Cleveland Jewish News

Take precautions to avoid health care identity theft

February 1, 2024 | By Alexandra Golden | Andrew Zashin consulted and quoted

When it comes to health care identity theft, it can fall under the subcategories of health care fraud and general identity theft. Once someone’s information is stolen or misused, it can be difficult to recover it and may affect what services they are able to receive in the future.

Madelyn Grant, attorney at Friedman Nemecek & Long, L.L.C. in Cleveland, and Andrew Zashin, founding partner of Zashin Law in Mayfield Heights, spoke with the Cleveland Jewish News about the different forms of health care identity theft and the different ways it can be stolen.

“Health care identity theft falls under a larger umbrella of just health care fraud in general,” Grant said.

With health care fraud, the “most common things” people would think of are doctors improperly coding for the wrong service, “upcoding” for services that were not completed or are more expensive, or the theft of the health insurance information, social security information, Medicare numbers and using that information to submit fraudulent claims to the health insurance, she said.

It can also fall under the subcategory of general identity theft, Zashin said. This can be a person wanting someone else’s health care or health care related items, medicine or treatment that “they might not be able to have gotten themselves” or that they “just want the benefits from another person,” he said. These benefits include drugs, services or treatments, Zashin said.

Having information stolen can hinder future services and care because someone else used them before you had the opportunity to, Zashin said.

People might assume that health care identity theft affects only the older population as they often fall victim to scams over the phone, which is one of the ways people obtain information, Grant said.

“I think it’s because they’re not, understandably so, used to somebody calling to try to scam them out of their information,” Grant said. “I think that the younger generation is a little more nervous about things like that and they’re not so quick to give out their information over the phone or over email.”

Although the elderly are impacted, it can affect anyone. But, the two categories of people that are mainly impacted are minors and people who are getting treatment more regularly, Zashin said. The ones regarding minors “typically fall under the radar” because “of the nature of their treatments” and “parents aren’t expecting to review the benefits that minors might receive,” he said. Moreover, minors are not getting credit reports which make it harder for parents to figure out if their insurance is being abused, he said.

“Those people who are getting lots of treatment might miss people who are using their services inappropriately,” Zashin said. “They might miss certain treatments that have been poached from their basket of available services.”

There are different ways that information can be stolen and obtained. It is still the same crime whether someone voluntarily or involuntarily gives the information, Grant said. One of the ways is from a party that has the information being hacked, she said.

“My insurance carrier could get hacked and my information could be leaked that way. Or my insurance information, which is potentially submitted through an employer, that employer could get hacked and my information could be fraudulently used or obtained that way,” Grant said.

The information could have been stolen by “general sloppiness,” by people not paying attention or someone “inappropriately” trusting someone else with it, Zashin said.

“People need to be very careful with their information, keep secure and in a proper place … and not trust people … with what would otherwise be confidential,” he said. “Not be too trusting with confidential information. Not even about your condition or what the nature of your treatment. Just as you would protect your credit card numbers and your financial information, keep your insurance and health information private.”

When information is stolen, it can be “very difficult” to recover. People should take the same steps as they would in an identity theft situation, but there is no “one-size-fits-all” rule for that, Zashin said. People should try to figure out where someone could have obtained their information by retracing their steps, he said.

A way to prevent information being stolen is to never give it out over the phone or email, Grant said. If information is needed over email, Grant recommends sending information in separate emails, so it is not all together in one, or verifying with the sender that they are the ones who sent the email, she said. People should also watch over their insurance bills to make sure they are being billed for the services they received, she said.