HW: Laws target health ID theft

New federal regulations aimed at detecting potential health identity theft are changing some procedures at Grand Valley businesses.

Patients checking in at local hospitals or physicians’ offices can now expect to show photo identification at every visit. That wasn’t always the case, local hospital officials said.
In November, a new regulation from the Federal Trade Commission required all financial institutions and creditors to develop an identity theft prevention program. Health care providers fit into the category of creditor because they can extend credit to patients and report people to collection agencies.

Officials with St. Mary’s Hospital, Community Hospital and the Mesa County Sheriff’s Department said health identity theft is not a problem in this area, but admitted it exists.

Stealing someone’s health care is not only illegal but can also be fatal.

“We have heard of health insurance fraud in two forms,” said Heather Benjamin, Mesa County Sheriff’s Department spokeswoman. “First, people stealing insurance cards and then getting medical service for free, essentially. The second, people are stealing identities and carrying them over into medical records, essentially changing the medical history for people who most likely don’t even know it. This is the scariest example because a person’s blood type can be changed in their medical history. When they need a blood transfusion, let’s say for a car crash, they could die.”

To date, the Sheriff’s Department has not taken a report of health identity theft, Benjamin said.

Medical identify information can be stolen from an insurance plan card, off statements in the mail or from electronic records.

People need to protect their insurance cards like credit cards and shield their medical records as they would bank statements, said Dr. Larry Leaming, president of the Institute for Rural Health Leadership in Grand Junction and former chief executive officer of several smaller Colorado hospitals.

Leaming said that people should check all correspondence from hospitals and insurance companies to prevent fraud.

Medical identity theft also occurs when an individual gives his or her insurance card to a relative for medical treatment. Even if sharing health care cards with family members isn’t malicious, it is still theft, Leaming said.

“There are a lot more people who aren’t insured or are underinsured,” Leaming said. “It’s tempting (to steal someone’s health care identity) when an expensive procedure’s coming.”

In addition to hospitals and physician offices requesting photo identification, local health insurance providers want to be proactive in preventing health identity theft, said Jim Quillin, fraud investigator with the insurance company Rocky Mountain Health Plans.

Quillin said he once heard the story of a woman who received bills from a hospital for a foot amputation. The woman literally had to walk into the hospital to prove she still had both her feet.

“She worked with the hospital to get that (amputation charge) retracted, but of course that has longer implications,” said Quillin, who added the incident did not happen locally. “Those medical records can, in many cases, follow you.”

Health care identity theft became more of a problem several years ago, Leaming said, which is why federal regulations have been put in place to try and stop it. He said it can take more than a year to clear up billing and medical record problems with hospitals or insurance agencies.

At Community Hospital, even employees show photo identification for treatments, said Shelley Friesen, the hospital’s business office director.

Friesen said that medical treatment will never be denied to patients at Community, but if anything suspicious is detected when a patient checks in, the hospital will internally investigate the case.

“We have seen cases where we have had identify theft happen,” Quillin said. “Is it a big issue?
No, but it is one of the issues that is terribly hard to look for because it’s terribly elusive. It’s getting riskier by the day, too.”


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