2016 Healthcare Industry Wisdom on Medical Identity Fraud

Healthcare Industry Wisdom on Medical Identity Fraud is a collection of expertise by anti-fraud experts to help businesses within the healthcare industry better understand how to deal with medical identity fraud. It offers various food-for-thought on what a healthcare organization or business associate might consider when building or fine-tuning their anti-fraud programs.

Topics discussed in the paper include a look at the Medical Loss Ratio mandate and how it may be affecting health plans’ ability to invest more heavily in fraud prevention, health IT issues, and patient authentication.

Key points include:

1. The changing landscape within the healthcare sector that may contribute to medical ID fraud.

2. Current and forward-looking fraud management practices.

3. Identity proofing.

4. Fraud mitigation planning.

It also includes a Resource Appendix with information to solutions offered by MIFA members and partners.

A complimentary Executive Summary may be downloaded here.

How to Get the Paper

MIFA Members and Partners, contact Ann Patterson for your complimentary copy. If you are unsure if your company is a member or partner, please see our roster.

To obtain a copy of this report, please make a donation to support our mission to reduce medical identity theft and fraud. You will be directed to the paper after your donation.

Thank you to our Members, Strategic Partners and Working Group Members who supported this project

• AARP
• Aetna
• Association of Credit Counseling Professionals (ACCPros)
• BlueCross BlueShield Association (BCBSA)
• CareFirst BlueCross BlueShield of Maryland, Inc.
• Center for Identity Management and Information Protection-Utica College (CIMIP)
• Clearwater Compliance, LLC
• Coalition Against Insurance Fraud
• Consumer Federation of America (CFA)
• CSID
• Experian
• Florida Blue
• Generali Global Assistance
• Henry Ford Health System / Health Alliance Plan
• ID Experts Corporation
• Identity Fraud Institute at Hodges University
• Identity Guard
• Identity Theft Resource Center (ITRC)
• IDology, Inc.
• Information Systems Security Association – South Florida Chapter (ISSA)
• Kaiser Permanente
• LifeMed ID, Inc.
• Maryland Crime Victims Resource Center
• National Health Care Anti-Fraud Association (NHCAA)
• Northwell Health
• Secure ID Coalition
• Smart Card Alliance
• SPHER Inc.
• Stoel Rives LLP
• UnitedHealthcare
• U.S. Department of Labor Division of Energy Employees Occupational Illness Compensation
• U.S. Department of Veterans Affairs