Medical identity theft climbs

Someone using tweezers to pluck an ID card represents identity theft.

Kai Ryssdal: So we were just talking about hacking and data theft, which can sometime lead to identity theft. Now we're going to turn to different kind of ID theft.
One that doesn't get a whole lot of attention. One that victims sometimes don't find out about until years later. One that can be messy and expensive to fix -- and harmful to your health.

Ashley Milne-Tyte reports.

Ashley Milne-Tyte: You expect your roommate to make off with your t-shirt, some food, maybe some old CDs. Scott Bennett's made off with his identity. Not long after, Bennett started hearing from hospitals and collection agencies demanding payment for treatment he'd never had. He's been trying to clear up the mess ever since.

Scott Bennett: Right here on top is actually a police report with fingerprints where I had to go locally to a police station to be fingerprinted...

Over the years Bennett has spent untold hours trying to prove he was hundreds of miles away in his home town of San Antonio, when the fake Scott Bennett was being treated at hospitals in Nevada. It's not as easy as it sounds because health privacy laws protect the patient -- even if the patient is an imposter.

Bennett: In order to battle this I need to know a lot of information about the actual charges, the doctors, procedures, things that have taken place, in order to fill out police reports. And that information cannot legally be given to me, so that makes it difficult also.

A recent survey conducted by the Ponemon Institute for Experian, the credit reporting bureau, says medical identity theft costs victims around $20,000 in lost time, increased insurance premiums and legal fees. And the recession has made things worse.

Larry Ponemon is chairman of the Ponemon Institute.

Larry Ponemon: Thirty-six percent say a family member actually took and used their personal identification.

Including insurance cards, to get medical care. That's up from last year. Medical identity theft costs providers and insurers around $2 billion a year. Once another patient masquerades as you, your medical records are inaccurate, and that can jeopardize your future treatment.

Linn Freedman heads the privacy practice at law firm Nixon Peabody.

Linn Freedman: This hospital or this doctor's office has treated this person as you. They've come in with an ailment and now all of those medical records are under your name and physicians are relying upon that medical information, which is false.

Victims have found their records showing everything from a different blood type to diseases and operations they've never had. They've also found their insurance benefits have been spent. The shift to electronic record keeping should make it somewhat easier to track medical identity theft. But it can only do so much.

Pam Dixon is director of the World Privacy Forum.

Pam Dixon: Even the most extensive audit trail that I've personally ever seen in the field, it doesn't reach to the subcontractors. And any hospital system is going to have hundreds and hundreds of subcontractors to make things work.

Like back-office billing operations and labs. Dixon says sometimes a staff member sells off patient information. Sometimes criminals buy a clinic to commit fraud, billing insurers for procedures that never took place.

It's been 10 years, and Scott Bennett is still haunted by his persistent thief. The situation is a strain on the whole family.

Bennett: It's stressful. You know, some of the questions we've had is what if this gentleman dies using my identification? What happens to my Social Security, what happens to life insurance?

His identity thief was at a hospital in Oregon recently. He says the bills should make their way to Texas in a few months.

I'm Ashley Milne-Tyte for Marketplace.

Log in to post3 Comments

Why does Mr. Bennett have to prove he was hundreds of miles from Nevada when a fake Scott Bennett was treated at a hospital there? Should it not be the hospital’s responsibility to prove that Mr. Bennett incurred the charges rather than the other way around?

The hospital was defrauded. The story presented no evidence that Mr. Bennett was a party to the crime. If the hospital cannot prove that Mr. Bennett incurred the charges, that is their problem. The hospital failed to perform due diligence and as a result lost money. If they attempt to extort money from Mr. Bennett, then the hospital is perpetrating a crime against Mr. Bennett.

Mr. Bennett should be seeking restitution from the hospital. He should be seeking further damages for the mishandling of his patient records as a result of their failure to verify the identity of their patients.

The hospital should be held accountable for their mistakes. The only victims of identity theft should be those who fail to properly identify their customers before extending credit.

Unfortunately, Mr. Cavano, I don't think they caught the bit about withholding your name. You should address it, if you fear it puts your job at risk.

Now to reply:

I have a huge problem with replacing the "colossal, rent-seeking, soul-sucking medical-industrial complex" with the colossal, power-seeking, soul-sucking, overlord political class - also known as the US Federal Government. There is little difference to being $100K in debt and having every penny sucked out of you via taxes.

Health care is not a "public" issue. It is a private issue. Yes, the current insurance company (with huge government oversight and regulation) is broken. However, trading out insurance company for government agency is not the solution. We need to get back to direct pay. Is that perfect. No. But I at least have some say. And, if I take care of myself, then I'm less likely to have to pay for someone else that does not take care of themselves.

So, now we have people who steal medical services; the juxtoposition of this story with the story about the McKinsey report purporting to show that 30% of employers are thinking about dropping coverage in 2014 shows, once again, just how defective the American public health system is. Why promote a simple solution -- Medicare for all, financed through direct payroll taxes, when we can sustain a colossal, rent-seeking, soul-sucking medical-industrial complex. Meanwhile, people who would rather not be $100,000 in debt are lying about their identities to piggyback on other peoples health insurance -- a situation that sounds like the proverbial beggar who steals a loaf of bread because he is hungry. Since my employer, the largest hospital chain in Pittsburgh, is likely to disagree, please withhold my name should you wish to cite this comment. Thanks!

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