After shoulder surgery last year, Lind Weaver was stunned when hospital bill collectors demanded that she pay for the amputation of her right foot.
"Either you didn't do the surgery, or you did a really [shoddy] job of it," Weaver told them, sending along notarized photos of her toes, all still attached. "Either way, I'm not paying."
But the 56-year-old retired schoolteacher quickly discovered she was dealing with something more nefarious than a simple clerical error: An identity thief had obtained medical care under Weaver's name and had the bill sent to her insurer.
Medical identity fraud: A Sept. 25 article in Section A about medical identity fraud should have noted the findings of a report published in May by nonprofit research group World Privacy Forum in San Diego. The report, authored by Pam Dixon, was titled "Medical Identity Theft: The Information Crime That Can Kill You." The news accounts and conclusions in that report were part of the research that led to The Times article on the subject.
A year later, Weaver is still trying to catch errors in her medical records and clear the hospital bills fraudulently run up in her name.
"It became a 40-hour-a-week job," Weaver said. "I put my phone to my ear and sat there listening to elevator music."
Although the most typical of the millions of identity theft cases in the U.S. each year involve credit cards, a 2003 federal report estimated that at least 200,000 instances involved medical identity fraud. Experts believe that the rising cost of healthcare is driving more identity theft, and that many people are unaware they have become victims unless they receive a hospital bill or query from their insurer.
"There's no reason to assume the patients ever find out," said Harvard University management professor Malcolm Sparrow, an expert on regulatory agencies who has written books on healthcare fraud. "The bulk presumably remain invisible."
With their medical records compromised, victims of this kind of fraud face a greater risk of injury or even death if doctors make treatment decisions based on bad information. Files might list incorrect prescriptions or the wrong blood type. Or, as in Weaver's case, an erroneous diagnosis of diabetes.
Bad information can also put careers and insurance at risk. Many employers, including more than a third of the Fortune 500 companies, demand access to medical records when making hiring, promotion or benefits decisions, according to the nonprofit Patient Privacy Rights Foundation. Health and life insurance companies routinely scan medical files or payout reports before issuing new policies.
Victims, though, often find that clearing their medical records of bad information is much more difficult than fixing credit reports, which are centralized in three major credit bureaus.
- Fraud Problem Is Very Real Sep 29, 1997
- Combating Insurance Fraud Jan 18, 1999
- FHP Certified to Offer Workers' Comp Insurance Nov 23, 1994
