Medical Identity Theft and the Need for Healthcare Compliance

Medical Identity Theft and the Need for Healthcare Compliance

Identity theft that started mushrooming with the advent of bank credit cards and the internet paved the way for another crime much more dangerous and serious than the regular financial identity thefts. With the regular identity theft, people normally lose money but with medical related identity theft, you get to lose much more than that. Apart from financial implications, it gives rise to other serious issues that can prove very costly in the long run.

Medical Identity Theft

Medical identity theft refers to the use of other person's name and details for personal gains. The fraudster uses the personal information including health insurance details to

acquire highly expensive medical treatments, surgery or prescription drugs

make false medical claims

Implications of Medical Identity Theft

As mentioned above, the implications of medical identity theft are far more serious and dangerous than financial identity theft. Apart from unpaid charges and damaged credit as seen in regular identity theft, medical related identity theft involves the inclusion of false and incorrect entries in the victim's medical records. The most damaging part of medical theft is that the victims would be denied health care coverage if the fraudsters have exhausted all the benefits. The victims might even lose the insurance completely, if they do not restore the coverage by paying the bills for the treatments they did not receive. Moreover, the wrongful entries in the victim's medical records would prove risky because it can lead to improper diagnosis and inappropriate treatment which can be life threatening. Hence medical related identity theft would ruin not only victims' medical life but also their financial life for years to come.

Medical related theft is increasing at an alarming rate and what makes it a serious issue is the fact that there is no proper procedure to handle these kinds of issues. It can never be fixed since there are limitations to what the authorities and the victims can do to rectify it.

HIPAA & HITECH Acts

Understanding the difficulties and challenges of storing sensitive Patient Health Information (PHI) in paper form, federal government enacted legislations to encourage medical record computerizing. Since switching to EMRs (Electronic Medical Records) from paper form might make it easy for fraudsters to access sensitive patient information and since in most medical identity thefts, medical practitioners, healthcare solution providers, and business associates are found to be involved, government decided to take concrete steps to thwart healthcare fraud. Hence, it was made mandatory for all medical practitioners, healthcare providers, and business associates to achieve and maintain healthcare compliance with the regulations laid down in the HIPAA Compliance & HITECH Acts.

With HIPAA and HITECH Acts coming into play, patients can be rest assured about the privacy and security aspects since HIPAA and HITECH Acts plug all possible loopholes within the health care industry.

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