Medical identity theft hurts employers too

Vicki Lee Blair, a 63-year-old former computer analyst from Westminster, Calif., had the surprise of her life. Blair went to a clinic seeking antidepressant medication. She said she was shocked when clinicians bombarded her with questions about a blood test in her file indicating thyroid problems and illegal drug use.
She insisted the records were inaccurate, potentially the result of an identity theft that occurred a year earlier. And like most victims, her response was, “I never thought this could happen to me.”
Unfortunately, statistics show that it is likely to happen to Vicki, as well as many others.
Medical identity theft affects an estimated 1.5 million people in the U.S. at a cost of $41.3 billion, according to the Ponemon Institute, a research center focused on privacy and data security. The crime has grown as health care costs have swelled and job cuts have left people without employer-subsidized insurance.
A child-protection services worker recently accused a woman of giving birth to a child that had tested positive for methamphetamine, although she hadn’t given birth in more than two years. After investigating the phone call, the Salt Lake City mother of four realized she had been the victim of medical identity theft. Turns out a pregnant woman strung out on drugs gave birth using her name and her medical insurance to pay for it. The victim was now in danger of losing her children.
But convincing medical investigators that she hadn’t given birth wasn’t easy. “I said I had not recently had a baby, that my youngest was 2 years old,” the victim explained. “I said, ‘Come meet me and you’ll know that I didn’t just have a baby.’ ” Investigators still made her life a living hell, she said, questioning her employers and interrogating her children.
Individuals are not the only ones impacted by medical identity theft. The collateral damage can also be felt in the workplace, where the result is often significant increases when it comes renewal time, both in employer premiums and employee contributions. And very often hospitals are in no hurry to help the recovery process as they have, in most cases, already been paid their premiums. To many victims, this feels like a clear-cut case of not being accountable to a problem that may have arisen from a hospital or medical facility having their data either physically stolen or cyber-stolen. “What makes it so difficult is you have to go provider by provider, hospital by hospital, office by office and correct each record,” said Sam Imandoust, a legal analyst with the Identity Theft Resource Center.
Some forms of identity theft can take as little as a few days to resolve, since banks and other financial institutions are generally equipped to handle the complaints. But medical identity thieves typically get treatment at five facilities or more, and the system isn’t set up to fix those kinds of errors. In another case, a man received a $44,000 bill for surgery he never had. “The hospital actually thought that I was going make this $44,000 payment, and here I was proving to them I had no scars from a surgery,” he said.
A few individuals are doing what it takes when it comes to making hospitals accountable. According to CBS/New York, 12 people filed a $50 million lawsuit against a New York City hospital after medical records with their personal information were stolen. They claimed since fall 2010, medical records with full names, addresses, Social Security numbers, dates of birth, medical histories and other information were stolen from the hospital.
There are ways to fight back, or at the very least keep things in check. For instance, make it a point to keep your eye on the explanation-of-benefits form sent by your health insurer. Check your medical records frequently as thieves can alter information. Don’t let somebody play games with your life. If you see inaccuracies on your medical records, make every effort to fix them. But be forewarned, unless you are a trained expert at such things, it can be a very daunting task. In general, federal law lets patients correct medical records created only by the medical provider or insurer that now maintains your information. A hospital or insurer that later receives your information doesn’t have to correct its records – even when they’re wrong. But you do have the right to have your records state that you disagree with the information, and why.
Be sure your complaint is entered into your records.
The seriousness of medical identity theft has not been lost on employers, who have now started offering recovery service to their employees as a value-added benefit, which is important because it can sometimes take hundreds of hours to correct mistakes, hours that are often spent on company time.
These benefits can usually be offered by the company’s insurance agents and brokers, who have now viewed offering an ID-theft recovery package as a way to not only bring value to their clients but as a substitute for lost commissions which have started to fall by the wayside over the past 10 years or so with the economic crunch.
When it comes to such theft it’s not a question of “if” but “when.” So when it happens, the key is to find out the information as quickly as possible and then sign on with a company that will conduct the recovery as rapidly and painlessly as possible. •


Christopher Durso is CEO and co-founder of ID Theft Solutions USA, based in Mahwah, N.J.

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