Medical Identity Theft

Figuring out if an identity is stolen is not easy only because it can be unknown until damage is dealt. This is why identity theft isn’t easy to stop. When most people report a crime, police arrive on the scene before serious damage is dealt, but when a thief steals a person’s identity, the victim can be unaware for quite some time before they realize the amount of money they lost. According to Tracey Whittaker and Anne Dilascio, in 2003, the average money lost from identity theft per person was $4,789, but in 2006 the average was less than $2000. The average out-of-pocket cost of identity theft victims in 2005 was

When confidential patient information is disclosed without consent it is a violation of the HIPAA Title II Security Rule. This rule was enacted in response to private information being leaked to the news and emails containing privileged information were read by unauthorized people. Identity theft is a real concern so patient privacy should be taken seriously. This is a rule can easily be broken without the

In the health care business, there are certain standards and laws that have been put in place to protect our patients and their personal health information. When a health care facility fails to protect their patient’s confidential information, the US Government may get involved and facilities may be forced to pay huge sums of money in fines, and risk damaging their reputation.

Let’s analyze about financial impact of HIPAA violations in healthcare companies and find out how to prevent security breaches. Patients and healthcare facilitators both need to be informed on how to help these companies be protected and be prevented from identity theft. Also, there will be emphasis on what the penalties are in result to violation of HIPAA

Hospital and health facility administrators face hardened criminals who hack medical records with ever-increasing sophistication. Hackers gain access to critical information, such as medical claims, financial data, Social Security numbers and credit card data that enable identity theft, credit card fraud and other privacy breaches. One of the major security failures in the news was the CareFirst BlueCross BlueShield attack that exposed 1.1 million of its members to thefts of their personal information.[1] Combined with high-profile breaches at Anthem and Premera Blue Cross, the breach illustrates the changing role of medical administrators

The significance of patient privacy and the security of confidential information are increasingly vital given the approval of electronic health records. Healthcare providers have recognized striking prices due to security threats and subsequent breaches. According to U.S. Department of Health and Human Services (2002), under the Privacy Rule healthcare establishments must establish protections that establish procedures and rules that guarantee least levels of privacy in relation to patient information. When violations are recognized, it is required that a compliant be created by the individual or unit experiencing the violation. In the complaint, the name of the person who participated in the violation, in addition to the nature of the violation, must be comprehensive. The filing of the complaint initiates an investigation by the Secretary of the U.S. Department of Health and Human Services under HIPAA values (U.S. Department of Health and Human Services, 2013). The establishment of a procedure related to privacy violations has resulted in many cases relating to electronic data breaches. Next is a consideration of two such cases to demonstrate the role of privacy in regards to HIPAA and electronic health database breaches.

(Jones and Jing) Though citizens might not see the effects of health care fraud directly, everyone is impacted in one way or another either through increased taxes, high insurance costs, or the inability to afford health care coverage. While we all hear about major frauds in the system, a majority of the frauds are small and usually go through undetected, unreported, or seriously underreported. (Sparrow) These small frauds add up to be a huge problem. There is a large spectrum of frauds in the health-care systems ranging from the theft of a wheelchair, to organized crime groups that steal patient information and bill for phantom services in multimillion-dollar schemes. (Jones and Jing) In many cases, the fraud is minor but all the small scams add up to an enormous loss to the public. For example, the frequent occurrences of forging of a doctor’s signature on a prescription accounts for billions of dollars lost each year. (Jones and Jing) One of the most common crimes involves billing for services that were never performed. This involves a health care provider submitting a false claim to be paid for a patient that was never treated or adding on services to a patient. For example a doctor may obtain names of other people such as a patients spouse or child who are covered by insurance and put in a claim for them as well as the actual patient. (FBI) Another common fraudulent activity involves upcoding of services. This is when a healthcare

The Health Insurance Portability and Accountability Act (HPAA) violation has been a continuous problem for the healthcare industry. The Mishandling of private health information has become far too common in today’s health system, resulting in negative or harmful effects on patients and the health care providers. Therefore, of main concern in the health care industry is to secure the confidential Protected Health Information (PHI). Healthcare professionals have the ethical, moral, and legal obligation to protect all electronic health data. Failure to adhere to the law can have both ethical and legal ramifications that can result in civil and criminal penalties (Indiana University 2016).

