Health Information Management

New guidelines for preventing and remedying medical identity theft

HIM-HIPAA Insider, November 25, 2013

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by Jaclyn Fitzgerald, Associate editor

The State of California Department of Justice Office of the Attorney General recently released a report featuring new guidelines for the prevention and remedy of medical identity theft. AHIMA and various industry professionals contributed to the development of the guidelines in the report, entitled Medical Identity Theft: Recommendations for the Age of Electronic Medical Records.

Medical identity theft is a quality-of-care issue because it corrupts medical records with information that can result in incorrect diagnoses and treatment, according to the report. The Ponemon Institute’s 2013 Survey on Medical Identity Theft revealed that the number of medical identity theft victims increased 20% in the past year. The survey also found that instances of ‘family fraud,’ in which a person uses a family member’s insurance information with or without permission, is on the rise. Instances of ‘family fraud’ will likely decline as more uninsured and underinsured Americans receive coverage as the Patient Protection and Affordable Care Act takes effect, according to the report.

However, in the meantime, healthcare professionals can follow some guidelines in an effort to reduce medical identity theft:

  • Build system capabilities that can assist in the prevention, detection, investigation, and mitigation of medical identity theft.
  • Adopt policies and standards that recognize the possibility of medical identity theft. Include specific policies relating to medical identity theft as part of privacy and security policies and procedures.

The report also outlined recommendations for providers, payers, and policy makers. HIM professionals should be actively involved in the prevention of medical identity theft because they “play a key role in safeguarding health information, and helping address issues when questions of identity theft occur,” AHIMA CEO Lynne Thomas Gordon, RHIA, MBA, CAE, FACHE, FAHIMA, said in a press release.

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