The Dangerous Consequences of Medical Identity Theft

The 2013 Survey on Medical Identity Theft, sponsored by the Medical Identity Fraud Alliance, with support from ID Experts, finds that an estimated 1.84 million people are victims of medical identity theft in the U.S., costing victims an estimated $12.3 billion. Medical identity theft occurs when someone uses an individual’s name and personal identity to fraudulently receive medical services, goods, and/or prescription drugs, including attempts to commit fraudulent billing.

The Harmful Side Effects of Medical Identity Theft

What does this mean to individuals who have had their medical identities compromised? Money, for sure. In the Ponemon report, 36 percent of respondents paid an average of $18,860 in out-of-pocket expenses.

Yet, far more dangerous are the medical side effects. Corrupt medical records can and do lead to mistreatment, misdiagnosis, a delay in treatment, or being prescribed the wrong pharmaceuticals. One victim I know of nearly received a possibly fatal injection of penicillin because someone used his lost medical insurance card.

Ignorance Can Be Hazardous to Your Health

A recent paper by the Medical Identity Fraud Alliance^[1] cites the lack of awareness among professionals and consumers about the crime and its potential dangers. “Few people think of themselves as having a medical identity and thus the idea of someone stealing their medical identity is not even on their radar screen,” the report says.

In addition, few people understand—or even try to understand—their insurer’s Explanation of Benefits (EOBs). Fifty-six percent of respondents in the Ponemon report do not check their health records and EOBs for inaccuracies because they either don’t know how or said it’s too difficult.

But, as we noted in the Decade of Data Breach infographic, medical identities are the new “black market.” A stolen medical identity has exponentially higher street value than a Social Security number. Criminals are motivated to acquire and exploit medical identities.

The increased use of electronic health records and the Affordable Care Act will make it easier than ever for individuals, organizations, and even nations to steal and sell medical records. It is a societal issue that must be addressed at all levels, from individuals to providers to health plans. Criminals will always be around, but with the efforts of the Medical Identity Fraud Alliance and the healthcare ecosystem as a whole can make it a lot harder to commit these dangerous crimes.