Friday, August 3, 2012

A New Threat to Health Providers?

We’ve written time and time again about faulty security practices that lead to data breaches and victimized patients. Now, it seems the shoe is on the other foot.  An increasing number of health providers are reporting cases of Medical Identity Theft. In this variation of a common 21st century crime, scammers track down insurance cards, social security numbers, and fake IDs to impersonate physicians and health workers. They are then able to use these credentials to make millions off of Medicare.

Worried, yet? It gets worse. Medicare isn’t the only victim of these crimes; physicians that are targeted for these scams suffer more than monetary loss.
Physicians also face repercussions when their patients’ identities are stolen. Patients report losing trust in their physicians after a medical ID theft has occurred. There is also the potential for medical errors and bad outcomes caused by two patients using the same identity. Physicians also potentially could be subjected to violations of the Health Insurance Portability and Accountability Act if they did not adequately protect the data from being stolen.
That’s right. Not only are physicians responsible for repaying Medicare and any incurred taxes (costs which quickly add up to an average of $22,000), they can also be held responsible for any damage their patients face at the hands of ID scammers. So, what can be done? The warning signs of Medical ID Theft are actually easy to spot, if you know what to look for. American Medical News lists things as simple as checking Medicare remittance notices for suspicious services, and checking Medicare’s Provider Enrollment, Chain and Ownership System for practices associated with your name that aren’t related to your own.


Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at

No comments:

Post a Comment