medical fraud webWe have all heard or read about identity theft and the financial nightmares that arise when an individual’s identity is stolen. Unfortunately, this crime has bred a relatively new form of identity theft - medical identity theft. This crime can be even more dangerous than the more publicized financial identity theft since medical identity theft can cause life-threatening events or even death.

Medical identity theft occurs when someone steals your personal information and uses it to obtain medical care, buy drugs, submit false billings to an insurance company or Medicare, or sell it to someone else for illegal purposes.
Medical identity theft can leave you with a pile of bills to deal with, and as a consequence, create credit problems for you. But more importantly, this crime can result in incorrect information being inserted into your medical records - information that your doctor or other health-care provider might rely on during your care, such as the wrong blood type or prescription medication.
Once inaccurate information gets into your medical file, it can be difficult to correct because of certain privacy laws.
Take these steps to protect your personal medical information:
Don’t share your insurance or other personal information with anyone other than a legitimate health-care provider.
Don’t provide your medical information to anyone, even someone who has promised free services.
Don’t lend your insurance card or Medicare card to anyone for his or her use. Besides the obvious potential medical consequences, this is illegal and you could face criminal charges.
Credit reports are also a valuable review tool to ensure that someone else hasn’t stolen your medical information. Under federal law, you are entitled to one free annual credit report from each of the three credit reporting companies. You can request it by writing: Free Annual Credit Report - Annual Credit Report Request Service, P.O. Box 105281, Atlanta GA 30348-5281; or visiting

Correcting the record
If you are a victim of medical identity theft, here are ways to correct your record:
Report it. If you learn of medical services that were paid on your behalf, but you never received, report it to the PA Attorney General’s Office at 1-800-441-2555. If the services were paid for by Medicare, contact the U.S. Department of Health and Human Services Inspector General hotline at 1-800-447-8477.
File a police report. If it becomes apparent that your records have been stolen and are being improperly used, file a report with local law enforcement. You may need to provide this information to medical providers when you try to correct your medical records. Your insurance company also may require a copy of the report.
Request copies of your medical records from health-care providers and correct them. This may include contacting doctors, hospitals, pharmacies and laboratories. It also may require contacting health-care providers with whom you’ve never had any dealings, but who have sought payment from you or your insurance company.

HIPAA can help
The Health Insurance Portability and Accountability Act (HIPAA) is intended to protect patients’ health information.
Under this law, you have the right to obtain your medical records, although you can be charged for the copies. To get these records, you should contact your provider and ask about the process for requesting them.
Once you have had the opportunity to review your medical records and you believe changes are necessary, contact your provider.
Ask if the provider has a specific process for amending medical records and follow it. You should identify sections of your records that you believe are inaccurate or incorrect. If the provider agrees with your changes, he/she must include those changes in your file.
If the provider disagrees with your changes, he/she must notify you. You will have the opportunity to add a short statement to your records that explains what you believe the inaccuracies are and why. Your provider does have the opportunity to provide its own statement in your records explaining why it was unwilling to change your medical file.
If you have other questions regarding your medical records, contact the U.S. Department of Health and Human Services Office of Civil Rights at 1-866-627-7748. For more information, contact the U.S. Department of Health and Human Services Office of Civil Rights at 1-866-627-7748.

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