice president and program director at MIFA. “Stolen personal information can be used for identity theft, including medical identity theft and the impact to victims can be life-threatening.”

Noteworthy takeaways and key findings from the report include:

Medical identity theft is costly to consumers
Unlike credit card fraud, victims of medical identity theft can suffer significant financial consequences.Sixty-five percent of medical identity theft victims surveyed paid more than $13,000 to resolve the crime. In 2014, medical identity theft cost consumers more than $20 billion in out-of-pocket costs. The number of victims experiencing out-of-pocket cost rose significantly from 36 percent in 2013 to 65 percent in 2014.

Medical identity theft is a complicated crime
In the case of medical identity theft, victims are seldom informed by their healthcare provider or insurer. On average, victims learn about the theft of their credentials more than three months following the crime and 30 percent do not know when they became a victim. Of those respondents (54 percent) who found an error in their Explanation of Benefits, about half did not know to whom to report the claim.

Resolution of medical identity theft is time consuming and may never occur
Due to HIPAA privacy regulations, victims of medical identity theft must be involved in resolution of the crime. In many cases, victims struggle to reach resolution following a medical identity theft incident. Only 10 percent of survey respondents reported achieving completely satisfactory conclusion of the incident. Consequently, many respondents are at risk for further theft or errors in healthcare records that could jeopardize medical treatments and diagnosis.

Medical identity theft can cause embarrassment; negatively impact consumer confidence
Nearly half of respondents (45 percent) say medical identity theft affected their reputation in some way. Of those, nearly 90 percent suffered embarrassment stemming from disclosure of sensitive personal health conditions and more than 20 percent of respondents believe the theft caused them to miss out on career opportunities or lose employment.

Consumers expect healthcare providers to be proactive in preventing and detecting medical identity theft
Although respondents are not confident in the security practices of their healthcare provider, the vast majority (79 percent) of respondents expect their healthcare providers to ensure the privacy of their health records. Forty-eight percent say they would consider changing healthcare providers if their medical records were lost or stolen. If a breach does occur, 40 percent expect prompt notification to come from the responsible organization.

For a copy of the Fifth Annual Study on Medical Identity Theft, visit http://medidfraud.org/2014-fifth-annual-study-on-medical-identity-theft.

About the Study
The Fifth Annual Study on Medical Identity Theft is based on survey research conducted in 2014, involving adult-aged individuals who self-reported they or close family members were victims of medical identity theft. The survey offers a detailed view of the complex issue of medical identity theft. Additional questions were added to the 2014 survey to expand the understanding of how victims were affected by the theft, the costs they incurred, and the actions they took to resolve the crime.

About Ponemon Institute
The Ponemon Institute is dedicated to advancing responsible information and privacy management practices in business and government. To achieve this objective, the Institute conducts independent research, educates leaders from the private and public sectors, and verifies the privacy and data protection practices of organizations in a variety of industries.

About Medical Identity Fraud Alliance (MIFA)
MIFA is an industry trade association of healthcare providers, payers and service provider stakeholders, working to help its members better protect consumers from medical identity theft and the resulting fraud. MIFA’s goal is to reduce the frequency and impact of medical identity fraud through research, public-private collaboration and information sharing. MIFA members provide leadership to: mobilize the healthcare ecosystem; cooperate to leverage collective power; research to adequately understand the problem and guide solution building; educate consumers, industry, legislators and regulators; and empower individuals to be the first line of defense in protecting their Protected Health Information (PHI). More information can be found at http://medidfraud.org/.

Media Contacts:
Leah Motz
Edelman
206-664-7843
[email protected]

Ann Patterson
Medical Identity Fraud Alliance
703-407-0958
[email protected]

MIFA Installs New Board, Hires Staff and Launches Initiatives

Washington, DC, May 6, 2014 – The Medical Identity Fraud Alliance (MIFA) announced it is moving from development to operational status, which includes installing a board of directors, hiring staff and launching several new initiatives to address medical identity fraud.

New directors include David Popik, Florida Blue; Meredith Phillips, Henry Ford Health System; Bill Fox, Emdeon; Greg Radinsky, North Shore-LIJ Health System; Ralph Carpenter, Aetna; Doug Mailhot, CareFirst BlueCross BlueShield; Bob Gregg, ID Experts; Marita Janiga, Kaiser Permanente; and Rick Munson, UnitedHealthcare. The board will drive MIFA’s strategic vision for association growth and promote its mission to strengthen the healthcare ecosystem by collaborating to reduce the frequency and impact of medical identity fraud.

