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Largely a family affair, medical identity theft on the rise

Survey finds this crime is on the rise and leads to average cost of $18K-plus to resolve

By , Network World
September 12, 2013 02:36 PM ET

Network World - Medical identity theft is the act of using an individual's name and identity credentials, including insurance information, to fraudulently obtain medical care or medicine as well as to submit bogus bills. A survey out Thursday asserts such activity is up almost 20% vs. a year ago.

The “2013 Survey on Medical Identity Theft” asked about 43,000 people in the U.S. if they or family members had suffered this type of fraud and what it cost them. Almost 2% said they had experienced medical identity theft. Of these, 42% said they had private insurance, 24% had Medicare or Medicaid, and 21% were not insured at all, with the remaining respondents in the survey citing various health savings accounts, coop plans or other means to pay medical costs.

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Credit: Wikimedia.org

More than one-third of the victims of medical identity theft said they had to pay an average of $18,660 related to problems stemming from reimbursements to healthcare providers to pay for services to imposters, legal fees, or lapse in healthcare coverage.

RELATED: Health insurance credentials raise the cost of identity theft kits in underground marketplaces

Half of the victims said they didn’t know that medical identity theft can create inaccuracies in their permanent medical records, which might even lead to misdiagnosis and medical errors in prescriptions. More than half of victims said they lost confidence in their healthcare provider following the loss of their medical credentials. However, most of the other victims said they had no financial or healthcare consequences after becoming a victim of medical identity fraud.

The survey, conducted by Ponemon Institute and sponsored by the Medical Identity Fraud Alliance with support from ID Experts, offered insight into how medical identity theft happens.

Some 30% of survey respondents admitted knowingly permitting a family member to use their personal identification card to obtain medical services and pharmaceuticals, the report points out.

“Fifty-three percent said they did it once. However, 21% could not count the number of times they shared their identification,” the report says.  

These respondents to the survey said they fraudulently shared their medical I.D. credentials as a way to help both family and non-family get medical care, often believing the person they were giving their ID to couldn’t afford to pay or had no insurance. The survey found the average age of respondents who admitted they share their medical credentials is 40 years old and had an average household income of $45,801.

Those who didn’t share their medical credentials were on average 36 years old with an average household income of $69,309.
Fifty-eight percent of those who shared are women, whereas the no-share group was 52% male, according to the survey. The type of insurance also factored in, with respondents who have private insurance less likely to share their medical credentials than those with government insurance.

Twenty-eight percent of the time, a family member took the personal identification or medical credentials without consent. Most of the remainder of the incidents of medical identity theft stemmed from personal information having been stolen, either through a data breach or an employee in the healthcare provider’s office stealing it, though 14% claimed they “don’t know” how it happened.

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