Will 2010 be a Banner Year for Identity Thieves?

For the past six months or so, this blog was put on hold. I could come up with a lot of excuses why it was put on hold -- such as increased workload and job responsibilities -- but I probably just needed a break from writing.

Now that I am taking a look at getting back into blogging, it doesn't appear much has changed in the fraud arena or that the news is getting better. Of course, I probably already knew that. After all, I didn't get much of a break from all the fraud that is going on out there, I merely wasn't writing about it.

For instance, Jay Foley at the Identity Theft Resource Center did a recent interview with Tom Field at Bank Info Security and is predicting some scary trends for 2010. Two of the predictions are that medical identity theft and too good to be true scams will be on the rise.

I can attest to the too good to be true schemes being on the increase. They happen all over North America on a daily basis. Strangely enough, the scams seem to recycle themselves and use the same bogus financial instruments, over and over, again.

"Well, first and foremost we are going to see a lot more scams. Because of the tough economic times, we are seeing a lot of scammers come out of the woodwork and try to suck you into this quick job, that quick job, here make a little extra money, and invariably what happens is you find yourself on the hook for greater debt and greater problems because you went to work with these scammers," according to Jay Foley.

Besides this, Jay is predicting an increase in medical identity theft, which struck me as "interesting" given all the media attention on health care legislation. Apparently, he is seeing a lot of people, who are without insurance, use some else's name and social security number to piggyback on someone else's benefits. In the article (also a podcast), Jay aptly points out that the medical industry has been plastering social security numbers on just about every document they create for years.

It should be noted -- especially as move towards digital medical records -- that in the wrong hands these records can be used for more than medical identity theft. The same information can be used to commit a host of financial crimes, including scamming the government and the insurance companies. In case you missed it, the WSJ did a story on the subject, where an insider (employee) downloaded 1100 records, which were later used by his cousin to commit $2.8 million in fraud.

There is no doubt that medical records have been identified as an easy place to steal information by the criminal element. The "trillion" dollar question right now is if making these records digital is going to make the problem worse? Only time will tell.

Estimates on medicare fraud vary greatly, but some go as high as $80 billion a year. Please note this is an estimate on medical fraud in the public sector and doesn't account for the fraud directed at the private sector. The NHCAA (National Healthcare Anti-Fraud Association) is a good place to see all the different aspects of this growing problem. The end result is a monetary loss that we all end up paying for, whether as a taxpayer or a consumer.

It's pretty hard to get an accurate estimate of how much fraud occurs, we can only guess what it might be based on the known incidents. The reality is the more successful frauds are never discovered. After all, most of the people committing fraud go to great lengths to keep their activities anonymous. It is bad for business, otherwise.

So far as industries that will be targeted, Jay predicts the payment services industry and medical industry will be the most attractive to information thieves. Is this because the payment services industry is where there is instant access to money and the medical industry has an abundance of easily accesible information to steal?

Also predicted is that the scammers, hackers and identity thieves behind these schemes are going to be much younger. Citing the urban legend status given to Albert Gonzalez (28), who has now been identified as being a member of the Shadow Crew and behind the TJX, Heartland and Dave and Buster's breaches as a fueling factor. According to Jay, his group is seeing a trend where teenagers are putting up fake e-commerce sites etc. etc. to steal payment information and steal money.

Jay also points out that most information theft is being done by insiders, or people who are given access to it. I've always said that you can have the best security systems out there -- but if you give the wrong person access -- even the best systems can be redered useless. With information being worth money, people can be recruited or even planted in organizations to steal it. While the Albert Gonzalez types make good news stories, if an organized crime group (or lone crook) wants to get in a system, it's a lot easier if they have an inside connection.

Perhaps we need to take a step back and realize that the human being is the most important part of any security equation. Human beings are on both side of the equation, whether they are the victim or the victimizer. As long as we continue to maintain information in easily accesible places (to make money) and send it (electronically) all over the place, we are going to have a problem.

