Health Information Management

Medical identity theft: Part 1

Briefings on HIPAA, July 1, 2016

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Protecting patients' identities

Medical identity theft: Part 1

Editor's note: This is part one of a series about medical identity theft. Look for part two in an upcoming issue of BOH.

Privacy and security officers are sitting on a hoard of valuable data: medical identity information. Social Security numbers. Medicare, Medicaid, and other insurer numbers. Credit card and bank account information. This data can fetch a high price on the black market, and medical identity theft costs patients, providers, and insurers millions of dollars a year. The lure of medical identity information makes healthcare organizations an appealing target for criminals, from large operations launching sophisticated hacking schemes to smaller groups running tried and true fraud scams.

A 2015 study conducted by the Ponemon Institute and sponsored by the Medical Identity Fraud Alliance (MIFA), the Fifth Annual Study on Medical Identity Theft, found that medical identity fraud nearly doubled between 2010 and 2014. More than 2.3 million adults were victims of medical identity theft and fraud in 2014 alone. The average cost per victim was $13,500 and the combined out-of-pocket cost was approximately $20 billion. But the financial impact is only the tip of the iceberg. Medical identity theft can result in physical harm to a patient if the medical record is altered to include another person's information such as allergies, disease status, or blood type.

Healthcare organizations often absorb some of the costs, and if the stolen PHI was used to commit Medicare or Medicaid fraud, they could be investigated by the OIG.

The stakes are high but by raising awareness and championing education and robust security programs, privacy and security officers can help their organizations stay one step ahead of criminals.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on HIPAA.

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