Medical Identity Theft Archives | Georgia Medicare Plans

Identity Theft Prevention Act

Bob Vineyard · March 13, 2015 ·

The Identity Theft and Tax Fraud Prevention Act of 2015 is proposed legislation whose time has come. Retirees are easy targets and carrying a Medicare card with your Social Security number on it is an open invitation to thieves. Medical identity theft is a so-called “victim-less” crime that often goes unnoticed until thousands of dollars in fraudulent claims have been filed.

Identity Theft and Tax Fraud Prevention Act of 2015

Sen. Sherrod Brown of Ohio has introduced legislation aimed at curbing identity theft by offering more consumer protections for your Social Security number.

The Identity Theft and Tax Fraud Prevention Act of 2015, among other things, would:

Allow the IRS to prohibit employers from displaying a worker’s full Social Security number on W-2 forms.
Phase out “unnecessary storage and display of Social Security numbers by Medicare and private health care providers.” Brown said the Centers for Medicare and Medicaid Services has been asked for years about removing Social Security numbers from Medicare cards but claims it needs congressional approval to do so.
Give victims the ability to pursue civil action against people who’ve committed fraud against them. – Cleveland

Georgia Medicare Plans supports this move to protect citizens from identity theft.

Protecting your Medicare card

In the past we have suggested carrying a copy of your Medicare card that has blacked out all but the last four numbers of your Medicare claim number which is also (usually) your Social Security number. This was not our original idea. We got it from Money Magazine.

But we have been taken to the woodshed by a MOM (Medical Office Manager) in this revealing post by a fellow blogger.

I was a bit perplexed when not once, but twice in the past few months, I had patients who presented a photocopy of their Medicare Card with their billing number (which is their social security number) blacked out. Each time I gave the “card” back to the patient and said I could not accept a photo copy, I needed the original card with all the information visible. You see, the only way I can get my doctor paid is to bill Medicare for your service and I need that number to bill. – InsureBlog

As Kelley goes on to say …….

because of identity theft and the ability to change insurances during the open enrollment each year (and sometimes more often), the physician has to confirm each time you visit that you do, in fact, have insurance, and that insurance is, in fact, yours. This is done by confirming your Insurance Number and Name with outside entities that assure your doctor that, yes, the insurance is active and you are you.

Thanks, Kelley, for pointing this out and helping us understand these issues from a doctor’s office perspective.

Medigap may offer more protection

In the battle against medical identity theft, a Medigap plan may offer you more protection than a Medicare Advantage plan.

As the Cleveland article pointed out, many insurance carriers use your SSN as part of your member ID number. Most retirees will review and often change Advantage plans on an annual basis. Each time you change that is more exposure to potential identity theft.

Contrast that with having a Medicare supplement plan that most will keep for years without making a change. We have clients who have had the same Medigap plan with the same carrier for 5 years or longer.

Contrast that with Advantage plans that are changed every 2 – 3 years.

When was the last time you reviewed your Medigap plan? Most of the people we talk to are paying too much for their plan by an average of $450 per year. We show them even more savings by swapping their expensive plan F for plan G or N.

With more than 170 different Medigap plans in Georgia, how do you find the best plan for you?

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#IdentityTheft #TaxFraud #MedicareCard #SocialSecurity #GAMedigapQuotes

Health Care Fraud – Medical Identity Theft

Bob Vineyard · February 24, 2015 ·

Health care fraud and medical identity theft is a growing concern for Georgia retirees on Medicare. Stone Mountain nurse convicted of health care fraud. New study finds medical identity theft grew by 22% last year.

The recent Anthem Blue Cross hack is just one more example of how thieves gain access to your information and can file fraudulent claims using your identity. Here is just one example of how this “victim-less crime” can impact you.

When thieves use your information to file claims everyone pays. Retirees on Medicare aren’t giving birth but their medical ID can be used to gin up claims and diagnoses that have nothing to do with you.

For instance, your ability to obtain needed pain medication could be compromised if a junkie is using your Medicare card to commit health care fraud and obtain prescriptions for pain killers.

Health care fraud, the victim-less crime

One reason why health care fraud is difficult to track is because most of the time it isn’t discovered until after the fact. There are no hidden camera’s to record a thief using your Medicare card to obtain medical services. When the crook uses your identity to fill prescriptions a fraud alert does not show up on the pharmacy computers.

Have you had your medical identity compromised?

In most cases the only way to know is to regularly review your claims. One way is by using iBlueButton to track your Medicare claim activity.

Unfortunately, too many people don’t look at Medicare claims or health insurance claims as their money. Claims paid by Medicare doesn’t come out of your pocket (directly) so why care?

