Doctors, insurers ask, ‘Who are you?’ - Nightly News with Brian Williams

More doctors, insurers asking, ‘Who are you?’

Medical identity theft, on the rise, can threaten lives as well as wallets
NBC VIDEO•Medical ID theft creates concerns
April 3: Medical ID theft is on the rise in the United States, and there’s more to be worried about than just the financial ramifications. NBC’s Anne Thompson reports.

Nightly News

By By Anne Thompson and Alex JohnsonNBC News

Anne ThompsonChief environmental correspondent•ProfileAndrew Brooke’s family knew something was screwy when they got a collection notice for unpaid bills for treatment of his work-related back injury, which included large prescriptions of the controlled painkiller Oxycontin.

“I’m looking at this bill, and I’m looking at my 3-week-old baby that can’t even hold his head up, and it’s just a sense of outrage,” said Andrew’s father, John Brooke, of Bothell, Wash., a suburb of Seattle.

Likewise, Jo-Ann Davis knew there was a mistake when a cop greeted her at the medicament where she had gone to pick up a prescription in early 2005.

“I’ve never even had a speeding ticket,” said Davis, a veterinary technician from Moon, Pa., near Pittsburgh.

Medical providers, it turned out, thought Andrew and Davis were other people. Their medical identities had been stolen.

These are not isolated incidents: In a report last year, the World Privacy Forum found that the number of Americans identifying themselves in government documents as victims of medical identity theft had nearly tripled in just four years, to more than a quarter-million in 2005.

Motives for medical identity theft can vary. Some thieves, as in these cases, are seeking controlled medications. Others are seeking federal money. A case that wrapped up in January in Southern California illustrates just how sophisticated such operations can be.

Five health care providers pleaded guilty to stealing more than $900,000 in 2003 by luring hundreds of elderly Vietnamese patients to a fake medical clinic in Milpitas, where they would offer free checkups. According to prosecutors, they would copy the patients’ Medicare records and then use the information to bill the government for phantom services.

Click for related coverageRead the full World Privacy Forum report (PDF)Check your records: State-by-state guide

Steep costs on money and lives
Of all the forms of identity theft, misappropriation of your medical records is among the most damaging. It’s not just the financial toll �" if your medical identity is stolen, erroneous entries can turn up in your records, which could end up killing you.

Get your medical records

All hospitals and most doctors have a release form you can use to request your records. Because state laws differ on how long such records must be archived, call the office to make sure your records still exist.

You can have your records sent to yourself or directly to a health care professional. If you do have the records sent to a health professional, let him or her know to expect the files.

In many cases, a letter may be all you need. It should include:

-Your birthdate-Your full name (including any information about name changes)-When you were seen -The specific information you want

Source: GeneticHealth.com

“If someone shows up in an emergency room and this has happened to them, they could receive improper treatment, and that is a real problem,” said Pam Dixon, executive director of the World Privacy Forum, a nonprofit research group.

For example, if an identity thief presents himself at the hospital in your name and is identified as having a different blood type, that blood type ends up registered in your medical history, with potentially disastrous consequences if you end up in a serious accident.

Or suppose you apply for a new job. Even if you’re fit as a fiddle, you could still fail a pre-employment medical screening or be rejected for company-provided health insurance because of the inaccurate presence of an ailment in your medical history that you don’t have.

It is also the most difficult type of identity theft to fix after the fact, because victims have limited recourse. Dixon found that medical identity theft typically leaves a trail of false information in medical records that can plague victims for years, because even if you manage to correct your records in one place, it’s almost impossible to track down everywhere they have been disseminated across the networks of medical providers, insurers and government agencies.

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Too many roadblocks
Five states �" California, Florida, Nevada, Arkansas and Delaware �" have recently passed or are considering laws to address breaches of medical information, but the privacy forum still recommends that everyone check his or her medical records for accuracy.

Live survey

Are you confident your records are safe?

Georgetown University’s Center on Medical Rights and Privacy maintains a state-by-state guide to checking your records. But if you find an error, trying to correct it can be a complex and sometimes fruitless task.

Alex JohnsonReporter•Profile

The federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, requires health care providers and insurers to give you access to your medical records and to give you a copy of their privacy practices. If your records are wrong, the act gives providers and insurers as long as 90 days to respond, but if they disagree with you, they don’t have to do anything.

Moreover, HIPAA doesn’t require medical providers and insurers to remove incorrect information; in fact, it says that if incorrect information leads to inappropriate treatment, the bad information should not be removed from your records, in order to preserve a paper trail.

CONTINUED: Authorities slow to prosecute1 | 2 | Next >