Blog | Wednesday, July 3, 2013

Futuristic medical fraud prevention


An article from Bloomberg Businessweek highlights an interesting and often-overlooked area of medical fraud: patients that use false identification to obtain medical care, racking up huge bills under someone else's name.

Here's the lede: "When a Columbus (Ohio) man was indicted by a grand jury in April on identity theft charges, the case had nothing to do with stolen credit cards or bank accounts. Instead, police say the suspect, who pleaded not guilty, used a South Carolina man's identity to obtain more than $300,000 in treatment at Ohio State University's Wexner Medical Center."

The article points out that we know very little about how big of a problem medical ID fraud is, citing an estimate of about seven billion dollars per year in the U.S.

Some leading edge places have started using iris scans to verify patients' identities–like something out of spy movies.

I've only seen medical identity fraud a couple of times (that I'm aware of). In one instance, a patient took her sister's identity in order to get insurance coverage for medical treatment. Her treatment was astronomically expensive, so I could understand what prompted her to do this. When her true identity was discovered, she fled, and I don't know what ever happened.

The other case involved a person who turned out to be an undocumented immigrant who suffered what turned out to be a minor injury. In that case the patient used a co-worker's ID to get treatment out of fear of being reported to authorities and being found out as "illegal."

Again, it's not hard to see why a patient frightened by cost or authorities might elect to make such a choice.

It certainly is going to be harder to do this as iris scanning technology becomes more widely available.

As Businessweek does, I'll include "the bottom line" from their story here (talk about pithy!):

The bottom line: Data breaches cost hospitals about $7 billion a year. Biometric scanning gear is being used to verify patients' identities.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.