Realities of Medical Identity Theft
Posted by realityrounds on March 15, 2009
In a very busy nurses’ station a very pregnant, Spanish-speaking only patient, waddles up to the front desk. She hands the unit secretary her medical card, who then proceeds to admit “Scarlett O’Hara” into the system. Voices whisper and eyes roll, but the staff continue to give the patient the care they would give anyone, and help her bring her child into the world with respect and compassion. This current practice however, is about to change.
The federal government is mandating that health care providers install new safeguards against medical identity theft by the spring. Federal regulators insist these safeguards will decrease rising health care costs and protect against medical errors due to corrupt medical records. For example, if someone is using your identity to receive medical care, their medical conditions will then become part of your medical records and health history. This could potentially lead to mis- diagnoses and treatments. According to the Chicago Tribune:
“In May, health-care providers will be required to have in place new federal guidelines designed to block the theft of identities from roughly 250,000 people a year and risks inserting misinformation into their medical records. Hospital surveys and government data indicate illegal Immigration plays a minor role in the overall problem. But some activists say undocumented immigrants who need long-term care—but have no legal claim to public aid—are using stolen IDs more frequently than officials suspect.”
No one knows the full scope of medical identity theft in the United States. Some estimates put the number of victims between 250,000 to 500,000 individuals. This may be even higher because some victims are unaware that they have had their identities stolen. Medical identity theft leads to millions of dollars of lost revenue and fraud for health care providers and taxpayers.
The American Medical Association is against the federal mandates that put pressure on health care providers to figure out the safeguards to prevent medical identity theft. The AMA feels it will deter patients from seeking care out of fear, and these patients will delay care until they are gravely ill. This will then add even more cost on to the system. It also turns health care providers into police, turning their focus away from treating patients to checking if they have valid ID’s.
As a nurse, it makes me uncomfortable to have to interrogate my patients to make sure they have the proper ID. What if they don’t? We are still obligated by law to treat, but do we then call the police to have patients arrested in the hospital? I don’t think so. While medical identity theft is reprehensible, it should not be the responsibility of health care providers to reign in the offenders. Also, as the Chicago Tribune reported, only a small fraction of medical identity theft is believed to be from illegal immigrants, yet they will surely be the focus of the scrutiny. Will nurses need to resort to racial profiling when admitting their patients to the unit? It appears to be a very slippery slope we will be mandated to climb.
Click here to read the entire Chicago Tribune article profiling medical identity theft. The article left quite a heated debate in the comments section, that turned into a debate against illegal immigration. The story itself was tragic and frustrating at the same time. It examined the case of an illegal immigrant from Mexico named “Gloria” who was diagnosed with advanced cervical cancer shortly after arriving in America. She stole another woman’s identity and recieved a half a million dollars in free care, under another woman’s name. Click the link for more details on this story.
RR
Ill and Uninsured in Illinois said
This is a sad story, and what’s sadder still is how it will be used to propagandize all kinds of political agendas over both immigration and health-care reform.
Meanwhile, millions of Americans go without needed health care. Let’s not let the possibility of abuses by a few blindside us to the needs of the many.
realityrounds said
Thanks for your comment. The Chicago Tribune story was definitely twisted to bring on anti-immigration comments. I wonder why they did not profile an American citizen who had stolen someone’s identity to receive medical care? Not as interesting I guess.
Ben said
I would be pissed if someone stole my identity, and racked up a half a million dollars in bills under my name, that I am responsible to pay. Would medical identity theft be less of a threat if everyone had some form of medical insurance? I am not forgiving the crime, but many may be so desperate that they resort to this theft in order to receive care.
realityrounds said
I also worry how the people at the front lines, mainly nurses, are supposed to police making sure patients are not stealing someone else’s identity. It is just one more non-nursing function that is being pushed are way.
Change of Shift: Volume 3, Number 19 // Emergiblog said
[...] Our colleague at Reality Rounds (a renaissance nurse if there ever was one!) takes on this topic in Realities of Medical Identity Theft, including a link to an article on the same topic in the Chicago [...]
emmy said
I don’t think that I have ever gone into a medical situation where it was the nurse who was doing the admission paperwork. Ususally that is done up-front by office personel. I am routinely asked to provide my ID, so it wouldn’t bother me that someone asked for it. And as to whether someone should call the police, well, maybe. I have cancer, and multiple other co-morbidities. Over the past 5 years I have racked up nearly a quarter of a million dollars in health care expenses. Since my insurance policy is limited to 2 million dollars, how it is spent is a concern for me. Health care identity theft for me would potentially leave me with a lack of coverage when I’m sick and need it, so my heart isn’t so inclined to bleed for Gloria. I’m sorry that she’s ill, but she is here illegally and why is she any more entitled to that care than the person she is stealing it from? Likewise, if it were an uninsured American: I’m sorry that they are ill, but it is my insurance money that is part of my total compensation package at work. I work for this protection. It isn’t OK for someone to steal from me simply because they are ill.
realityrounds said
Thanks for your comment. I completely agree. It really is reprehensible for someone to steal another person’s identity, for any reason. As you surely know, the last thing a person needs who is battling an illness, is having to worry about bills and clearing up their records because someone stole their identity. As far as the nurses role in safeguarding against medical identity theft, there has been more and more pressure on us to insure patients are who they are. Nurses spend more time with patients than any other medical profession. I have been personally held accountable for a patient not having the correct insurance, and being transferred to a hospital that does not carry that insurance, as an example. The kinks in the federal law have not been worked out yet, and I have not received any notices as how we will implement it. I will update the blog whenever I receive more news on this from the front lines.
Panda said
We actually caught a patient once. She came in using her cousin’s name and insurance. The hang up was when she needed a type and cross. Her cousin had been a patient in our system before, and had a type and cross. Guess what didn’t match up? We didn’t have to call the cops. The Case Manager had to call the insurance company to let them know, and the insurance company pressed fraud charges. I don’t know how that all turned out.
Fake Boobs in More Ways Than One, I Mean Two. « Reality Rounds said
[...] by realityrounds on March 24, 2009 Remember my post on Realities of Medical Identity Theft? Well, here is an absurd story on just this [...]