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July 22, 2014

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CRIME:

Complications abound when identity stolen is a patient’s

Scott Bennett

Scott Bennett

Ronald Adkins

Ronald Adkins

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Scott Bennett has gone to Las Vegas Valley hospitals for medical care dozens of times in the past five years — impressive for a Texan who hasn’t set foot in Nevada since 1998.

The real Scott Bennett is a 45-year-old engineer who works at the Federal Reserve Bank in San Antonio. The Clark County patient is a fake Scott Bennett, a 56-year-old drifter named Ronald Adkins who stole Bennett’s identity, authorities allege.

Adkins goes to a hospital and, months later, Bennett gets a collection letter. The bogus Bennett has racked up more than $20,000 in hospital charges that the bona fide Bennett must prove aren’t his.

Although medical identity theft makes up only a small portion of all identity theft crimes — about 3 percent of cases reported to the Federal Trade Commission in 2007, or roughly 250,000 known victims annually — it’s a growing fraud that experts say can be far more destructive than other forms of ID theft. People who discover their bank accounts have been compromised can dispute charges and set up credit monitoring services. People whose medical identities are stolen, however, have no clear-cut way to correct inaccurate records or challenge false insurance claims. Straightening out stolen health care is a red tape nightmare, complicated by strict patient privacy laws and the paper-shuffling bureaucracy of insurance providers.

This isn’t just maddening, it’s potentially dangerous. An impostor’s medical procedures can contaminate the victim’s records — if the fake Bennett gets a Type A blood transfusion, for example, doctors looking through the real Bennett’s records after a serious car accident might reasonably assume it’s the type he needs, even if that’s incorrect.

The potential for improper treatment will only grow, experts fear, as medical providers trade paper records for electronic archives and the country moves closer to a computerized health information network.

Because the real Bennett lives in Texas, the fake Bennett’s Las Vegas medical care hasn’t tainted doctors’ files kept in San Antonio. If medical records are electronically shared among hospitals, however, the real Bennett could have problems anywhere.

And Bennett has enough problems with his impostor already.

Ronald Adkins rented a room from Bennett in 2000. The two men had met one year prior, and Adkins seemed all right ­— religious, always at Bible study, quoting Scripture and watching TV evangelists. So Bennett was surprised when he came home after a weeklong trip to find some of his personal documents and credit cards had vanished with his roommate. In the following months, someone traveling from San Antonio to Oklahoma City took cash advances on new credit card accounts opened in Bennett’s name. Grainy ATM photos later showed it was Adkins who withdrew the money, Bennett said.

Bennett subscribed to a credit monitoring service and in the next few years got alerts about suspicious activity. A fake Bennett opened a store credit card in Colorado. He checked out books from the Denver library and never returned them, so Bennett got the collection notice. He got a job in Louisiana, but the bill from the IRS for unclaimed income went to Bennett. The bogus Bennett gave false addresses, which meant it took months for the real Bennett to become aware of each incident, when the charges or debts would show up as a collection on his credit report.

Bennett got his first collection notice from University Medical Center in 2004. Since then, someone has gone to Las Vegas Valley hospitals 38 times posing as Bennett, according to the victim’s accounting of incidents, which is based on the bills he receives. Metro Police say that so far they have been able to determine that on at least 19 of those occasions, the patient was Adkins posing as Bennett.

Eventually, Bennett got the bills — stacks of them. One hospital stay can involve several entities with their own billing departments: labs, doctors, ambulances, hospitals, pharmacies. Bennett had to provide each with a police report and a Federal Trade Commission affidavit claiming his innocence. Even with paperwork and police reports, Bennett often spends hours on the phone with billing reps, a headache anyone who has wrangled with his insurance company can appreciate. Imagine fighting over bills that aren’t even yours.

One woman found her medical identity had been stolen when she received a bill for the amputation of her right foot. After weeks of fighting the charge, BusinessWeek reported, she stormed into a hospital administrator’s office and propped her heels up on his desk — both of them.

The real Bennett doesn’t know much about his impostor’s hospital visits. The bills he receives are seldom itemized, and when he has asked for that information, in the course of disputing charges, privacy laws prevent anyone from providing it.

Some medical identity theft victims have successfully convinced hospitals and doctors of their circumstances only to find that, as a result, they can no longer look at their own medical records because if the care providers provided access, that would compromise the privacy of the impostor who has infiltrated them.

Salt Lake City mother Anndorie Sachs discovered her medical identity had been stolen when social workers reported her newborn tested positive for methamphetamine and the state was going take all four of her children away as a result, MSNBC reported. Only, Sachs hadn’t given birth in years. A meth user who stole her identity had. Even after Sachs hired a lawyer to sort out the mess, when she landed in the hospital with a kidney infection, the meth user’s address was listed as her emergency contact — their medical records had been intermingled. When Sachs asked to see the records, hospital staff refused. They weren’t just hers anymore.

The few itemized bills Bennett has received make it clear his impostor obtained powerful pain medications. One $4,900 bill from Desert Springs Hospital lists charges for oxycodone and hydromorphone.

In April, Metro detectives obtained a warrant to arrest Adkins. His is one of roughly 20 medical identity theft cases Metro detectives have investigated in the past year, according to Lt. Robert Sebby, who thinks unemployment and the failing economy have exacerbated the problem.

“People are still sick, and they’re going to see a doctor somehow,” he said.

In many cases, medical ID theft is an inside job, perpetrated by people with access to records, he said. Moreover, it’s not always a matter of one impostor stealing one victim’s identity. A medical clerk in Florida made headlines after she downloaded the records of more than 1,000 Medicare patients and gave them to a relative, who used the information to make $2.8 million in fraudulent claims. In other cases, thieves have set up bogus free clinics merely to collect information from duped patients and bill their insurance companies for services never rendered. Stolen medical records are worth about $50 on the black market, according to Pam Dixon, author of a report on the subject and founder of the nonprofit World Privacy Forum. Dixon, like many observers, is an advocate of the FTC’s proposed “red flag” rules, which would require doctors to take extra steps to identify and “flag” identity theft. In April the FTC delayed enforcement of the flagging rules until August, after groups such as the American Medical Association protested, arguing the responsibility to identify thieves should fall on health insurance carriers.

Red flag rules, and similar efforts on behalf of medical professionals, are necessary as America increasingly interconnects medical records, said Linda Foley, founder of the nonprofit Identity Theft Resource Center.

President George W. Bush wanted every American have an EMR, or electronic medical record, by 2014, and President Barack Obama recently echoed that call, pledging the government would contribute $19 billion to the cost of making everyone’s records computerized within five years.

Without a system for identifying and rectifying cases of medical identity theft, the new, national records system could lead to new, national ID theft problems.

“Sometimes a crime comes up and we don’t have the laws in place to help deal with it,” Foley said.

The fake Scott Bennett’s last known visit to the hospital was in late March, according to his arrest warrant. The real Scott Bennett expects to get the bills any day now.

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