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MIFA Shares Industry Wisdom on Medical Identity Theft and Fraud

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Last year, more than 113 million healthcare records were exposed or stolen as a result of healthcare data breaches. With so much healthcare data available it is no surprise that medical identity fraud is increasing. Medical identity fraud is now the fastest-growing type of identity fraud. Each year, more than two million individuals in the United States discover their medical data have been fraudulently used by cybercriminals and the problem is getting worse.

Medical identity fraud involves the use of personally identifiable information (PII) and protected health information (PHI) to fraudulently obtain medical services, healthcare devices, and prescription medications. False identities are also used for fraudulent healthcare billing.

Medical identity theft can have a devastating impact on patients. Victims incur an average of $13,500 in out-of-pocket expenses after their identities have been stolen. Losses can be considerably higher. Medical identity fraud can go undetected for long periods of time and healthcare patients are not protected by the same legislation that protects them against credit card fraud. While the Fair Credit Billing Act limits losses to $50 for credit card fraud, victims are not protected from medical identity fraud. Patients may face a lifetime of financial hardship because of the misuse of their healthcare data.

The impact on patients is not just financial. Medical identity fraud can have a negative impact on patient health. Victims may be denied medical services due to fraudulent use of their data, while the identity thief’s medical treatment and medical history can become mixed up with the victim’s electronic health records.

According to the Medical Identity Fraud Alliance (MIFA), approximately 20% of victims of medical identity fraud have had an incorrect diagnosis and treatment or have experienced delays in receiving medical care as a result of fraudulent use of healthcare data.

Medical identity fraud also has a negative impact on healthcare organizations and on the industry as a whole. There is growing distrust as a result of data breaches, while patients are now more apprehensive about sharing their data with healthcare providers. Patients are also more likely to switch providers because of data breaches and identity theft.

To raise awareness of the problem and to help healthcare organizations prevent medical identity theft and fraud, MIFA has released a new white paper to help healthcare organizations with their detection and mitigation efforts.

As MIFA explains, “There is no silver bullet to preventing fraud and no one-size-fits-all solution,” although a multi-layered strategy can be adopted which can help healthcare organizations reduce risk in all areas of their business. By adopting a number of protocols, processes and technologies, the damage caused by medical identity theft and fraud can be reduced.

The MIFA white paper can be downloaded here.

Author: HIPAA Journal

HIPAA Journal provides the most comprehensive coverage of HIPAA news anywhere online, in addition to independent advice about HIPAA compliance and the best practices to adopt to avoid data breaches, HIPAA violations and regulatory fines.

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