Anthem hack opens multiple inroads to healthcare fraud
Over the past several years, IT experts have been frantically directing their attention toward healthcare, clamoring for the industry to improve cybersecurity, especially as more providers transition toward electronic health records (EHRs). Just a few weeks ago, President Obama highlighted cybersecurity as one of his top priorities in his State of the Union address.
Last week's Anthem hack has brought many of those concerns to life, exposing the personal information of approximately 80 million consumers. While many have pointed to the immediate financial impact of the hack, consequences surrounding medical fraud could leave a lasting impression.
Specifically, the information obtained through the Anthem hack--names, birthdates, addresses, email addresses, employment information and Social Security/member identification numbers--opens up three distinct avenues for healthcare fraud, said Ann Patterson, senior vice president and program director for the Medical Identity Fraud Alliance (MIFA) in an exclusive interview with FierceHealthPayer: AntiFraud.
First, fraudsters can use personal information to submit fraudulent bills for services that were never actually performed. Second, criminals can fraudulently fill prescriptions using the information obtained in the hack, and then resell the narcotics for street value. Finally, thieves can use stolen information to obtain care under someone else's name, potentially altering the medical record of that individual.