Prescription fraud occurs when an identity thief, using your personal information, has a prescription issued and possibly filled under your name. Prescription fraud is just one consequence of medical identity theft, where a thief obtains enough of your personally identifying information to be able to assume your medical identity.
Prescription fraud affects the victim in many ways, including their finances, ability to get necessary health care and possibly their ability to check their own health records. According to the Ponemon Institute’s 2013 Survey on Medical Identity Theft, 60% of medical identity theft victims they surveyed indicated that their identity was stolen to obtain prescription pharmaceuticals or medical equipment.
An identity thief using your identity to be prescribed restricted medications may also use your health insurance to purchase the medication. This means that you, the victim, will often get left with the bill for any unpaid expenses the identity thief incurs while using your identity and medical insurance. It is important to be alert for any explanation of benefits (EOB) you receive from your health insurance provider or bills for medical services you did not seek or receive. This may be your best warning that an identity thief is abusing your medical identity and insurance.
Unfortunately, there are worse consequences to being a victim of prescription fraud than bearing the brunt of fraudulent medical bills. When an identity thief uses your medical identity to be prescribed medication, this information will be incorporated into your health record. Any subsequent medical personnel looking at your record will see the new prescriptions and make medical decisions based on this fraudulent record.
Lastly, it can be exceedingly difficult to set your health records straight after an identity thief has received services or prescriptions under your name. Under the Health Insurance Portability and Accountability Act, or HIPAA, strict rules prevent access to patients’ medical records by unauthorized entities or individuals. Sadly, this very same rule prohibits victims of prescription fraud from accessing their personal health records in order to correct it because health care providers fear it may be a violation of the identity thief’s rights to confidentiality of their medical records.
The best defense to prescription fraud or any identity theft is to be keenly aware of your personal information. Any documents that contain personal information such as your birth date, Social Security number, driver’s license number, or insurance plan information, should be stored somewhere safe and secure or shredded when no longer needed. Do not carry your Social Security card, military identification, or Medicare card on your person as they have your Social Security number on them and are extremely helpful in the hands of an identity theft. New military identification cards no longer have Social Security numbers on them, so if you have an old military ID you can always renew your card to reduce your risk of identity theft.
"Prescription Fraud Resulting From Identity Theft was written by Sam Imandoust, Esq., CIPP, CIPA. He serves as a legal analyst for the Identity Theft Resource Center. We welcome you to post/reprint the above article, as written, giving credit to the author and linking back to the original posting.