The Rise in Health Care Fraud

The Rise in Health Care Fraud

Health care data is increasingly becoming a top target for scammers and hackers. A reason why fraudsters may be going after health care data more is because of its longer shelf life and rich potential for identity theft. Financial data has a finite lifespan and loses its worth as soon as the consumer notices the frauds and cancels their accounts or cards. However, health care data contains information that can’t be cancelled or changed as easily as a credit card.

Every year, with the exception of 2015, the number of healthcare data breaches has increased 70%, rising from 199 breaches in 2010 to 344 in 2017.[1] According to a study published by the Journal of American Medical Association, “those breaches have resulted in the loss, theft, exposure, or impermissible disclosure of 176.4 million healthcare records. 75% of those records were exposed or stolen as a result of hacking or IT incidents.” Medical identity theft not only affects the patient (consumer), but has potentially disastrous ramifications on insurance providers as well as the healthcare providers.

What is medical identity theft?

Medical identity theft occurs when a fraudster illegally obtains and uses a patient’s Personally Identifiable Information (PII), such as name, Social Security number, and/or medical insurance identity number, to fraudulently obtain or bill for medical goods or services. This kind of fraud also includes the unauthorized personal gain of insurance benefits, prescription drugs, employment, government benefits, or other financial gain acquired through the theft of another individual’s PII. Hackers have also been known to sell stolen health care records on the black market.[2]

The ten largest data breaches of patient data in 2018 involved email, targeted phishing attacks, and database misconfigurations. The largest health data breach during this same time was caused by a hack on a billing vendor, AccuDoc Solutions. 2.65 million Atrium Health patients were involved in the breach.

Who is at risk?

Everyone is at risk for medical identity theft but seniors are increasingly targeted. Navigating the Medicare system isn’t easy to begin with. When confusion enters the picture, scammers view it as an especially ripe time to take advantage of the ever-growing aging population. Always keep in mind that Medicare will never call to ask for sensitive personal financial information.[3]

How can you help protect yourself?[4]

  • Review the Explanations of Benefits (EOB) statement or Medicare Summary Notice that your health plan sends after treatment. Immediately report any mistakes or unfamiliar charges, such as a doctor’s visit you did not make or prescriptions that you did not fill.
  • Check in with your doctor(s) to ensure your medical records are accurate. Make sure the records contain your procedures, treatments, prescriptions, and other medical activities. If you notice inaccurate health details such as the wrong blood type, pre-existing conditions, or allergies, it may be a sign that an identity thief has accessed your records.
  • Get a copy of your medical records periodically and keep them in a safe.
  • Do not share your medical or insurance information with other individuals.Especially do not provide your medical information over the phone or via email unless you initiated the contact and have verified the entity you are contacting.
  • Treat your medical identity with the same care and caution you do any of your other sensitive information, such as your financial credentials. Shred health documents you no longer need. Peel the labels off of your prescription bottle and shred them as well.
  • Read the Privacy Policy on a website before you provide your Personally Identifiable Information. Find out why your Social Security number or insurance account numbers may be needed and how the website will keep it safe, or if it will be shared, and if so, with whom. (Websites with “https” in their URL are secure.)

If you are unsure about sharing your personal information with someone who says they are from your health plan—DON’T. Directly contact the Member Services number on your ID card so you can be sure the person is a verified health representative.

Taking the Mystery out of Shopping Scams

Taking the Mystery out of Shopping Scams

It’s no secret that being a mystery shopper for a reputable company is a legitimate way for an individual to earn some income. Mystery shopping, also known as secret shopping, is estimated to be a $1.5 – 2 billion dollar industry with over 8.1 million mystery shops conducted a year. This profitable enterprise has been around for decades.

Contrary to what many believe, mystery shoppers don’t get paid to shop. They are independent contractors who pose as shoppers in order to gather data about the customer experience in a specific environment. Mystery shoppers complete reports, often using an online form, after leaving the establishment they observe. They get paid for their work and do not front any money first in order to work.

Fake check fraud is an exploding epidemic and scams involving the mystery shopping industry have made a big comeback … unfortunately, our tech-savvy teenagers are the targets of late.