You can read more about Jay Foley and the Identity Theft Resource Center (highly recommended), here.

Rapper DMX Charged With Medical Identity Theft

Earl Simmons a.k.a. DMX -- a rap artist who seems to run afoul of the law frequently -- was arrested in a Phoenix mall on Saturday for identity theft.

Apparently, DMX used the name Troy Jones when seeking medical care for pneumonia, according to KNXV-TV in Phoenix. He also used a social security number that didn't belong to him. Allegedly, DMX did this to get out of paying a $7500 bill.

Earlier this month, DMX was arrested at Sky Harbor Airport in Phoenix for outstanding warrants. He was flying into Phoenix after being arrested for drugs in Florida. Maybe the reason, he doesn't have the money to pay his medical bills is because of all the drugs he buys (speculation)?

Prior to this arrest, DMX was recently arrested for speeding over 100 miles per hour on a suspended licence, drugs and animal cruelty. According to a Associated Press article, Maricopa County Sheriff Joe Arpaio said the investigation into DMX committing identity theft started following the investigation into animal neglect at the rapper's home in Phoenix. During the search warrant of DMX's digs -- drugs, guns and 12 malnourished Pit Bulls were found. The remains of three other dogs were found on the property, also.

The type of identity theft DMX allegedly committed is known as medical identity theft. Medical identity theft is a growing phenomenon that causes great harm to it's victims, according to the World Privacy Forum, who performed the first in-depth study of the problem.

Despite the risk it carries, it's probably one of the least studied forms of identity theft. When someone becomes a victim of medical identity theft they not only face having to fix all their financial records, they also face having a lot of erroneous information placed in their medical records.

Medical identity theft victims might receive the wrong treatment, have their insurance used up, and could even be classified as a bad risk when seeking life and medical coverage. They could also fail a medical exam for employment when diseases show up in their medical records that they never had.

While most identity theft victims can correct errors in their credit reports and place alerts or freezes to prevent further fraudulent activity, the victim of medical identity theft doesn't have the same legal rights to clear their files of bad information. In some instances, they aren't even allowed to see what is in their files. Furthermore, medical identity theft victims don't have the right to stop insurers, health care providers and medical clearinghouses from sending this information back and forth to each other.

As medical records become electronic, this poses even greater risks because the information is being transmitted to a variety of databases. Sadly enough, one of the reasons many of these databases are being created is to prevent fraud.

It is also not unheard of for dishonest people in the medical industry to steal identities to submit fraudulent claims to insurance companies and even the government. Authorities within the law enforcement community estimate we are losing $60 billion a year due to Medicare fraud, according to an article in the Washington Post.

If you are interested in learning more about this, or have been a victim of Medical Identity Theft, I recommend reading the Medical Identity Theft Information Page on the World Privacy Forum.

The World Privacy Forum plans to issue a second study on this problem later on this year.


Booking photo of Earl Simmons a.k.a. DMX at the Maricopa County Jail shortly after his arrest.

$60 billion would provide a lot of health care to the people who need it!

The candidates all are talking about making the health care system available to everyone. I wonder if any of them have considered that a lot of tax dollars are already being handed over to crooks scamming the current system providing free healthcare to the general public? Some estimate that this costs the taxpayers up to $60 billion a year.

$60 billion would go a long way to helping people, who need medical attention and can't afford it.

Carrie Johnson of the Washington Post writes:

All it took to bilk the federal government out of $105 million was a laptop computer.

From her Mediterranean-style townhouse, a high school dropout named Rita Campos Ramirez orchestrated what prosecutors call the largest health-care fraud by one person. Over nearly four years, she electronically submitted more than 140,000 Medicare claims for unnecessary equipment and services. She used the proceeds to finance big-ticket purchases, including two condominiums and a Mercedes-Benz.

And while law enforcement efforts are admirable in going after this, it is is being described as a game of "Whack a Mole."

