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What Is Physician Medical Identity Theft?
By T.J. Evans, Esq. M
EDICAL IDENTITY THEFT is the fastest-growing type of identity theft. It can involve the theft of a patient's health
information or the theft of a physician's professional identifiers. Although physi- cians are implicated by both types, the latter can create substantial professional and financial harm for physicians. In fact, a Ponemon Institute survey estimated that resolving medical identity theft on average takes more than one (1) year and costs more than $22,000. Physician identity theft arises when
a physician's professional identifiers are used either to bill for services that are not actually provided or to order fraudulent
prescriptions or medical devices. A major contributor to physician medical identity theft is the widespread availability of physicians' professional identifiers, which are publically available on the National Provider Identifier ("NPI") registry website. A basic search for a physician reveals the physician's NPI number, license number, licensing state, and taxonomy. Until physicians' professional identi-
fiers are preserved as confidential, risk averse physicians should take steps to protect their identity. Physicians should consider: (1) educating patients on the importance of reviewing Medicare summary notices and the explanations of
benefits; (2) confirming the accuracy and currency of the information contained on the NPI registry website; and (3) verifying and updating their enrollment information at the Provider Enrollment, Chain and Ownership System website. T.J. Evans is an attorney with Krugliak,
Wilkins, Griffiths & Dougherty Co., LPA, in Canton. s Note: This general summary of the
law should not be used to solve individual problems since slight changes in the fact situation may require a material variance in the applicable legal advice.
NOVEMBER-DECEMBER 2012 s MDNEWS.COM s MD NEWS Cleveland/Akron/Canton | 35
