New Organization Targets Medical ID Fraud | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

New Organization Targets Medical ID Fraud

August 21, 2013
by David Raths
| Reprints

Imagine going to the doctor’s office for a checkup and finding procedures or prescriptions in your medical record that were a surprise to you. Just as with financial identity theft, an increasing number of Americans are finding themselves the victims of medical identity fraud, as thieves steal their health-insurance number, Social Security number and other personal information and resell them on the black market for use by other people.

Studies conducted by the Ponemon Institute (www.ponemon.org) indicate that the number of medical identity theft victims in the United States has grown from an estimated 1.4 million in 2010 to more than 1.8 million in 2012. Now a nonprofit public-private sector organization is being formed to unite stakeholders to develop best practices, solutions, and technologies for the prevention, detection and remediation of medical identity theft and fraud. Founding members of the Medical Identity Fraud Alliance (MIFA) (www.medidfraud.org) include ID Experts, the Identity Theft Resource Center, the National Health Care Anti-Fraud Association, the BlueCross BlueShield Association, the Consumer Federation of America and AARP.

Robin Slade, one of MIFA’s development directors, says the digitization of protected health information and access by business associates has made patient records more vulnerable to data breaches. MIFA’sfounders saw a need for a coordinated effort from providers, payers, policymakers and service providers to address the problem, she adds.

Both Slade and co-development director Bill Barr have extensive experience in financial sector fraud prevention. She says the medical field can learn from the experiences of the financial sector. “We see a direct correlation to what the financial sector went through when e-commerce developed,” she says. “We have an opportunity to learn from that experience. One thing the financial services companies realized is that fraud is not a competitive issue, and they cooperated on combatting it.”

A MIFA white paper notes that the credit card industry first developed sophisticated analytics and began sharing fraud data to stop credit card fraud. The companies also began calling customers about transactions flagged by the analytics, which raised the visibility of the problem with the public.

“There is a lot of value in getting parties together to get information out to chief information security officers about specific threats,” Barr says. “Technology use in ID authentication and fraud prevention in healthcare is still in a primitive state. It will help to have a conversation that includes policymakers on steps we can take to move forward.”

The white paper suggests that innovative technology solutions might help:

• provide better authentication of the identities of individuals requesting healthcare services;

• provide for greater security and privacy of an individual’s healthcare records as they are transmitted throughout the healthcare ecosystem; and

• provide a means for victims of a PHI breach to monitor and protect their medical identities.

Topics

News

Dignity Health, CHI Merging to Form New Catholic Health System

Catholic Health Initiatives (CHI), based in Englewood, Colorado, and San Francisco-based Dignity Health officially announced they are merging and have signed a definitive agreement to combine ministries and create a new, nonprofit Catholic health system.

HHS Announces Winning Solutions in Opioid Code-a-Thon

The U.S. Department of Health and Human Services (HHS) hosted this week a first-of-its-kind two-day Code-a-Thon to use data and technology to develop new solutions to address the opioid epidemic.

In GAO Report, More Concern over VA VistA Modernization Project

A recent Government Accountability Office (GAO) report is calling into question the more than $1 billion that has been spent to modernize the Department of Veterans Affairs' (VA) health IT system.

Lawmakers Introduce Legislation Aimed at Improving Medicare ACO Program

U.S. Representatives Peter Welch (D-VT) and Rep. Diane Black (R-TN) have introduced H.R. 4580, the ACO Improvement Act of 2017 that makes changes to the Medicare accountable care organization (ACO) program.

Humana Develops Medication Management Tool

A new tool developed by Humana enables the company’s members to keep a list of their medications in one place.

Four Hospitals Piloting OurNotes Initiative in 2018

Beginning in January, four academic hospitals—Beth Israel Deaconess Medical Center in Boston, University of Washington in Seattle, Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire and University of Colorado in Boulder—will begin piloting a new digital tool called OurNotes that enables patients to contribute to their clinical notes.