Identity theft 101: what is medical ID theft?

August 3, 5:33 PMIdentity Theft ExaminerJoe Campana

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Medical identity theft occurs when an identity thief uses the personal identifiers such as a social security number of a victim to obtain medical care, services, products, insurance benefits or insurance.  A 2006 report on medical identity theft by The World Privacy Forum suggests that as many as a half million Americans have been victimized by this crime. Other reports suggest the number is growing and underestimated.  Detecting and reporting medical identity theft can be tricky for consumers. Many may be victims and don’t know it.

Social Security and Medicaid cards are
easy to forge.  Thieves may use them for 
medical, benefits, and other types of identity
fraud. All the thief needs is your name and 
Social Security Number to ruin your life.

Medical identity theft is potentially lethal to its victims. When the identity thief obtains medical treatment, medical records are created in the name of the victim. When treatment occurs in the same locality as the victim, the treatment of the thief can be appended to local medical records of the victim. With the strong movement towards  electronic medical records, all those under the victim’s name and social security number can be collated in seconds. Once the thief’s medical records are collated with the victim’s, there is a risk of mistreatment of the victim, which can potentially lead to death.

Lind Weaver, a retired school teacher, was harassed by a bill collector for a medical bill for the amputation of her foot.  The problem was that Weaver still had two feet.  Foot amputations are associated with diabetes, a disease that Weaver did not have. Months later Weaver suffered a heart   attack, when she awoke in the hospital a nurse asked her which type of drugs she was taking for her diabetes.  Had Weaver underwent heart surgery as a diabetic, mistreatment could have been life threatening.

Medical identity theft can affect your health and your finances too. Weaver was left to fight the $66,000 medical bill.  Brandon Sharp found thousands of dollars in medical collections on his credit report including $19,000 for medical air transportation.  Sharp checked his credit report just before applying for a mortgage to buy his first home.  The medical debt incurred by an identity thief prevented Sharp from obtaining a mortgage.

Joe Ryan, a pilot and aviation business owner (see video), had trouble obtaining business loans after an uninsured career criminal obtained a $44,000 kidney transplant  in Ryan’s name.

Medical privacy laws, for example the Health Insurance Portability and Accountability Act (HIPAA) can make it difficult for victims to review and correct their medical records. Although patients have a right to review their medical records under HIPAA, the medical records of an identity thief, posing as the victim, are protected by privacy laws.  (Government tax and social security records generated by an identity thief are similarly protected under privacy laws.)  When erroneous medical records are identified by a victim, health care workers confused by the complexity of HIPAA may use the law as a reason why the victim cannot have their medical records corrected.  It may be necessary for victims to have an attorney skilled in medical privacy laws to get involved to resolve the problems.

To detect medical identity theft, consumers should  review their medical records annually including their Medical Information Bureau (MIB) consumer profile. In addition, consumers should review carefully their medical bills and health care statements looking for treatments and procedures they did not receive. When monitoring credit reports note actions by collections agencies, in particular those for unpaid medical bills to detect medical identity theft.  Looks for clues, such as a sudden increase in health insurance premiums or your doctor asking you about conditions that you never had.