Your Medical Records, Stolen! (page 5 of 6)

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When Professionals Are Dishonest

But photo IDs won't stop one of the most insidious forms of medical identity thieves: insiders who fabricate care on real patients for profit. The crooks can be anyone with access to your medical info -- nurses, receptionists, pharmacists and, rarely, even doctors. The most egregious case involved Boston-area psychiatrist Richard Skodnek, who was convicted in 1996 on 136 charges and ordered to repay the government and insurance companies nearly $1.3 million.

The case also reveals how difficult it can be to recover from medical identity theft. Among Skodnek's victims is the family of Debra Harritt of Natick, Massachusetts. In 1991, after suffering a family crisis, Harritt and her then-husband began seeing Skodnek. Shortly thereafter, the couple split up, and Skodnek was arrested for Medicare fraud. Soon Harritt discovered that Skodnek had been double-dipping -- billing Blue Cross Blue Shield for visits that she and her husband had paid for out of pocket.

But the worst was yet to come. Skodnek gave Harritt's son and daughter, whom he'd never seen, psychiatric diagnoses and billed Blue Cross.

Harritt, who testified against Skodnek, spent months trying to get her kids' medical and insurance records corrected. "Theoretically, that information was removed," says Harritt. "But a woman at Blue Cross admitted that the information was probably still archived in backup computer files."

Skodnek lost his license to practice medicine in Massachusetts, was barred from participation in federal and state health care programs, and served time at the Allenwood Federal Penitentiary -- "the one they call the Country Club," notes Harritt with a sigh. "I wanted him to do hard labor."

Ganging Up on Patients
Medical ID theft is beginning to attract organized-crime rings, adding a new dimension to the problem. Last year, California authorities busted a group led by Ukrainian twin brothers Alexander and Leonid Dzhuga, who had allegedly set up a phony health clinic in Milpitas, near San José.

According to the indictment, the Dzhugas and their associates lured Medicare patients to the clinic by dangling free transportation and baby formula. Phony doctors performed cursory exams and ordered ultrasound tests, then billed Medicare. Meanwhile, patients had no idea their medical information was copied so more fake treatments could be filed. (The defendants are awaiting trial.) Experts say organized medical fraud can be particularly damaging because the theft is deliberately spread among numerous patients, using small, routine claims like ultrasound exams to avoid detection.