Stolen Medical IdentitiesSometimes these "compromised healthcare providers" have their identifying information compiled into lists which are sold or traded from one criminal to another. This may wind up causing thousands of
false claims to be submitted using their identification. This may also cause millions of dollars in taxpayer money or in
health insurance proceeds to be paid out to crooks.
The Centers for
Medicare and
Medicaid Services (CMS) maintains a list of compromised providers that is used to screen for any claim submitted under that providers identification, including prescriptions, orders for durable medical equipment, orders for home
health services, orders for diagnostic tests and other services paid by a third party payer. CMS estimates that there are approximately 5,000 providers whose medical identities have been stolen and used to submit
false claims. A physician may be on this list and not even know it until his or her claims start being denied.
In 2011, Cybil G. Roehrenbeck of the American Medical Association wrote a good article explaining the entire problem in detail. I highly recommend that you review it and you can do so by
clicking here.
Helpful ResourcesCMS has published a "Fraud, Waste and Abuse Toolkit" to help
physicians and other
health care providers prevent the false use of their billing information. It is titled: "
Health Care Fraud and Program Integrity: An Overview for Providers." It also has several other informational publications on how
physicians and other
health professionals can avoid
identity theft. You can access these publications by
clicking here:
Contact Experienced Health Law Attorneys.The
Health Law Firm routinely represents
pharmacists,
pharmacies,
physicians, nurses and other
health providers in investigations, regulatory matters, licensing issues,
litigation, inspections and audits involving the
DEA,
Department of Health (
DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in
Health Law as well as licensed
health professionals who are also attorneys.
To contact The
Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Sources: Roehrenbeck, Cybil. "Physician
Identity Theft." ABA
Health eSource. (October 2011). Web.
"Fraud, Waste, and Abuse Toolkit." Centers For
Medicare and
Medicaid Services.(July 2016). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in
Health Law is an
attorney with The
Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The
Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.
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