Medical Identity Theft

What is medical identity theft? In this serious and growing problem, someone else uses your personal information to obtain medical goods or services. Medical identity theft affects consumers, health care providers, and insurance organization. According to the Federal Trade Commission (FTC), medical identity theft accounts for about 3 percent of all identity theft, and the World Privacy Forum claims it’s the most difficult form of identity theft to correct.

When you are the victim of medical identity theft, incorrect information about diagnoses and treatments may appear on your medical records, potentially affecting your health care providers’ decisions about your care and treatment. Also, in addition to paying for treatment you didn’t receive, in some cases you might be denied treatment or coverage because of fraudulent medical or insurance information.

But there is some good news: HIPAA (the Health Insurance Portability and Accountability Act) regulations and the Identity Theft Protection Act, already in place, give you many of the tools you need to get errors corrected at your doctor’s office and with your insurance provider. Of course, like any crime, you’re better off preventing it from happening in the first place.

Spotting Medical Identity Theft

Among other signs, the FTC states that you may be a target of a potential medical identity theft or fraud if you are charged for medical services you didn’t receive. Keep a calendar to track your appointments, treatment dates, and any hospital admission and discharge dates. If the explanation of benefits from your insurance provider or Medicare isn’t exactly right, clear up the error as soon as possible.

Medical receipts, prescription drug information, health insurance forms, and any documents bearing your health care providers’ names might be all a clever thief needs to begin off-loading other medical claims to you. If you don’t need to keep medical documents, shred or burn them, and peel off labels from your prescription medications before recycling the containers.

Legal Protection to Combat Medical Identity Theft

The Identity Theft Protection Act of 2005 requires any commercial, charitable, educational, or non-profit organization that acquires or uses sensitive personal data to provide significant administrative, technical, and physical safeguards to prevent that data from being mishandled.

The same act that allows consumers to place a freeze on their credit reports also requires any covered entity to investigate suspected misappropriation of personal medical data and to do everything possible to correct resulting inaccurate medical information and billing problems.