Medical Identity Theft

February 8, 2019

Identity theft is generally associated with financial transactions and financial fraud, but it can happen with regard to medical care, too.

Medical identity theft occurs when:

  • Someone uses another person’s name or health insurance information to get medical treatment or prescription drugs.
  • Someone in a medical practice uses another person’s personal information to submit false claims for reimbursement to insurance companies or public health care programs, such as Medicare and Medicaid.

Medical identity theft is a concern for patients because it compromises their personal information, medical records, and medical history. Further, it can disrupt medical care or worse – it can cause a mix up between the patient’s legitimate health records and those of the perpetrator, which can complicate proper diagnoses and medical treatments. Also, medical identity theft may result in medical debts that will need to be disputed.

It is a concern for health care providers because fraudulent billing based on medical identity theft may amount to HIPPA violations or other regulatory violations, and may lead to licensure complaints, fines and penalties, preclusion from public health care programs, and damage to the reputations of the physician and medical facility.

Instances of medical identity theft may be hidden for a long time and can be difficult to detect. For a number of reasons, identity theft that results in financial fraud is often detected far sooner. This is because many people actively track their financial lives, banks contact consumers when charges raise an alarm, credit cards or other financial services may send an alert when a credit score decrease is detected. Whereas people do not necessarily track their medical services or read their Explanation of Benefits statements, or review benefits paid in their name or insurance reimbursements paid out as part of their plan.

Medical identity theft can be criminally charged under federal or state statutes. The criminal case may involve charges for identity theft, conspiracy, and depending on the facts, as health care fraud as well.

To get the best defense it is imperative that you hire an attorney knowledgeable with medical identity theft cases.

If you have been accused of medical identity theft, we are prepared to defend your rights. Our attorneys will work hard to provide you with the best possible defense. There may be aspects of your case that can be challenged in court in the early stages, so it is essential that you contact us as soon as possible. For a case evaluation contact us or call (480) 219-1366.