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Healthcare fraud and identity theft: digital data security

White-collar crime is by no means a technical term. It generally refers to financial crimes such as fraud, embezzlement and money laundering, historically committed by people wearing white shirts and perhaps even a gray flannel suit.

In its origins, then, the term "white collar" did not refer to doctors, nurses or others in white lab coats. But in practice, both in St. Louis and across the nation, many white-collar cases today involve claims such as Medicare fraud and Medicaid fraud.

One of the drivers behind the increase in healthcare fraud is the transition to digital health records. Electronic patient records are often vulnerable to security breaches. And this increases the change of identity theft, which is often involved in healthcare fraud.

Overall, the number of identity theft cases across the nation has more than doubled in the last decade. Ten years ago, there were 5 million reported cases. By last year, the number had increased to 12.5 million.

It isn't only the frequency of identity theft that has increased either. In the recent past, exposure to identity theft was more haphazard, as in cases of lost devices, purses or billfolds.

Today, however, identity theft cases have become much more sophisticated, often featuring high-end hacking and cyber attacks. The personal information obtained through these targeted tactics can then used as part of a larger fraud scheme.

For example, many healthcare fraud cases involve bills submitted to Medicare or Medicaid for work that wasn't actually performed. Personal information gained through identity theft is often used in the preparation of these bogus bills.

Source: American Medical News, ""Health data breaches usually aren't accidents anymore," Pamela Lewis Dolan, July 29, 2013

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