Would you report a shoplifter to the store manager?

Most people probably would.

Why?

Because when someone steals from a store that store has to raise prices to compensate for the lost revenue. Similarly, when someone steals from Medicare or the insurance carrier prices have to rise. In the end, you pay more.

Higher health care costs.

Higher Medicare premiums.

We save our clients an average of $450 per year in Medigap premiums and over $1,000 yearly in out of pocket drug costs. Shop and compare now.

Medical identity theft impacts millions

The Anthem hack made headlines for many reasons, including unauthorized access to 80 million personal records.

According to Forbes, the distinction between medical identity theft and other types of identity theft like consumer financial information or credit cards is important for many reasons.

Data breaches in healthcare (like the Anthem breach) often involve permanently identifiable information like Social Security numbers and date‒of‒birth. This makes the data itself much more valuable, with a much longer shelf-life and easier for criminals to sell.
The direct out‒of‒pocket costs to victims of medical identity theft are significant. While the financial liability for consumer credit cards is often limited to $50 (and the card itself can be easily cancelled and replaced) the Ponemon study suggests that 65% of medical identity theft victims had to pay an average of $13,500 to resolve the crime.
Unlike credit card theft, medical identity theft victims are rarely informed by a healthcare entity about suspicious and potentially fraudulent activity for health services.
On average, medical identity victims typically learn of the fraudulent activity more than three months after a crime has been committed and 30% do not know when they became a victim. Of those who found an error in their Explanation of Benefits, about half didn’t know who to report the claim to.
Full resolution of medical identity theft is hard to achieve and the Ponemon research suggests that only 10% of respondents reported achieving a completely satisfactory conclusion.

Think about that.

If someone gains access to your credit card your liability is minimal as long as you report the fraud on a timely basis. Your card is revoked and a new one is issued.

Game over for the crook.

Not so when they have your name, Social Security number and date of birth. They can continue to use your identity to commit health care fraud for years.

Health care fraud hit’s close to home.

A stone mountain nurse filed fraudulent claims for services that were never provided.

Prosecutors say that between May 2013 and September 2013 Daphne Patterson billed five health insurance companies, including UnitedHealthcare and Aetna, for services she did not provide, reports WABE.
The indictment says Patterson “sought reimbursement for at least approximately $2.2 million for the various allergy tests and treatments that had not been provided to the health care benefit program beneficiaries.”
The indictment adds, “In total, Patterson received more than $1 million from the health care benefit programs as a result of the fraudulent claims.” – Atlanta Business Chronicle

All of that took place over 5 months. Consider the damage that could have been done if allowed to continue for years?

Protect yourself against health care fraud by regularly reviewing your claims. Report Medicare fraud when you discover it.

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#healthcarefraud #medicalidentitytheft #anthem #medicare

Anthem Blue Cross Hacked

Bob Vineyard · February 5, 2015 ·

Anthem Blue Cross recently made headlines but for all the wrong reasons. A “sophisticated” attack on their computer systems exposed millions of customer personal data to hackers. Current and former customers names, addresses, Social Security numbers, dates of birth and other personal information may be in the hands of the bad guys.

Most people think of identity theft as a source for opening fraudulent lines of credit in the consumers name, but this time it may be more ominous.

What Anthem isn’t saying about this breach that could hurt them more than it does you.

Anthem hack and fraud

No doubt the breach at Anthem is serious. Exactly when the attack occurred and what was stolen has not been completely revealed.

Most hacks are discovered by accident and often it is long after the attack. It is not unusual for a company to state they have never been hacked but the real question is, how do they know?

Unless one of their IT people stumble across suspicious activity, or clients complain about fraudulent activity, the company may not be aware of a problem.

I am not suggesting this is the case with Anthem, just making a general (but informed) comment.

How bad is it?

We don’t know, and possibly neither does Anthem. Much depends on how the breach was discovered and how often they backup their web traffic.

Exactly how many people are affected wasn’t immediately clear. The database that was infiltrated contained records for 80 million people.
The company is still investigating exactly how many records were actually stolen but, “at this point we believe it was tens of millions,” said Cindy Wakefield, an Anthem spokeswoman.
If the entire file was taken it would be “the largest health care breach to date,” said Vitor De Souza, a spokesman for Mandiant, the computer security company Anthem has hired to evaluate its systems. – USA Today

80 million records.

That’s a bunch.

How far back does the data go? Five years? Ten? Twenty?

Anthem isn’t saying.

What this means to you

Anthem has released a public statement about the situation and will be offering a credit monitoring service for their current (and presumably former) policyholders. What was stolen?

