The Growing Threat of Medical Identity Theft Among the Elderly

Computer keyboard with a button titled medical identity theft.

Medical identity theft is becoming a threat to elderly persons around the nation, particularly those living in nursing home facilities. Elderly identity theft statistics show an increase of 8,902 medical identity theft cases in 2021, a significant increase from 2,744 in 2019.

If you have an elderly loved one at risk of financial abuse, you can take proactive steps to prevent medical identity theft and protect their personal information. Knowing the signs of medical identity theft in nursing homes or assisted living facilities and taking swift action if suspicious activity occurs helps ensure your loved one receives the care they need without fear of financial harm.

What is Medical Identity Theft?

Medical identity theft involves using personal information, such as Social Security numbers, to bill Medicare and insurance companies for services that victims didn’t receive. Older citizens who have had their insurance information stolen can experience the following examples of medical identity theft:

  • Bills from a doctor for services not provided
  • Services and prescription medications that the victim did not receive on the Explanation of Benefits statement
  • Calls from debt collectors for medical debts
  • Credit score reports, including unrecognized medical debt collection notices
  • Letter from the health insurance company stating that the victim reached their maximum benefit limit
  • Denial of health insurance coverage due to the medical records showing a pre-existing condition

How Does Medical Identity Theft Occur?

The HHS Office of the Inspector General reports that nursing homes and assisted living facilities are prime targets for fraudsters who offer medical services in exchange for Medicare and Medicaid numbers and submit fraudulent claims. Providers and prescribers may perform medically unnecessary treatments or give unneeded medication or medical products, then bill for the extra services.

The trusting nature of senior citizens makes them particularly susceptible to such abuses. According to the FBI, they are more vulnerable to identity theft and fraud because of their difficulty saying no to scammers. Additional factors such as shame and uncertainty about how to report these incidents make them less likely to report incidents when they occur.

Chart showing total medical identity theft loss in millions. 60 million in 2021 and 25 million in 2019.

This vulnerability has resulted in increased financial losses among older people. According to recent medical identity theft stats, the total loss due to identity theft in 2021 was $59,022,153, marking a significant increase from the $25,739,680 reported in 2019.

Medical identity theft can have severe consequences, such as medical errors, incorrect diagnoses, delayed treatment, and increased healthcare costs. 20% of medical identity theft victims received the wrong diagnosis or treatment, or their care was delayed due to confusion over their medical records.

What to Do if Someone is Using Your Loved One’s Medical Information

It is vital to take action if you suspect medical identity theft is happening to your loved one. If you suspect an elderly relative is a victim of medical identity theft, take the following steps to limit the damage and protect their health and financial well-being:

Check Medical Records for Errors

Review your relative’s medical records for errors, such as missed or unreceived visits or services. Contact each healthcare provider where the perpetrator may have used your loved one’s information and request copies of medical records.

When examining these documents, look for potential red flags indicating fraudulent activity. Some examples of these warning signs include mistakes in group or account numbers and incorrect names of medical professionals, facilities, or procedures. If you notice any discrepancies, notify the health plan provider and report the inconsistencies immediately.

Evaluate Your Loved One’s Credit Reports

You can get a free copy of your loved one’s credit report from the three main credit bureaus, Experian, TransUnion, and Equifax, at AnnualCreditReport.com. Look for medical billing errors on your loved one’s credit report, such as unrecognized collection notices for medical debts. If you find any medical billing errors in the credit report, you can make a report through the FTC’s IdentityTheft.gov.

Create a Personal Recovery Plan

Visit IdentityTheft.gov to create a personal recovery plan that includes steps to take in case of medical identity theft. The site walks you through each recovery step, updates your plan as needed, tracks your progress, and pre-fills forms and letters. Implementing a fraud alert or a credit freeze can help prevent future fraud on your loved one’s credit report.

Consider seeking the help of a nursing home abuse lawyer to pursue justice with guidance and support throughout the legal process. This can include explaining your rights, answering questions, and helping you navigate the complex legal system.

Punishment for Financial Elder Abuse in California

Under Penal Code § 368(e), financial abuse of elders is considered a serious crime, and perpetrators can face severe punishment. If someone is convicted of financial elder abuse in California, it is considered a wobbler offense. This means they may face misdemeanor or felony criminal charges that come with jail time and fines of up to $25,000.

Victims of elder financial abuse and their families can also seek restitution against perpetrators through civil action. This can involve filing a claim for damages against a nursing home facility or its staff through their insurance carrier or a personal injury lawsuit against an individual or organization.

You can pursue economic damages for your loved one through a civil claim to help them recoup the money lost through fraudulent activity. They can also receive funds for medical care they paid out of pocket due to financial abuse.

A personal injury attorney can also help your loved one seek non-economic damages for their abuse, including pain and suffering, emotional distress, and loss of enjoyment of life. These claims hold the perpetrators responsible for their actions outside of the criminal justice system.

Preventing Senior Medical Identity Theft

Senior medical identity theft can compound the damage and harm inflicted on victims’ credit reports and healthcare needs. It is essential to take proactive steps to prevent this abuse, such as regularly reviewing medical records and financial statements for any signs of fraudulent activity.

If you suspect your loved one has been victimized by elder financial abuse due to senior medical identity theft, you should immediately contact the police and seek legal help.