2016 Healthcare Industry Wisdom on Medical Identity Fraud Healthcare Industry Wisdom on Medical Identity Fraud is a collection of expertise by anti-fraud experts to help businesses within the healthcare industry better understand how to deal with medical identity fraud. It offers various food-for-thought on what a healthcare organization or business associate might consider when building or fine-tuning their anti-fraud programs. Topics discussed in the paper include a look at the Medical Loss Ratio mandate and how it may be affecting health plans’ ability to invest more heavily in fraud prevention, health IT issues, and patient authentication. Key points include: 1. […]

Health care organizations have increasingly become the target of hackers. The data breach of Anthem, the second-largest U.S. health insurer, was among the major headlines of 2015. The breach, which exposed private data of as many as 78.8 million customers, was the result of a cyberattacks attributed earlier this year to someone acting on behalf of a foreign government. While health care industry breaches of this magnitude may be infrequent, health care organizations have increasingly become the target of hackers. One of the reasons is the value of medical identity records on the dark web. Because they have a much […]

By hacking an insurance company or hospital, criminals can access all of your sensitive information in one fell swoop. This year is already on track to topple 2016’s record-breaking 1,093 data breaches. In the first six months of 2017, 791 data breaches have already been reported, according to a report from the Identity Theft Resource Center and CyberScout. This is a 29% increase compared to this time last year. Data breaches have become so common that credit card numbers are virtually worthless on the black market because there’s so many available. That’s disturbing in itself, but what’s even more scary […]

Medical identity theft is on the rise and hackers are being more creative about obtaining personal medical information. In fact, a recent study by researchers at Michigan State University found nearly 1,800 incidences of large data breaches in patient information over a seven-year period from October 2009 to December 2016. In the U.S., medical identities are 20 to 50 times more valuable to criminals than financial identities. According to BankRate.com, the average cost for victims of medical identity theft is $22,000 to resolve the crime. And, the impact can go well beyond financial. For example, a fraudster could use your […]

Having your Social Security number removed from your Medicare card helps fight medical identity theft. Changes are coming to your Medicare card. By April 2019, your card will be replaced with one that no longer shows your Social Security number. Instead, your card will have a new Medicare Beneficiary Identifier (MBI) that will be used for billing and for checking your eligibility and claim status. And it will all happen automatically – you won’t have to pay anyone or give anyone information, no matter what someone might tell you. Having your Social Security number removed from your Medicare card helps […]

New research suggests that your personal health information may be at higher risk of exposure in certain types of hospitals. But there are steps you can take to secure your info. You may never have considered whether your preferred hospital is one of the approximately 311 major teaching hospitals in the U.S., but according to a new study, the type of hospital you choose might affect your privacy. Teaching hospitals are often affiliated with medical schools, which use the facilities to help train future doctors. And the new report, published Monday in JAMA Internal Medicine, found that these hospitals—which tend […]

Criminals know there are dollars in data and that monetizing medical records is a lucrative pastime. This trend could foreshadow the next evolution of medical identity fraud. Cyber criminals could sell medical identities to uninsured or underinsured individuals, peddle pharmaceuticals online, obtain and resell expensive medical equipment, or simply file insurance claims by matching up stolen patient and provider identities. A recent report by Accenture Consulting found that 35 percent of victims reporting medical identity fraud had their identities used for fraudulent billing and 26 percent, for fraudulent services. Ponemon Institute’s earlier study found that 59 percent of victims’ medical […]

Pennsylvania residents are receiving phone calls from people asking them to switch their health insurance from their current carrier to the “Pennsylvania Department of Health’s plan.” It’s a scam. The state health department and the Erie County Department of Health provide medical services to uninsured or underinsured Pennsylvanians, but they do not provide insurance. It appears scammers are trying to get valuable medical information, including your Social Security number, health insurance account numbers or even details about your health. It’s called medical identity theft. Criminals can use this information to schedule office visits, order prescription drugs or even file health […]

The state of Florida has released a resource guide to help residents prevent identity theft. The guide offers information about the many forms of identity theft, ways consumers can further protect private information and steps to take if identity theft occurs, officials said. Identity theft occurs when someone uses or attempts to use the private personal information of another person to commit fraud, typically for economic gain. Tax identity theft has been the most common form of identity theft reported to the Federal Trade Commission for the past five years, state officials said. However, there are other ways scammers can […]

Study also finds that half of these victims were subject to medical identity theft and on average had to pay $2,500 in out-of-pocket costs per incident. Twenty-six percent of U.S. consumers have had their personal medical information stolen from healthcare information systems, according to results of a new study from Accenture released at HIMSS17 in Orlando. Among those who experienced a breach, 50 percent were victims of medical identity theft, the survey found. Most often, the stolen identity was used to purchase items (cited by 37 percent of data-breached respondents) or used for fraudulent activities, such as billing for care […]

As medical identity theft continues to rise, so does its impact on the healthcare industry and patients. Prevention is possible with the right health IT solutions. In 2014, nearly 9 million patient health records were breached in 164 reported incidents. By March 2015, that number had increased tenfold. In fact, it is estimated that one in three health records were compromised during 2016 alone.1 Records can be physically stolen from medical facilities, so it is important to prevent data acquisition in this manner. But with the prevalence of health IT systems in place, cybersecurity—not just on the backend, but with […]