They don’t know (or aren’t saying) but it could include the following:

Hackers had gained access to the company’s computers and that their names, birthdays, Social Security numbers, addresses and employment data including income.

The logical path most consumers will take is wondering if someone will try to establish a line of credit with their information. Data monitoring services can certainly track that and there is a good chance you won’t find someone in Bangladesh buying a car in your name.

The more likely use of this data will come in the form of medical identity theft.

Hackers can use the Anthem data to print fake health insurance cards and Medicare cards. This kind of theft is more difficult to track and much more lucrative than applying for a Nieman-Marcus card in your name.

Credit cards have upper limits of anywhere from a few hundred to several thousand dollars. Once the card is used the fraud is exposed and the card is shut down.

But a health insurance ID card or Medicare card has an unlimited line of credit that can’t be tracked by credit monitoring services.

It is easy enough for a thief to make a new Bob Vineyard Anthem Blue Cross card and pay a street person $20 to pretend they are me, walk into a clinic and get a prescription for drugs. Take the prescription to a pharmacy that is in on the scam, fill the order, then sell the drugs on the street.

Things like this happen every day.

But once Anthem gets wind of a bunch of fake Bob’s getting fake medical care to buy real drugs all Anthem has to do is cancel that card and issue a new one with a new ID number.

But if the crook makes a fake Medicare card the theft is more difficult to detect. Even worse, since your Medicare number is also your Social Security number don’t expect Medicare to cancel the card. If you are on Medicare and have a supplement plan through Anthem claims filed with Medicare automatically are filed with Anthem once Medicare approves the claim.

If you have an Anthem Advantage plan the fraudulent claims are filed with Anthem for processing.

What you can do to protect yourself

You can take advantage of credit monitoring services. You can also freeze your credit. These steps should prevent most routine identity theft situations.

For medical identity theft you need to be proactive.

If you are a current or recent Anthem policyholder check your online claim reports on a weekly basis for the next few months. Report any suspicious claims to Anthem.

If you are on Medicare and have an Advantage plan with Anthem, log into your account to monitor and report fraudulent activity.

For your Medigap plan through Anthem log into MyMedicare.gov on a regular basis and report suspicious activity to HHS

Georgia Medicare Plans has a contract with Anthem Blue Cross and can place Medigap clients with Blue. However our preference is to use more competitive carriers that save our clients hundreds or even thousands of dollars each year. Many of these Medicare supplement carriers are low profile and generally not targets for hackers.

Shop and compare our Medigap rates instantly online.

#Anthem #hack #BlueCross #Medicare #Medigap #IdentityTheft #GAMedigapQuotes

Is Your Medical History a Target for Thieves?

Bob Vineyard · July 29, 2013 ·

Is your medical history safe from prying eyes? Do you trust your doctor? Where is your data most vulnerable? Why would thieves want your health history? How can you protect yourself?

Medical history thieves want your data.

Is your doctor’s office a gateway to stored medical information? How do you protect yourself?

Medical records hold an average black market value of $50 per record. He also cited other surveys that said 94% of health care organizations have had at least one breach in the previous two years.

Amednews

Identity theft makes headlines but mostly when it concerns credit. When was the last time you read about thieves targeting your medical history?

Did you hear about the breach at Stanford? In the most recent compromise 57,000 medical records were accessed.

This was the third time in as many years that Stanford patient data was hacked.

Why do thieves want your medical history?

Amednews gives you a clue.

Your records are worth $50 to a thief. Now multiply that by 57,000 medical records and suddenly you are talking about a lot of money.

Shameless plug follows.

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Is your medical history safe with your doctor?

Doctor’s offices can be a primary source or a gateway to even bigger game. Medical records stored on site are only the beginning.

Because data can now reside in multiple locations, including unsecured smartphones, laptops and tablets, and can be transported to an infinite number of locations, thieves, whether they be outside hackers, device stealers or people who try to use staff to share sensitive information, have more areas to target.

A thief that hacks your records at your doctor’s office can use the doctor’s passwords to get your records and those of others stored in hospital data banks.

How can you protect your medical history?

The sad news is, you can’t. Thieves have many ways to access your medical data that is beyond your control.

Most insurance plans no longer use your Social Security number as your ID, but Medicare has not followed this path. For most individuals, your Medicare number is also your Social Security number.

The best thing you can do is to monitor your medical history. If you have not set up your account at mymedicare.gov do so now. Check your claims on a regular basis (something you should already be doing). Report any suspicious activity to Medicare.

Be proactive when it comes to your medical history.