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Medical Identity Theft Affecting 1.84 Million U.S. Victims

Consumer awareness lacking, as industry group is formed to address issue

by: John Gaspari

Medical identity fraud has increased nearly 20 percent compared to the year before in the U.S., affecting an estimated 1.84 victims and having a total out-of-pocket medical cost incurred by medical identity theft victims to be $12.3 billion. Those are takeaways of the 2013 Survey on Medical Identity Theft, an annual survey now in its fourth year, which released yesterday by the Ponemon Institute LLC, Traverse City, Mich., and sponsored by Portland, Ore.-base ID Experts. The report’s release roughly coincided with the launch (on August 29) of the Medical Identity Fraud Alliance (MIFA), an industry group formed to raise public awareness of the issue and to come up with potential ways to address the medical identity theft issue.

(For the purposes of the study, medical identity theft occurs when someone uses an individual’s name and personal identity to fraudulently receive medical services, goods, or prescription drugs, including attempts to commit fraudulent billing. The survey results were based on responses of 788 adults who reported that they or close family members were victims of medical theft. The number of new cases over the past year is estimated at 313,000; the increase of the base rate of identity theft victims climbed from 0.68 percent to 0.82 percent, which represents a 19-percent increase in incidents over one year.)

In speaking of this year’s findings, Larry Ponemon, Ph.D., chairman and founder of the research group, says that medical identity theft is having serious consequences, not only in monetary damages, but in compromised personal medical records which can result in misdiagnoses, wrong treatment or wrong prescriptions. Ponemon notes that inaccuracies in a person’s medical record resulting from identity theft are difficult to correct. “Once it’s in your medical record that you are a certain blood type or have an allergy, it’s hard to correct in one place. It’s not like a credit report; it’s complex and for the rest of your life you have to inspect your medical records,” he says.

Resolution of a crime is time-consuming, according to the survey. Of those who did try to resolve an incident, 35 percent worked with their health plan or insurer and 31 percent worked with their healthcare provider. Such activities consumed almost a year or more, according to 36 percent of respondents, and 48 percent said the crime is still not resolved.

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