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Scams & Fraud
by Katharine Greider and Sid Kirchheimer, AARP Bulletin, March 23, 2009
With as many as 9 million Americans victimized by identity theft each year, according to the Federal Trade Commission (FTC), there’s good reason to monitor and protect those items essential to your life—your credit cards, bank accounts, credit history, driver’s license and Social Security number.
But while the rapid growth of ID theft has spurred a flurry of credit-monitoring services and greater awareness of protecting financial records, less attention has been paid to perhaps an equally dangerous crime—medical identity theft, which can compromise life itself.
Medical identity theft occurs when someone uses your name or other parts of your identity—such as your health insurance—to obtain health care services for themselves or make false claims for medical treatment. Not only can you can be stuck for those expenses, leading to your own financial ruin, but the scam can jeopardize your own future treatment.
Until now, only about 250,000 Americans have been victimized by medical identity theft, according to FTC statistics—one reason, perhaps, is that this crime has largely flown under the radar. But a new government report says that medical identity theft is “an emerging issue that raises concerns for consumers, health care providers, health plans, government, and others.”
With Obama administration efforts to computerize patient health records—part of the economic stimulus package—some experts suggest that e-records (EHRs) can provide an even greater “open window” for this crime. And older Americans are perhaps most vulnerable.
“People 50 and older are at the greatest risk, because they often have some kind of government-issued insurance, such as Medicare or Medicaid,” says Pam Dixon of the World Privacy Forum, a consumer protection advocacy group. “That’s a big lure for the scammers, because the system is so large and automated that the government doesn’t really do medical insurance fraud alerts.”
In addition to fraud that can damage your finances, medical identity can lead to getting the wrong medications or treatment. Several years ago, Janet, who does not want her real name revealed, noticed that her pharmacy printed the wrong address on a prescription bottle. When she received a letter from her insurance company asking her to confirm a four-page list of drugs prescribed in her name, she realized she was a victim. Most of the drugs listed were narcotics she’d never taken.
“I thought maybe there was some mix-up, two people with the same name cross-referenced in the computer somehow,” she recalls. But for years, apparently, someone else had been seeing dozens of doctors—using Janet’s name and insurance number.
Because victims may not get a bill, medical identity theft can be harder to detect than other financial identity crimes. And once suspected, it’s harder to fix. That’s because there could be problems pinpointing the source of bogus information that could be held by various parties—doctors, insurers, pharmacies and labs. And although patients have a legal right to request amendments to their records, doctors and insurance companies can easily say no, wanting to do their investigation before altering records.
To prevent medical identity theft, more health care facilities are asking patients for picture identification. But some scammers with access to private health records can get fake picture IDs of their victims. That means it’s often up to you to take measures to protect your medical identity. Here’s how:
If you note errors or suspect identity theft, immediately call the billing physician and request that your file be amended. Also, notify the office of your state attorney general and the regional office of the Centers for Medicare & Medicaid Services, if you receive those services.
Sid Kirchheimer is the author of "Scam-Proof Your Life" (AARP Books/Sterling). Katharine Greider is a freelance health writer and author of "The Big Fix."
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