From a Boston psychiatrist who submitted false bills to insurance companies, marring the medical records of several patients, to a Florida woman who found an impostor had led a hospital to record a false blood type causing a potentially fatal error, experts say medical identity theft is becoming more pervasive.
The San Diego County district attorney’s office and nonprofit groups that have done extensive studies on the issue say it is underreported and difficult to detect. Federal reports say there are at least 200,000 medical identity fraud victims each year.
Like elsewhere, it’s difficult to gauge its penetration in San Diego. But some local hospitals have taken preventive measures, acknowledging the risk.
One way medical identity thieves work is by using a stolen or fake ID to obtain medical services. Using another’s name with a false billing address could mean that neither the thief nor the victim ever sees the bill, experts say.
Ruining Job Prospects
The shocking real-life examples come from a report called “Medical Identity Theft: The Information Crime That Can Kill You,” from the San Diego-based World Privacy Forum, a nonprofit group.
False conditions on medical records can ruin prospects for a new job, as more than a third of Fortune 500 companies review medical records when hiring, according to the Austin, Texas-based Patient Privacy Rights Foundation.
Erroneous information gets re-reported from hospitals and doctors’ offices to insurers, collection agencies and credit bureaus. And since the health care industry’s information technology is not yet centralized, as in the banking industry, victims have more difficulty reversing the damage.
“It may even be difficult to get your record to correct it,” said Tena Friery, research director at the San Diego-based Privacy Rights Clearinghouse.
These privacy rights groups, which help consumers nationwide, say parts of the Health Insurance Portability and Accountability Act, or HIPAA, which is meant to protect patient privacy, have stood in the way of consumers who want to fix their medical records following medical identity theft.
“You can only correct your own record, so if it might not be your record in the first place, you can see why the medical provider would not give you the record,” Friery said.
HIPAA does have a provision that allows consumers to see and ask to correct information. Doctors or health plans must respond within five working days of a written request, according to the California Department of Consumer Affairs. If they deny the request, they must give a reason, and the patient has the right to add a statement to his or her file, adding or explaining information.
Identity theft has been the fastest growing crime in the country for the past six years, said Keith Burt, a deputy district attorney who oversees the San Diego County district attorney office’s identity theft unit.