MIFA addresses issues across a broad spectrum, exploring areas where medical identities may be compromised. Issues are addressed through collaboration within our working groups.

Medical Loss Ratio (MLR)

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.


Medicare Common Access Card Act

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.

MIFA Letter of support H.R. 3220
MIFA Letter of support S. 1871