Consumer Federation of California

Medical identity theft is a national healthcare issue with life-threatening and hefty financial consequences. According to the 2013 Survey on Medical Identity Theft conducted by Ponemon Institute, medical identity theft and “family fraud” are on the rise, with the number of victims affected by medical identity theft up nearly 20 percent within the last year.

Key Findings of the 2013 Survey on Medical Identity Theft
Feedback was collected from several government agencies to develop the survey to measure the prevalence, extent, and impact of medical identity theft in the U.S. to consumers and the healthcare industry. Following are key findings of the report:

Medical identity theft is growing in volume, impact, and cost.

Medical identity theft and fraud are major societal problems, placing enormous pressure on the country’s healthcare and financial ecosystems. In 2013, the economic consequences of medical identity theft to victims are estimated at more than $12.3 billion in out-of-pocket expenses. Fifty-six percent of victims lost trust and confidence in their healthcare provider. Fifty-seven percent of consumers would find another provider if they knew their healthcare provider could not safeguard their medical records.

Medical identity theft can cause serious medical and financial consequences, yet most consumers are unaware of the dangers.

Half of the consumers surveyed are not aware that medical identity theft can create permanent, life-threatening inaccuracies and permanent damage to their medical records. Medical identity theft victims surveyed experienced a misdiagnosis (15 percent of respondents), mistreatment (13 percent of respondents), delay in treatment (14 percent of respondents), or were prescribed the wrong pharmaceuticals (11 percent of respondents). Half of respondents have done nothing to resolve the incident.

Most consumers don’t take action to protect their health information.

Fifty percent of respondents do not take any steps to protect themselves from future medical identity theft. Fifty-four percent of consumers do not check their health records because they don’t know how and they trust their healthcare provider to be accurate. Likewise, 54 percent of respondents do not check their Explanation of Benefits (EOBs). Of those who found unfamiliar claims, 52 percent did not report them.

Consumers often share their medical identification with family members or friends, putting themselves at risk.

Thirty percent of respondents knowingly permitted a family member to use their personal identification to obtain medical services including treatment, healthcare products or pharmaceuticals. By sharing medical identification with family members or friends, consumers unintentionally leave themselves and their health records vulnerable. People do not know that they are committing fraud. More than 20 percent of people surveyed can’t remember how many times they shared their healthcare credentials. Forty-eight percent said they knew the thief and didn’t want to report him or her.

Consumers Can Take Action With These Seven Steps

• Review your Explanation of Benefits (EOBs). Ensure the doctors listed and services provided are accurate. If you find an incorrect item, even if no money is owed, contact your insurance company immediately.
• Obtain your “benefits request” annually. Your insurance provider can provide a list of all benefits and services paid in your name, which you can review to confirm all the services listed were received.
• Protect your medical insurance card. Leave your insurance card in a safe place, and don’t carry it with you unless it’s necessary.
• Safeguard your insurance-related paperwork. Shred or file your Explanation of Benefits in a safe, and preferably locked location.
• Report lost or stolen health insurance identification cards. Alert your insurance carrier of misplaced, lost, or stolen cards to avoid unauthorized use.
• Use vigilance when providing your personal or insurance information. Be sure you’re dealing with a reputable healthcare provider. Be cautious when offered free medical services. Often fraudsters use this as a way to obtain your health information.
• Review your credit reports annually. You have a right to request a free annual credit report from each of the three credit bureaus. Be sure your reports are free of any medical liens.

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Read more:

• Your Medical Privacy Rights
• Health Information Portability and Accountability Act (HIPAA)
• Confidentiality of Medical Information Act (CMIA)
• Submit a Medical Privacy Complaint
• Recent California Medical Privacy Legislation
• Other States’ Medical Privacy Laws
• Medical Privacy in the News