Medical Identity Theft

(HealthNewsDigest.com) - Imagine your personal medical information has been compromised by a security breach. Then imagine finding out that your personal information has been used by someone to obtain medical treatments and even prescription drugs. The gravity of this breach becomes even more serious when you receive an invoice for the treatment, or worse, find out medical information in your personal file has been changed.

Medical identity theft is the fastest-growing form of ID theft in America today and has become a growing global problem, with The World Privacy Forum estimating the number of victims to be between 250,000 to 500,000 people each year.

According to a Harris poll, the numbers are even higher than what the World Privacy Forum estimates, with approximately 4 percent of American adults, or nine million people, believing that they or a member of their family have had confidential medical information lost or stolen.

Medical identity theft can expose a person’s personal information, which can then be used by fraudsters to get medical treatments, benefits, prescription drugs and generally defraud the medical system. The victims of identity theft may ultimately receive incorrect medical treatment if their records have been altered. In a medical emergency, these fraudulent changes could lead to incorrect diagnoses and even death.

Cases of Medical Identity Theft are Growing

In the U.S., where the for-profit healthcare system creates incentives for hospitals and insurance companies to root out identity theft, an estimated 15 percent of claims are considered fraudulent.

From the standpoint of medical institutions, the consequences of medical identity theft may be significant. Healthcare providers may be assessed of heavy fines, legal expenses, bad publicity and reputation loss. According to Forrester Research Inc., in 2006 companies that experienced security breaches lost between one and $22 million, and with the Ponemon Institute's 2009 Cost of Data Breach Study placing the average cost of a breach across a range of organizations as high as $202 per record or $6.6million per breach, a patient data breach is potentially a debilitating event for any healthcare facility regardless of size.”
The Mechanics of the Breach

The moment a hospital admits a new patient, a medical record is initiated. Moving through different phases of the medical process, the record accumulates a multitude of details – from the patient’s lifestyle to symptoms, test results, diagnoses, treatment plans, procedures, insurance and personal information. These files, often kept in paper-based form, may continue beyond the original medical institution, making their way to other hospitals and clinics, family practice offices, insurance companies and health-related organizations.

In a hospital, many people may have access to patients’ confidential information. While most employees would never use this information for fraudulent purposes, some may, by exploiting it themselves or leaking it to thieves.

Security breaches may also result from the intentional or unintentional negligence of healthcare employees. While stories about medical files being dumped into recycling dumpsters or garbage containers – and even posted on the Internet – may sound anecdotal, such incidents do happen. These kinds of security breaches are becoming more common worldwide:

* Confidential documents left in unsecure recycling boxes or garbage bins.
* Lack of training for staff on what patient information should be protected and securely destroyed.
* Unsupervised medical files in file rooms or on desks.
* Lack of focus on document destruction due to budgetary concerns.
* Unsupervised or inadequate in-house document destruction facilities.

Furthermore, medical records also must be stored for a period of time, increasing the chances for a breach. Regular paper records are often kept for 10 years, and if it is a teaching hospital, or concerns a pediatric patient, hospitals may keep the records for 15 years or longer.

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