KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Medical ID Thefts Can Harm Patients’ Health; Prosecutors Go After Medicare Fraud

News outlets covered different aspects of fraud in the health care system.

NPR/KSMU: "Experts say a different type of identity theft is on the rise -- one that could compromise both the victim's credit and physical safety. Patients using someone else's name, Social Security number or insurance card to get health care could risk their victim's health if inaccurate information, such as blood type and medications, is recorded on the victim's chart." Officials at CoxHealth Hospital in Springfield, Mo., "say more and more of these patients walking through the doors are pretending to be someone else so they won't have to pay for their own medical bills." 

"Pam Dixon, executive director of the World Privacy Forum ... says that in nearly all the identity cases she's seen, medical charts are changed, and that poses a major problem. 'We've had people who, all of a sudden, their health care record has different blood types,' Dixon says. 'They have health care records with different genders and ages. Different medications.' ... Dixon says there's no national standard for dealing with medical identity theft. It's also hard to fix once the damage is done" (Moore, 3/3).

The Miami Herald: "The fact that Yamill Ramos Perez, the owner of two Hialeah pharmacies, tried to dupe Medicare into paying him $20 million was hardly distinctive in Miami-Dade County, widely regarded as the nation's healthcare fraud capital. What set Ramos apart was that he threatened the lives of a Medicare fraud investigator and a government official last year, after his pharmacies were put on 'prepayment review' because of suspicious billing to the federal entitlement program for the elderly and disabled. No Medicare-licensed operator anywhere in the country had ever done that before, according to authorities." Ramos, who eventually pleaded guilty to conspiring to commit health care fraud and harrassing the officials, was sentenced on Tuesday to nine years in prison (Weaver, 3/3).

South Florida Business Journal: The government alleged that Ramos' two businesses "received about $6 million in fraudulent reimbursements" (3/2).

KMJ (Fresno, Calif.): Marian Moreno, 57, was convicted of Medicare fraud. She "targeted low-income seniors in Sanger and Parlier telling them they needed to purchase pricey powered wheelchairs. ...  Moreno turned over the patients' insurance information to an equally fraudulent Los Angeles clinic for bogus wheelchair orders -- in exchange for a cut of the profits" (Carrero, 3/2).

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