Medical Identity Theft: Under-Reported, Under-Researched, More Common than Generally Known

Medical identity theft is stealing health information for personal profit. If that sounds like a strange thing to do, it is-but it is more common than generally thought. What is known about it remains sketchy because it is the most poorly documented of all identity theft crimes, according to data from the Federal Trade Commission (FTC), which estimates that there are 250,000 to 500,000 victims, but the real number is probably triple that.

The FTC speculates that 1.5% of all Americans are victims of medical identity theft each year, and the crime increased almost 200% between 2001 and 2005.

Kurt Long, CEO of EpicTide, a company in St. Petersburg, FL, that markets corporate security, said that there are probably a half million victims to date, a number that will probably increase now to 250,000 each year.

Here’s how it works: A thief uses a victim’s name and/or other identifying information without the person’s knowledge or consent to obtain medical services. Or, the thief uses the stolen data to make false claims for medical services. The victim, or the insurance company, is billed for services not received. Even more frightening, the victim can end up with false information entered on his or her medical record, or an entirely new fictitious medical record can be created.

It can be notoriously difficult to uncover, according to a report issued last May by the World Privacy Forum (WPF), a nonprofit, public-interest research group in Cardiff, CA, that describes itself as focusing in a nonpartisan way on research and consumer education in the intersecting areas of technology and a range of privacy matters, including financial, medical, employment, and Internet privacy.

Medical identity is well hidden in large electronic payment systems and in widely dispersed databases and medical files, the report, titled Medical Identity Theft: The Information Crime that Can Kill You, noted. Medical identity thieves are usually professionals adept at making sure victims do not detect the crime-ever.

Organized crime rings are heavily involved, almost always in collusion with health care employees such as office and medical records personnel and insurance claims clerks. These rings are very organized and highly sophisticated, and they depend heavily on insiders, said Pam Dixon, the organization’s executive director and the author of the report.

The four most vulnerable types of patients are those with cancer, diabetes, and AIDS, and residents of inpatient drug treatment centers.