The Growing Threat of Medical Identity Fraud: A Call to Action

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The Growing Threat of Medical Identity Fraud: A Call to Action

July 2013 l MIFA (Medical Identity Fraud Alliance) l Download PDF
Bluewater Managing Partner, Gary Gordon, Author

Ten years ago, very few professionals or consumers knew anything about financial identity theft and fraud; today it is general knowledge. Likewise, today very few professionals or consumers are aware of medical identity theft and fraud and its potential for harm. Policy decision-makers, organizations that hold protected health information (PHI), law enforcement, regulatory agencies, and consumer advocates now have an opportunity and obligation to bring this serious societal problem to the forefront and work together to protect the public.

The use of another person’s PHI to gain medical services, to procure drugs, or to defraud private insurers or government benefit programs, such as Medicare and Medicaid, is pervasive and threatens the health of individuals and the trust in the healthcare system, and also contributes significantly to the rising cost of healthcare. The threats to individuals include contamination of their health records with erroneous information including, among others items, blood type, serious health conditions, and prescription drugs. Fraud losses in the healthcare system are astronomical and in most cases are facilitated by a stolen medical identity of an individual or a provider.

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