MIFA addresses issues across a broad spectrum, exploring areas where medical identities may be compromised. Issues are addressed through collaboration within our working groups.
U.S. health insurance plans are limited in their fraud prevention efforts due to the Medical Loss Ratio (MLR). The ratio limits “administrative” spending to 15 or 20 percent of premium monies collected from plan members, with 80 to 85 percent of funds spent on quality healthcare. This is to ensure that the majority of healthcare premiums are spent on improving and maintaining quality healthcare and administrative spending is kept within certain limits. Included within administrative expenditures are expenses related to “fraud reduction programs.” By hampering health plans’ full ability to expend funds and deploy robust fraud reduction programs, particularly related to identity fraud, the healthcare industry is vulnerable to negative health outcomes as medical identity theft and fraud continues to grow. An increasing number of medical records are being corrupted with erroneous medical information, putting the victims of this type of identity fraud at a serious health risk. Click here to learn more.
Click for MLR Quick Facts.
The Medicare Common Access Card Act is a bipartisan measure that seeks to reduce seniors’ vulnerability to medical identity theft by launching a pilot to remove the Social Security Number from the Medicare card and replacing it with a secure smart card. Medical identity theft and fraud exert enormous pressure on our healthcare and financial ecosystems, with billions of dollars in Medicare fraud lost every year. In Fiscal Year 2014 alone, the Government Accountability Office estimates that $60 billion was improperly paid to medical providers and suppliers. A modernized Medicare card would securely store sensitive information that is otherwise displayed on the Medicare card itself, thereby reducing seniors’ exposure to both medical and non-medical identity theft and making it harder to bill the government for fraudulent transactions.
Visit the Health ID Action Center to support the Medicare Common Access Card Act.
Learn How to Manage Medical ID Fraud
Industry Wisdom on Medical ID Fraud
Healthcare Industry Wisdom on Medical Identity Fraud offers food-for-thought on how healthcare organizations can implement and improve their anti-fraud programs. The paper spans across a variety of topics including fraud management, health IT issues and patient authentication.
Get the Healthcare Industry Investments paper
Investments to Fight Medical ID Fraud
Healthcare Industry Investments to Fight Medical Identity Fraud looks at the types of investments and priorities the industry is making to detect, prevent and mitigate medical ID theft and fraud.
Download the Survey
Survey on Medical ID Theft
The Fifth Annual Study on Medical Identity Theft measures the prevalence, extent, and impact of medical identity theft in the United States to consumers and the healthcare industry.
The Identity Theft Resource Center (ITRC) is proud to be a founding member of MIFA. Anyone can be a victim of medical identity theft and most individuals do not understand how it occurs, how to minimize their risk, or where to go for assistance. That is why the ITRC is committed to building awareness and educational tools for consumers and the medical community through various partnerships, such as MIFA.Eva Casey Velasquez, President/CEO, CIPA
Participation is open to all healthcare ecosystem stakeholders, including: health plans and healthcare providers; associations/consumer organizations; law enforcement and government agencies; academia and private research; and industry and technology service providers. Visit our Membership page or Contact Us.