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. […]

Cell phone? Check. Credit Card? Check. Health Insurance Card…? Most people are sure to protect their cell phone and credit cards. You should have the same sense of urgency to guard your health insurance card. Medical identity theft is a complicated, costly crime that is difficult to resolve, can negatively affect your reputation and potentially harm your health. It can happen simply by someone borrowing or stealing your health insurance card and using your information to: Have health services performed and file for reimbursement Bill for health services that didn’t happen File claims for health services or drugs not received […]

Action Line is written by Blair Looney, president and CEO for the Better Business Bureau serving Central California. Action Line: As promised in last week’s column, we are back on the topic of medical identity theft and what you can do if you are an unfortunate victim of medical ID theft. (Click here to read Part 1, Can someone steal your medical identity?) Let’s start with consumers. Here are ways you would know if you are a victim: Did you get a bill for something you did not receive? Have you been contacted by a debt collector for a medical […]

Action Line is written by Blair Looney, president and CEO for the Better Business Bureau serving Central California. Can that really happen? A reader asks: With all the identity theft that we hear about, the data breaches from large companies and credit cards being compromised, what is being done to keep my medical information safe? I’m starting to hear stories of medical ID theft. I just heard one where a person stole another’s identity and actually had cosmetic surgery with someone else’s ID and insurance coverage. Can that really happen? Action Line: Unfortunately, any and all are susceptible to any […]

Patient identity mix-ups can be disastrous, according to both common sense and statistics. A new report by the ECRI Institute, a nonprofit dedicated to improving patient care, revealed more than 7,600 cases of “wrong-patient” errors over a two-and-a-half-year period. In one instance, a patient died while undergoing cardiac arrest because the medical providers thought he had a do-not-resuscitate order. Another died after having the wrong surgery. The study focused on mistakes made by healthcare providers, but there’s another way you can be hurt by having the wrong information in your file: medical identity theft. And regulations intended to protect consumers […]

Senior citizens should be aware that scammers are using a false connection to Medicare to commit medical identity theft. Medical identity theft is different than regular identity theft in that someone uses your personal information to obtain medical care, buy prescription drugs, or submit fake billings in your name instead of setting up false credit cards or withdrawing cash. While there are a number of scams related to medical care, Medicaid or Medicare beneficiaries should be alert to a few common tactics criminals use when conducting a Medicare scam. One frequent method fraudster’s use is to pose as employees from […]

MIFA Strategic Partner launches Action Center to help reduce medical ID fraud for seniors. While the United States has made progress in moving towards a more modern healthcare system, significant work remains. There’s no disputing that our medical device and health technology companies are the most advanced on the planet, developing the solutions that are diagnosing diseases earlier, expanding treatment options, and improving quality of life. However, when it comes to healthcare and identity—making sure that the correct data is associated with the right patient, and ensuring that that information is able to be shared, analyzed, and acted upon in […]

The opportunities for the mistakes, which can be deadly, are increasing as health care becomes more complex. A patient in cardiac arrest was mistakenly not resuscitated because clinicians confused him with a patient who had a do-not-resuscitate order on file. Another patient was given an okay to undergo surgery based on a different patient’s records and was found dead in his hospital room the next day. Such patient-identification mix-ups are common and can have deadly consequences, according to a report from the ECRI Institute, a nonprofit research group that studies patient safety. The report analyzed 7,613 cases of so-called wrong-patient […]

In 2014, medical identity theft cases jumped an estimated 22 percent compared with the prior year. Someone steals your wallet and uses your health insurance card to buy prescription painkillers. Or a family member “borrows” your insurance coverage and racks up medical bills that you’re stuck with. Or someone pilfers your Medicare card to fraudulently access federal benefits in your name. All are examples of medical identity theft, an increasing threat in the digital age by cyberthieves who gain access to personal information, such as medical data, health insurance records and Social Security numbers. In 2014, medical identity theft cases […]

Thieves use insurance information for surgeries, prescription. Medical identity theft is a crime on the rise. Nearly 2.5 million cases were reported in 2014, an increase of 20 percent from the year before. A stolen medical identity can ruin finances, compromise medical treatment and cause legal problems. If a thief steals a person’s medical identity, he or she can use it to get expensive surgery and medical goods. Cleaning up the bills can take years and can also negatively affect a person’s credit score. According to the Medical Identity Fraud Alliance, once a person’s medical record is mixed with a […]