The board also hired Ann Patterson, Senior Vice President and Program Director, to build on the association’s foundational work, elevate MIFA’s operational excellence, and oversee member programming, recruitment, retention and marketing.

Recently launched initiatives include: Information Sharing, Research and Benchmarking; Education and Awareness; Legal and Regulatory; and Monthly Member Forums.

Each of these areas will focus on unique work products, such as industry best practices, to address specific areas of medical identity fraud. “We’re excited to have the new directors on board and collectively begin to tackle the issue of medical identity fraud,” stated Dave Popik, chairman of the board. “Ann has hit the ground running and begun to build our body of work that will positively impact the healthcare industry.”

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Media Contact:
Ann Patterson
SVP and Program Director, MIFA
703-407-0958
[email protected]

About the Medical Identity Fraud Alliance (MIFA)
MIFA is dedicated to helping its members better protect consumers from medical identity fraud. Members provide leadership to: mobilize the healthcare ecosystem; cooperate to leverage collective intellectual capital and power; research to adequately understand the problem and guide solution building; educate consumers, industry, legislators and regulators; and empower individuals to be the first line of defense in protecting their Protected Health Information. For more information visit http://medidfraud.org/.

Ponemon report concludes consumers unaware of life-threatening dangers; Medical Identity Fraud Alliance launched to mobilize healthcare industry and empower consumers

TRAVERSE CITY, Mich. and WASHINGTON, D.C. — September 12, 2013 — Medical identity theft is a national healthcare issue with life-threatening and hefty financial consequences. According to the 2013 Survey on Medical Identity Theft conducted by Ponemon Institute, medical identity theft and “family fraud” are on the rise; with the number of victims affected by medical identity theft up nearly 20 percent within the last year. The survey, sponsored by the Medical Identity Fraud Alliance (MIFA) with support from ID Experts®, finds that medical identity theft affects an estimated 1.84 million people in the U.S.; with victims forking out more than $12 billion in out-of-pocket costs incurred by medical identity theft. For a free copy of the 2013 Survey on Medical Identity Theft, visit http://medidfraud.org/2013-survey-on-medical-identity-theft.

For the purposes of this study, medical identity theft occurs when someone uses an individual’s name and personal identity to fraudulently receive medical services, goods, and/or prescription drugs, including attempts to commit fraudulent billing.

Consumers are Vulnerable; “Family Fraud” is a Growing Problem

Half of the consumers surveyed are not aware that medical identity theft can create life-threatening inaccuracies in their medical records, resulting in a misdiagnosis, mistreatment, or the wrong prescriptions. Yet, 50 percent of consumers surveyed do not take steps to protect themselves, mostly because they don’t know how. The survey also finds that consumers often put themselves at risk by sharing their medical identification with family members or friends—unintentionally committing “family fraud”—to obtain medical services or treatment, healthcare products, or pharmaceuticals.

“Medical identity theft is tainting the healthcare ecosystem, much like poisoning the town’s water supply. Everyone will be affected,” said Dr. Larry Ponemon, chairman and founder of the Ponemon Institute. “The survey finds that consumers are completely unaware of the seriousness and dangers of medical identity theft.”

Medical Identity Fraud Alliance Formed

The medical identity theft problem is getting bigger and more complex with the Affordable Care Act and the increased use of electronic health records (EHRs). Healthcare organizations cannot solve the medical identity theft problem alone. The Medical Identity Fraud Alliance (MIFA), also announced today, is the first cooperative public-private sector effort to unite all stakeholders involved in the protection of consumers—policy decision-makers, organizations that hold protected health information (PHI), health plans, law enforcement, regulatory agencies, companies, nonprofit organizations, and consumer advocates—to jointly develop best practices, solutions, and technologies for the prevention, detection and remediation of medical identity theft and fraud. More information is available at http://medidfraud.org/.

“With the formation of the Medical Identity Fraud Alliance, we have an opportunity to bring a serious societal problem to the forefront and protect the public,” said Robin Slade, development coordinator for the Medical Identity Fraud Alliance. “MIFA will act as the intersection between industry, government, and consumers. We are working together to vaccinate against medical identity theft and fraud.”

