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Medical identity theft—the misuse of a person’s name
or insurance information to obtain healthcare—is
emerging as a problem with serious implications for
consumers, government, and the healthcare industry.
As the nation moves toward the increased use of
electronic health records, industry experts anticipate
that occurrences of medical identity theft will
rise dramatically.
As part of a research and analysis project,
Booz Allen Hamilton worked with the US Department
of Health and Human Services (HHS) Office of
the National Coordinator for Health Information
Technology (ONC) to gain a better understanding of
the scope of the medical identity theft problem and to
develop a set of next steps to tackle an issue that has
the potential to endanger patients’ lives. Our
industry-experienced staff members helped health
officials gain a comprehensive understanding of
medical identity theft and consider solutions that can
be integrated into systems, operating procedures,
and training in support of electronic health
information exchange.
Medical Identity Theft:
Motives and Consequences
Medical identity thieves have many motives. Lacking
healthcare coverage or the money to pay for care
out-of-pocket, a thief may steal another medical
identity to receive treatment. A friend or family member
may use their own identity to help an uninsured
patient. Criminals may steal medical records to obtain
drugs for resale or pose as a physician to bill insurers
for fictional services.
Victims of identity theft face serious financial problems
if they are hit with medical bills for services they never
received. When they become ill, they may discover
that their health benefits have been exhausted.
Medical identity theft can also result in false reports of
pre-existing conditions that make it difficult for victims
to renew or receive healthcare coverage. At its worst,
medical identity theft can result in injury or death if
physicians use incorrect medical record