Identity Fraud in the Medical Sector and Its Impact on the Healthcare Field
In recent years, medical identity theft has emerged as a significant concern worldwide, particularly in countries like the United States, South Korea, and Switzerland. This form of identity theft involves fraudsters targeting either a Social Security Number or insurance card information, and in some cases, credit card information, to commit various illicit activities.
Fraudsters can use stolen identity information for a range of malicious purposes, such as obtaining doctor's prescriptions to buy and resell drugs on the black market, or using stolen insurance information to receive treatments they don't have insurance for. Moreover, thieves can hack databases containing patient identity information, making even the most cautious individuals vulnerable.
To combat this growing issue, businesses and individuals must adopt a multi-layered approach to protection. Here are some strategies that can help:
- Vigilant Monitoring and Validation: Regularly review medical claims and records to spot suspicious activity or errors indicating identity theft. Programs like the US CMS Victimized Provider Project offer guidance on validating and remedying identity theft claims, helping providers to avoid double victimization and financial liability.
- Collaboration with Fraud Investigation Teams: Engage or create specialized investigation teams that partner with law enforcement and regulatory agencies to identify, prevent, and prosecute healthcare fraud. Examples of such teams include Cigna’s Special Investigations unit.
- Patient and Provider Education: Educate all stakeholders to recognise signs of medical identity theft and the steps to take if fraud is suspected. This includes reviewing and correcting medical records promptly.
- Deploy Comprehensive Identity Theft Protection Services: Employ commercial identity theft protection services that include medical data monitoring, dark web surveillance, and restoration services. Examples like IDShield offer licensed private investigators, up to $3 million fraud reimbursement, and continuous monitoring of personal data.
- Data Security and Privacy Measures: Implement strong cybersecurity protocols, such as encrypted electronic health records, strict access controls, regular audits, and staff training on data protection best practices. This helps reduce vulnerability to hacking or insider threats.
By combining these approaches tailored to local regulatory environments and healthcare systems, businesses and individuals can enhance protection against medical identity theft and digital fraud in these countries. It's important to remember that vigilance and education are key in the fight against this growing threat.
[1] https://www.cms.gov/Medicare/Fraud-and-Abuse/Victimized-Provider-Assistance-Program [2] https://www.cigna.com/about-us/newsroom/press-releases/2018/cigna-announces-new-special-investigations-unit-to-fight-healthcare-fraud [3] https://www.hhs.gov/cms/news/press/2018-press-releases/2018/02/27/hhs-announces-new-efforts-to-protect-patients-from-medical-identity-theft.html [4] https://www.idshield.com/ [5] https://www.lifelock.com/idshield
- The stolen identity information can be utilized by fraudsters to obtain doctor's prescriptions for illicit purposes, such as buying and reselling drugs on the black market, which falls under the realm of health-and-wellness.
- Employing comprehensive identity theft protection services that offer medical data monitoring and restoration services, like IDShield, can help individuals protect themselves from medical-conditions-related identity theft and the potential financial implications.
