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A real steal |
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From http://www.modernhealthcare.com/article.cms?articleId=41856
"In 2001, William Winkenwerder, who was about to take over as assistant secretary of defense for health affairs, told attendees at a Boston healthcare information technology convention that "privacy and security are the Chernobyl that is waiting to happen for the healthcare industry." "
"Fast forward five years and it takes little imagination to see billows of steam pouring from the cracks of the nation's nascent healthcare IT network.
The news today is rife with horror stories about computer security failures. In fairness, all industries are implicated, but healthcare contributes its share of frightful tales, making good on another prediction Winkenwerder made about advancing healthcare IT in his keynote speech at the TEPR (Toward an Electronic Patient Record) trade show. "Privacy," he said, "is going to be our greatest hurdle, and we must protect it in order to succeed."
Failing to protect privacy could cost healthcare providers far more than their progress on an IT project, according to experts on a newly emerging healthcare privacy threat -- medical identity theft. Hospitals and physician practices risk damage to their reputations from public exposure by the media whenever patients become identity theft victims at their facilities. They also risk shouldering the expense of victims' credit monitoring, counseling costs and damages from big-dollar lawsuits.
On top of that, healthcare identity theft puts providers at risk for financial fraud, the experts warn. Although exact estimates aren't available, based on extrapolations from recent surveys, damages could easily total billions of dollars annually.
Privacy experts say medical information is being stolen increasingly by organized criminal gangs drawn to healthcare, in part because of tightening security in the financial services industry. Healthcare workers are often part of these privacy theft conspiracies, experts say.
"I tell you who should be shaking in their boots are the hospitals," says Eric Drew, a former software company executive whose identity was stolen while he was hospitalized for a bone marrow transplant in late 2003 and early 2004. Drew's case led to the first federal prosecution of a criminal privacy violation under the Health Insurance Portability and Accountability Act. The experience Drew gained in tracking down the Seattle Cancer Care Alliance phlebotomist who stole his identity helped him to launch KnightsBridge Castle, an identity protection business and counseling service for victims of identity theft.
"You can imagine the storm that's coming our way," Drew says. "I know where the most comprehensive files on you are; it is in healthcare. There are people who are getting jobs in healthcare specifically to get their hands on those records."
A rising tide
Through 2005, there have been nearly 18,000 cases of medical identity theft or about 1.8% of all identity theft cases reported to the Federal Trade Commission since it began tracking victims' complaints in 2000. The FTC says 4,746 of those reports came in 2005, up from the previous year by about 4% -- which is slightly more than the rate of increase in the number of reports to the FTC for all forms of identity theft.
The FTC defines medical identity theft narrowly as the use of a person's name or insurance information without consent to obtain medical goods or services, or to make false claims for medical services. Under that definition, if a healthcare employee steals a patient's information and uses it to go on a credit-card spree -- which is what happened to Drew -- it wouldn't qualify as medical identity theft, according to the FTC.
True medical identity theft is best illustrated by the most recent HIPAA criminal prosecution.
In September, a federal grand jury in Fort Lauderdale, Fla., named Isis Machado and Fernando Ferrer Jr. as participants in a scheme to steal the personal information of more than 1,100 patients of the Cleveland Clinic hospital in Naples, Fla. Machado worked as a front desk office coordinator for the Cleveland Clinic's Weston, Fla., hospital. Ferrer, Machado's cousin, was the registered owner of Advanced Medical Claims, Naples, according to the indictment.
The indictment alleges Machado used a computer database to access patients' names, birth dates, Social Security numbers, Medicare numbers and addresses, and Ferrer used the data to make fraudulent Medicare claims in excess of $2.8 million. Ferrer also provided Medicare beneficiary numbers to others unnamed in the indictment who then used those numbers to file fraudulent Medicare claims, the indictment said.
Medical identity theft "does kind of fall into a gray area between traditional financial identity theft and healthcare fraud," says Burke Kappler, an FTC attorney with the Division of Privacy and Identity Protection. The key differentiator between medical identity theft and other forms of identity theft is its impact -- which often goes undetected for long periods of time -- on the victim's medical records, Kappler says.
According to the most recent FTC complaint data, less than half of identity theft cases (43%) are discovered in the first month after they occur. In 23% of the reported cases, the victim was unaware of the crime for at least a month and up to one year. Nearly one-third of the victims (32%) didn't learn of the fraud until after one year. Some 9% didn't find out until after five years or more had passed.
"People don't find out until they go into the hospitals or they get the collection notices after the debt has sat there and sat there," Kappler says. "That makes it very difficult for the victims because it makes it hard for them to go back and get things fixed." "
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-- H. Melville, "Moby Dick" |
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