Healthcare services have been on the rise for over 10 years now. According to a 2012 consumer alert, the industry provided $2.26 trillion in payments for more than four billion health insurance benefit claims in the year 2011(Fraud in Health Care). The bulk of the claims and the mainstream of fraud and abuse stem from the Medicare system professionals, who are knowledgeable about the process and persuade new clients into handing over their pertinent information in hopes of deception and illegitimate claims. Multiple and double billing, fraudulent prescriptions, are some of the major flaws in this organization that has made the healthcare services industry curdle. (AGHAEGBUNA, 2011) This is a non-violet crime and is often committed by very

Security breaches of EMRs vary from someone without consent viewing the patient’s information, to a hacker using the information to steal one’s identity. According to Privacy Rights Clearing House, more than 260 million data breaches have occurred in the United States, including those of health related records. Approximately 12 percent of data breaches involve medical organizations (Gellman, 2012). According to Redspin, a provider of Health Insurance Portability and Accountability Act risk analysis and IT security assessment services, more than 6 million individual’s health records were compromised during a period from August 2009 and December 2010 (Author Unknown, 2010). A provision of the Health Information Technology for Economic and Clinical Health (HITECH) Act requires all breaches affecting 500 or more people to be reported to the Department of Health and Human Services. This reporting is to be accomplished within 60 days of discovery. The Redspin report covering the period above involved 225 breaches of protected health information. The amount of people with access to an individual’s health record creates concern with confidentiality. According to the Los Angeles

Healthcare fraud is costly for everybody, as it harms the reputation of the institution or physician committing it, and financially damages the patient being affected.By definition fraud may be defined as intentionally employing surprise, trickery, cunning, deception and unfair ways by which one party cheats another party out of financial resources. In order to educate a healthcare manager regarding fraud , many aspects of fraud must be assessed. This includes the types of fraud, the consequences that come with fraud,the individual(s) committing them, techniques to prevent fraud, and why the healthcare industry is vulnerable to fraud.

These crooks are the possible cause of ruining the reputation of the most trusted and appreciated professionals of our society – physicians. Healthcare fraud can be committed in a variety of ways, but three of the most widely used are described below. The first and most widely known, is billing services that were never endured by using general patient information. When giving personal information out, many hand it over to the front desk assistant at the local doctor. These appear to be people are some of the most known to scam the information and bill patient’s payments that never took place. Keep in mind that when handing over information, the handler is a trusted individual with a good reputation. On the other hand, many are scammed for the opposite; otherwise known as “upcoding,” where patients are billed more expensive services that were actually done. In fact, according to USA.gov a new study showed that 7 percent of identity fraud victims this year reported identity thieves stole their health insurance information, rising up from just 3 percent last year (Federal Bureau Investigation, 2010). This includes the latest scam, called “unbundling,” where scammers con bills and bill each step of a procedure as if it were a separate making the individual pay even more money, leaving devastating effects for the victim. All of which have a common goal of making taxpayers, insurance companies, and

The department of Health and Human Services protects and guides the health and well being of individuals here in America (Thacker, 2014). They fulfill these duties providing Americans with adequate and efficient health and human services and monitoring services designed to increase the efficiency of care in the health system (Thacker, 2014). One of the services being monitored by the department of Health and Human Services is the electronic health record system, which carries private and vital information of patient’s health record enabling all eligible participating health workers access to these records (Thacker, 2014). A breach of the protective health information of patients in a health organization creates chaos as these are against the health insurance portability and accountability (HIPAA) law (Thacker, 2014). Hence, measure will have to be put in place to determine what caused the breach and how to rectify it to ensure the breach never happens again (Thacker, 2014).

Identity theft is the fastest growing fraud crime in America (Finklea, 2009). Gaining knowledge in preventing theft will better the economy and lower the crime rates in America. There are reported 9.9 million victims of identity theft and this number is increasing rapidly as the years go on. It has been reported that an estimate of fifty billion dollars has been charged to our consumers every year due to identity theft (Finklea, 2009).

“Identity theft: the fraudulent practice of using another person's name and personal information to obtain credit, loans, etc.” In 2014, there were around 95,000 reports of identity theft in the UK alone. However, that enormous figure rose even further in 2015 to a spine-chilling 148,000 - causing identity theft to rise by 58% in one year alone. Someone new becomes a target every day. Every day, someone loses their individuality. Every day, someone gains an online twin. These so-called