Key Findings of the 2013 Survey on Medical Identity Theft

Feedback was collected from several government agencies to develop the 2013 Survey on Medical Identity Theft, the first research deliverable sponsored by MIFA, to measure the prevalence, extent, and impact of medical identity theft in the U.S. to consumers and the healthcare industry. Following are key findings of the 2013 report:

• Medical identity theft is growing in volume, impact, and cost.
  Medical identity theft and fraud are major societal problems, placing enormous pressure on the country’s healthcare and financial ecosystems. In 2013, the economic consequences of medical identity theft to victims are estimated at more than $12.3 billion in out-of-pocket expenses. Fifty-six percent of victims lost trust and confidence in their healthcare provider. Fifty-seven percent of consumers would find another provider if they knew their healthcare provider could not safeguard their medical records.
• Medical identity theft can cause serious medical and financial consequences, yet most consumers are unaware of the dangers.
  Half of the consumers surveyed are not aware that medical identity theft can create permanent, life-threatening inaccuracies and permanent damage to their medical records. Medical identity theft victims surveyed experienced a misdiagnosis (15 percent of respondents), mistreatment (13 percent of respondents), delay in treatment (14 percent of respondents), or were prescribed the wrong pharmaceuticals (11 percent of respondents). Half of respondents have done nothing to resolve the incident.
• Most consumers don’t take action to protect their health information.
  Fifty percent of respondents do not take any steps to protect themselves from future medical identity theft. Fifty-four percent of consumers do not check their health records because they don’t know how and they trust their healthcare provider to be accurate. Likewise, 54 percent of respondents do not check their Explanation of Benefits (EOBs). Of those who found unfamiliar claims, 52 percent did not report them.
• Consumers often share their medical identification with family members or friends, putting themselves at risk.
  Thirty percent of respondents knowingly permitted a family member to use their personal identification to obtain medical services including treatment, healthcare products or pharmaceuticals. By sharing medical identification with family members or friends, consumers unintentionally leave themselves and their health records vulnerable. People do not know that they are committing fraud. More than 20 percent of people surveyed can’t remember how many times they shared their healthcare credentials. Forty-eight percent said they knew the thief and didn’t want to report him or her.

Consumers Can Take Action With These Seven Steps

MIFA recommends that individuals be the first line of defense in protecting their PHI; and suggests that individuals follow these seven steps:

1. Review your Explanation of Benefits (EOBs). Ensure the doctors listed and services provided are accurate. If you find an incorrect item, even if no money is owed, contact your insurance company immediately.
2. Obtain your “benefits request” annually. Your insurance provider can provide a list of all benefits and services paid in your name, which you can review to confirm all the services listed were received.
3. Protect your medical insurance card. Leave your insurance card in a safe place, and don’t carry it with you unless it’s necessary.
4. Safeguard your insurance-related paperwork. Shred or file your Explanation of Benefits in a safe, and preferably locked location.
5. Report lost or stolen health insurance identification cards. Alert your insurance carrier of misplaced, lost, or stolen cards to avoid unauthorized use.
6. Use vigilance when providing your personal or insurance information. Be sure you’re dealing with a reputable healthcare provider. Be cautious when offered free medical services. Often fraudsters use this as a way to obtain your health information.
7. Review your credit reports annually. You have a right to request a free annual credit report from each of the three credit bureaus. Be sure your reports are free of any medical liens.

About the Study

The 2013 Survey on Medical Identity Theft is based on survey research conducted this year, involving adult-aged individuals who self-reported they or close family members were victims of medical identity theft. The survey offers a detailed view of the complex issue of medical identity theft. Additional questions were added to expand the understanding of how victims were affected by the theft, the costs they incurred, and the actions they took to resolve the crime.

About Ponemon Institute

Ponemon Institute is dedicated to advancing responsible information and privacy management practices in business and government. To achieve this objective, the Institute conducts independent research, educates leaders from the private and public sectors, and verifies the privacy and data protection practices of organizations in a variety of industries.

About Medical Identity Fraud Alliance

MIFA is dedicated to helping its members better protect their organizations and consumers from medical identity theft and the resulting financial, physical and emotional damage it can cause. MIFA Founding Members include Florida Blue; Clearwater Compliance LLC; Global Patient Identifiers, Inc; GuideIT; Henry Ford Health System; ID Experts; Identity Finder, LLC; LifeMed ID; M2SYS Technology; Meditology Services; and TraitWare. Members provide leadership to: mobilize the healthcare ecosystem; cooperate to leverage collective power; research to adequately understand the problem and guide solution building; educate consumers, industry, legislators and regulators; and empower individuals to be the first line of defense in protecting their PHI. More information can be found at http://medidfraud.org/.

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Media Contacts:

Kelly Stremel or Lisa MacKenzie
MacKenzie Marketing Group
503-225-0725
[email protected]
[email protected]

Note to Media:

To schedule an interview with Dr. Larry Ponemon or the Medical Identity Fraud Alliance, please contact [email protected].