When we think of identity theft, most of us picture the use of one’s credit card information in order to make fraudulent purchases. Of course, this is just one of many examples of how identity theft can negatively impact one’s life. However, it can be argued that to steal a person’s identity for the purpose of robbing someone of their healthcare benefits is among the lowest things a person can do.
At Allegiant Experts, we have first-hand knowledge about how bad the issue of medical identity theft is becoming in our country. There is a growing number of people who have stolen the identity of others in order to misuse healthcare benefits. In fact, during an audit for a small Medicaid health plan in the District of Columbia, one of our team members discovered numerous pieces of odd clinical data.
They included such findings as 6 month-old infants suffering from Chronic Obstructive Pulmonary Disease (COPD), alcoholic cirrhosis and lung cancer, 56-year-old males giving birth and teenage girls with testicular cancer. We even located a case of an individual who was receiving health care services in multiple states at the same time! When the medically impossible is being reported for the purpose of securing healthcare benefits, you know there is a real problem.
While this is a problem that predominately impacts the financially disadvantaged, we are starting to see it impact others as well. In many cases, the financially disadvantaged are unable to attain ID or are not even required to show ID with their Medicaid cards. As a result, a large number of fraudulent insurance claims are being made and fulfilled.
However, in other examples of medical identity theft, we have seen cases of electronic health data being entered for visits and conditions that don’t belong to the member. In some cases this had lead to erroneous information being shared with treating physicians and underwriting resulting in inaccurate medical records, inappropriate healthcare decisions, cancellations of coverage or even denial of health plan coverage. Don’t assume, by the way, that this is a small crime. Perpetrators can face several years in prison for committing such acts of fraud.
As reported earlier this month by Brian Rogers on Chron.com, 67 year-old Jerrie Mona Chesney of Montgomery County, Maryland is facing five years in a federal prison after pleading guilty to using the identity of a dead woman to rob the federal government of nearly $400,000 in Medicare benefits. Chesney admitted to using Medicare benefits and food stamp benefits for nearly two decades.
She began her fraudulent actions in the late 1980s after contacting the family of a recently-deceased woman in order to get her personal identification information. Chesney was able to swindle the woman’s family by posing as an old high school friend. Using the woman’s personal information, she was able to assume the dead woman’s identity and secure a Texas driver’s license and a Social Security card.
“From 1995 until 2014, she was able to get Social Security disability benefits and food stamps totaling about $388,000,” reports Rogers, “She faces up to five years in prison and $250,000 in fines when she is sentenced by U.S. District Judge Lee Rosenthal on Oct. 16. She remains free on bond until that hearing.”
At Allegiant Experts, we couldn’t feel more strongly about the need to eliminate medical identity theft. This is why our team of clinical experts is so committed to doing its part. If you’re an attorney seeking assistance with your legal battle against those who commit fraud, please contact us at 407-217-5831.