Anyone with a bank account and the desire to make some extra cash on the side can be a victim. High school and university students across the nation are increasingly being pursued. Why students? Students are easy targets for scammers due to their need for money to help fund their education.

Thousands are being contacted and thousands of dollars are being lost. The latest mystery shopping scam reported in the media last month disclosed that University students in Fargo, North Dakota had been targeted. One devastated student ended up losing $3,850.75. Being educated on how this type of scam operates will help prevent this from happening to you and your child.

How Does a Mystery Shopping Scam Work?

  • Scammer reaches out to victim with an offer in the mail to be a secret shopper and a check is included. Often times the amount on the check is for over a thousand dollars. The victim is told to deposit the check and understands that they will eventually keep several hundred dollars as payment for their upcoming shopping services.
  • Victim deposits the check and waits the expected day or two for the funds to clear. Note that even if the bank says the funds are available in a couple of days, the process of uncovering a fake check can take financial institutions weeks.
  • Victim is asked to buy something. Typically, the first shopping task is to test the in-store money transfer service like Western Union or MoneyGram by sending some of the money that was deposited back to the company.
  • Victim is then asked to buy a product, “often from a Walmart,” according to the Federal Trade Commission. Common items purchased are reloadable gift cards, such as iTunes. Part of this task requires the victim to send pictures of the purchased cards or to give the numbers on the cards to the company.
  • Two to three weeks later, the victim receives a notification from their bank that the deposited check was a fake. The realization that they have been scammed sets in. Victim is responsible for paying back the amount to their bank. Another unfortunate bonus is that the reloadable gift cards that the victim had purchased are suddenly empty of funds.

 

What Can You Do?

Help stop these scammers from making money. Educate your children about the issue. Explain what check fraud is. Let them know that they should never pay to become a mystery shopper. The fact that these scammers are targeting our children is another great reason to make sure that your identity theft protection covers every member of your immediate family.

3 Common Back to School Scams

3 Common Back to School Scams

You may think your children are safe; however, no matter the age of your child, whether they are a pre-teen or young adults, they are never out of the reach of cybercriminals and scams. The best way to protect your children is to teach them the signs of an untrustworthy email or a suspicious phone call. By doing so, you are protecting them when you may not be present.

If you, yourself, are unaware of what to look for, here are the 3 common back to school scams you should be familiar with.

Phishing Scams

Students who are, for instance, heading to university should be wary when it comes to their emails. The phishing scams that usually circulate this time of year are trying to get you to share your personal details, for the purposes of identity theft and fraud. Be cautious of any emails sent with regards to any loans you may be taking out, or if your bank or university themselves are asking for financial or personal details.

The best way to snub these emails is to phone the company they are perpetrating to be. They will be able to say whether they sent you an email or not. If it is the latter, you can ignore the email. Of course, if you do accidentally fall prey to a phishing scam, there are professionals in identity fraud who can help you out. You should also notify your bank immediately.

High School Diploma Scams

Not all of us complete our high school diplomas in the usual settings, and so if you are returning to high school or completing your diploma via online learning, you need to be cautious about the company or facility you are putting your trust in. Not only do these types of scams cost you money, but at the end of the day, the victim still won’t have a diploma.

The usual red flags consist of you having to pay for a diploma, being able to earn a diploma in a short amount of time (a couple of days or so), and being able to take the test online (these tests are never administered over the internet).

Scholarship Scams

College is not cheap, and unfortunately, some students have to take out loans for them to be able to pay for their education. Fraudsters, therefore, have found ways to offer fake scholarships to soon-to-be students. To protect yourself, follow these following tips:

  • Never pay for your scholarship. You will never be expected to pay fees or taxes, so if they ask you for any payment, it is a scam, and you should ignore it.
  • If a company guarantees your scholarship, this is, sadly, a sign of a scam. While companies are looking to help students, they can never guarantee a scholarship, and so this is a major sign of fraudulent activity.

You can never be too trusting when it comes to protecting your identity and finances, especially when it comes to securing your future with regards to school and tuition fees. Therefore, be sure to question any unusual activity, and if you are ever unsure, ask for proof by phoning up the company and confirming the email of the person they are claiming to be.