Access Intensive Counseling: Medical Identity Theft

According to The Federal Trade Commission "A thief may use your name or health insurance numbers to see a doctor, get prescription drugs, file claims with your insurance provider, or get other care. If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected."

Identity Theft Resource Center reports the number of U.S. data breaches hit a record high of 783 in 2014 and since the start of the year, three major health insurers (Anthem, Premera, Carefirst) have been victims of major data breaches, with up to about 92 million records affected.

The ramifications of having your medical identity stolen can range from financial to medical. Not only do medical records usually contain payment and billing information, leaving credit card information exposed, but they also often contain sensitive data like Social Security Numbers and information that could enable a thief to obtain medical services under the victim’s identity. If the perpetrator’s medical information mixes with the victim’s, they could receive medication to which they is allergic, or their record may even contain the wrong blood type and other incorrect information.

Both the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act in 2010 have incentivized and required that health care providers digitize their health information. Now, most health information is held electronically, creating more targets for hackers.

The Fededral Trade Commission suggests: Read your medical and insurance statements regularly and completely. They can show warning signs of identity theft. Read the Explanation of Benefits (EOB) statement or Medicare Summary Notice that your health plan sends after treatment. Check the name of the provider, the date of service, and the service provided. Do the claims paid match the care you received? If you see a mistake, contact your health plan and report the problem.
Other signs of medical identity theft include:

a bill for medical services you didn’t receive
a call from a debt collector about a medical debt you don’t owe
medical collection notices on your credit report that you don’t recognize
a notice from your health plan saying you reached your benefit limit
a denial of insurance because your medical records show a condition you don’t have

The Office of Inspector General - U.S. Department of Health and Human Services offers the following contact information:

Department Of Health & Human Services
Office Of Inspector General Hotline
Report suspected Medicare fraud:
Phone: 1-800-447-8477 (1-800-HHS-TIPS)
TTY #: 1-800-377-4950
Fax #: 1-800-223-8164
Online: OIG.HHS.gov/fraud/hotline
Medicare Call Center and Senior Medicare Patrols
Report questionable charges to Medicare
Phone: 1-800-633-4227 (1-800-MEDICARE)
TTY #: 1-877-486-2048
Online: medicare.gov
You can also contact your local Senior Medicare Patrols who work locally to empower seniors to fight health care fraud and resolve errors.
Phone: 1-877-808-2468
E-mail: info@smpresource.org
Federal Trade Commission's Identity Theft Hotline Report misuse of your personal information
Phone: 1-877-438-4338 (1-877-ID-THEFT)
TTY #: 1-866-653-4261
Online: FTC.gov/idtheft