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Medical Identity Theft: On the Rise
Incidents often go undetected or unreported, but comprehensive research conducted by the World Privacy Forum suggests anywhere from 250,000 to 500,000 Americans have already been victims.It's hard to tally the cost, but fraud is estimated to account for as much as ten percent of all health care costs. It's not known how much of that is from medical identity theft.
As Ryan discovered, money isn't the half of it. When someone steals your name to receive health care, his medical history becomes part of your record -- and setting the record straight can be extremely difficult. That's because, in part, the information is dispersed among dozens of caregivers, from doctors to pharmacies to insurance companies and labs.
Incorrect entries can prevent you from getting insurance, disqualify you for some jobs, and even lead to injury or death. Imagine arriving at the emergency room with a ruptured appendix, and your medical record shows (erroneously) that your appendix has already been removed. Doctors might waste valuable time looking for other causes.
In 2000, Florida resident Linda Weaver told a Federal Trade Commission workshop that shortly after her daughter's wallet -- which contained a family insurance card -- was stolen, someone began receiving medical care in Linda's name. She was shocked to find her blood type had been changed in a hospital record. "It could have been tragic," she told the FTC.
To make matters worse, medical identity theft is largely a hidden crime. Some people find out through billing agencies, or when insurance companies send "explanation of benefits" letters that include obviously fraudulent claims. Still others learn when insurance coverage is denied because they have inexplicably reached their benefit cap, or when their records indicate a life-threatening disease they don't have. Many more people may never realize they've been targeted by more sophisticated crooks, who change billing addresses and phone numbers to avoid detection.
"It's clearly a growing problem," says Pennsylvania Attorney General Tom Corbett. "Medical care is very expensive, and there are people who just don't want to pay, or can't." So far, the cases in Pennsylvania have involved small-time drug peddlers and health care freeloaders. But already other states are seeing a disturbing connection with organized crime.
Experts point to several distinct versions of the crime that consumers should look out for.
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