Medical Identity Theft: A Rising Threat


Mariana de la Torre was not your average criminal. She was the mother of three and dying fast from cervical cancer. But de la Torre was originally from Mexico and living out her days illegally in the U.S. Without health care or the necessary funds, de la Torre was forced to resort to desperate measures to receive treatment. She used a fake ID.

Shortly before she died in 2009, she revealed her true identity to hospital officials, but only after having racked up more than $500,000 in charges under another woman’s Medicaid plan. “I didn’t think to do harm to anyone; I only wanted the pain to end,” she said in an interview with the Chicago Tribune.

It all sounds like the plot to a complicated episode of CSI, but de la Torre’s story is just one of many in the continuing saga of medical identity theft. According to a report released earlier this week by the Ponemon Institute, nearly 1.5 million Americans to date have had their personal information stolen and used for other people’s medical procedures.

“It’s probably the most dangerous form of identity theft, not just because of the financial ramifications, but also because of the possibility that you might die,” Adam Levin, founder of and IdentityTheft911, said in an interview with MainStreet.

When someone steals your credit card or banking information, usually the worst you expect to happen is that the culprit might make a ton of pricey purchases in your name. But a fraudulent purchase in your name can’t damage your health. When someone gets access to your medical information, the possibilities are more severe. According to NPR, “Patients using someone else's name, Social Security number or insurance card to get health care could risk their victim's health if inaccurate information, such as blood type and medications, is recorded on the victim's chart.”

The frightening thing is that it’s not just the desperate and sick like de la Torre who are responsible for medical identity theft. NPR notes that there are professional scammers who get jobs as “receptionists and accountants within the health care field itself” in order to get access to records. Similarly, Levin recalls a story he heard about a gang in Los Angeles that installed affiliates in medical offices because they recognized that the medical files were a more “valuable asset” than anything else they could traffic.

Unfortunately, though the threat of medical identity theft is becoming more well-known, the response to it has been slow to non-existent. According to Levin, it all boils down to a strange side effect of patient privacy rights policies. The Health Insurance Portability and Accountability Act (HIPAA) accords thieves the same kind of privacy rights that you expect as a patient.

“If you are a victim of financial identity theft, you have a right to contact creditors and they have an obligation to investigate. And if it’s inaccurate, it has to be removed,” Levin said. But the same is not true in this case. Once a medical identity thief appropriates your information and changes your medical file, that information is private and difficult to remove or change. “If it is part of a medical file, there is a right to privacy.”

This problem has no easy fix and will likely be around for a while, but some hospitals are taking steps on their own to limit the risk. "We try to get our patients to speak their information to us, so that we can confirm it because we'll find that a lot of times if they're presenting with a false ID, they'll stumble on those words,” one official at the CoxHealth Hospital in Springfield, Mo., told NPR.

Levin encourages consumers to scrutinize the health statements you get from your health insurers, as well as your credit report to see if there’s any discrepancy in the charges. He also says you have a right to speak with your doctor to see if there’s been any “communication about you between them and other doctors.” If other doctors around the country have been asking your doctor for your medical information, it’s probably not a good sign.

(Check out MainStreet's coverage of other things to look out for when visiting a hospital.)

—For a comprehensive credit report, visit the Credit Center.

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