Courtesy of Ora DeMorrow

In early 2009, a Colorado hospital worker admitted to giving admission forms of St. Anthony Central patients and license data to a friend over a period of 18 months.

At first, this woman claimed that a family friend forced her to take the patient records from the hospital or he would kill her daughter, but she later admitted to concocting that story. In fact, she gave the documents to a family friend—a convicted identity (ID) thief—because she “owed him.” It turns out that she was contacted periodically over the 18 months and told what types of records were needed. She provided about 20 identities per week, eventually totaling more than 1,500 people.

To this day, only the victims know the extent of the ID thefts. Quite possibly, the hospital and the authorities don’t even know about some of them.

What is medical ID theft?

Medical ID theft is manifested in a number of ways:

• Existing patient confidential information is stolen—as physical paper records or hacked databases—and ID thieves capitalize upon that information outside of the hospital.
• A person comes into a hospital for treatment, uses a stolen ID (name, driver’s license, Social Security number), and his or her condition and treatment are added to the medical records of the victim. This includes the possible overwriting of the victim’s blood type with that of the thief. That same ID thief uses the victim’s health insurance to cover the cost of the treatment and ensuing medical and drug costs.
• The Social Security numbers of newborns are lifted from hospitals to provide clean, unfettered identities and credit histories for sale to illegal immigrants and those seeking new identities.

Medical ID theft is a burgeoning headache for hospitals and insurance companies. It’s even worse for the over 200,000 Americans who will become victims every year, according to the Federal Trade Commission. Unfortunately, the pace of medical ID theft is expected to accelerate.

Can you imagine if a heroin addiction or an HIV infection is mistakenly entered into your records? Victims often aren’t aware of errors until months or even years later, when they are denied coverage or informed that they’ve maxed out their insurance.

What if your medical record is overwritten by type O blood, when yours is type AB negative? Your next surgery could end up being your last breath. If you are headed for surgery, especially one that involves blood transfusion, be sure to carefully examine your medical records first.

How do thieves cover their tracks? Typically, they change the address on the insurance forms so that you never receive explanation-of-benefits letters. If you stop receiving them, consider yourself alerted. Victims of financial ID theft can at least restore their credit records, but no guidelines are in place for medical records. They are scattered among providers and hard to correct.

The repercussions of medical ID theft go beyond hospitals. Most Fortune 500 companies now require medical record reviews before making hires. Some people are unable to get a job or insurance because their records say they have MS, HIV, or some other illness or addiction that they don’t really have. [Editor’s note: With the recent passage of the health care bill, this should change.]

How to minimize the risk of medical ID fraud

Follow a few simple steps to minimize the risk of becoming a victim:

1. Protect your insurance card as carefully as your credit cards. If it gets lost or stolen, alert your insurance company immediately and request a new number.
2. Be selective about where you get care. Avoid clinics that advertise free exams. They may just want to copy your health insurance information.
3. Carefully read over the explanation-of-benefit notices that your insurance company provides. Make sure you recognize the doctors’ names and the dates of treatment—an unfamiliar provider is a big warning sign.
4. If you rarely see your doctors, call your insurance carrier and ask for an annual summary of all procedures that were paid out.

And finally, exercise your rights. Review your medical records before having surgery, whether minor or major.