The article sums up the problem rather nicely:

A critical aspect of the problem is that Medicare, the health program for the elderly and the disabled, automatically pays the vast majority of the bills it receives from companies that possess federally issued supplier numbers. Computer and audit systems now in place to detect problems generally focus on overbilling and unorthodox medical treatment rather than fraud, scholars say.

"You should be able to spot emerging problems quickly and address them before they do much harm," said Malcolm Sparrow, a Harvard professor and author of "License to Steal," a book about health-care fraud that advocates for greater federal vigilance. "It's a miserable pattern, a cycle of neglect followed by a painful and dramatic intervention."

Southern Florida was targeted by the authorities because a large amount of money seemed to be going up in smoke there, according to the Washington Post article.

Miami became a focus for Medicare fraud after investigators realized that a good portion of the medical suppliers weren't even open during normal business hours and didn't even have working telephone numbers (?). Even worse, the Government Accountability Office has been calling out that these programs had weak oversight for about a dozen years (?).

Southern Califonia is also one of the targets in the latest efforts to correct this problem:

The strike force recently established a base in Los Angeles, another area rife with fraud. Prosecutors announced criminal charges last month against two medical equipment company owners who are accused of falsely billing Medicare more than $2 million. Plans call for a similar rollout this fall in Houston, another potential fraud hot spot.

The political candidates can promise free health care for everybody -- but unless we start exercising a lot more due diligence spending this money -- any system is likely to go broke in a short time. I'm all for better health care for all, but we need to start making sure the money is being spent on the people receiving the care.

Spending even more money on law enforcement task forces to combat a problem described as a game of "Whack a Mole" isn't very proactive, either.

What is needed is a little more common sense in running these programs. If the programs are this mismanaged, I would propose investigating the enablers of this problem (the program managers) and find out why they are wasting so much money. By doing this, we might start spending the money where it should be spent, or on people who need medical attention.

This might go a long way to having the means to provide care to the people, who the money was earmarked for in the first place!

Washington Post article, here.

Does healthcare fraud tie into organized crime, illegal immigration and .... corporations?

Read a pretty interesting article about how identity theft is being used (more and more frequently) to commit healthcare fraud. The article also alleges that organized crime is exploiting this activity to their financial advantage.

Since organized criminals normally are hard to get a "quote" from, we'll have to speculate about how much they are involved in this phenomenon.

The article written by Jim McKay appeared in govtech.com and quoted a section chief (Sharon Ormsby) from the FBI:

At least 3 percent of U.S. health-care costs (about $60 billion) can be attributed to fraud, according to the National Health Care Anti-Fraud Association. Of that, 1 percent is attributed to medical ID theft - an ominous figure when the numbers are triangulated, according to Sharon Ormsby, section chief for the financial crimes section of the FBI.

"If you figure by 2012, national health-care expenditure costs for the country will be approximately $3 trillion, you look at the fact that the National Health Care Anti-Fraud Association conservatively estimates health-care fraud to be 3 percent to 5 percent of that expenditure amount," she said. "That's a significant amount of fraud, so we do have a strong interest in it."

Another interesting article related to the subject of healthcare fraud showed up in the news in the past few days, also. CBS News did a story about a "whistleblower," who turned in his superiors -- in this instance a hospital -- for fraudulently billing government healthcare programs.

Unlike the govtech.com article -- which only suggests a dollar loss -- the CBS piece estimates the cost of healthcare fraud at about $11 billion a year.

Sharyl Attkisson, a CBS correspondent covered this story and it points to more commentary about government waste in general on the Couric (Katie) and Co. blog.

Please note the whistleblower in this instance received $3 million for turning in his employer.

With the baby boom generation headed for retirement and reports of hospitals going under because they provide free healthcare for illegal immigrants, there is a lot of camouflage for healthcare fraud to hide in.

The fact that a hospital was in on the fraud shouldn't surprise a lot of people, either. If you are following the 2008 election, the subject of legitimate companies gouging the healthcare system for profit isn't a new topic.

There is little doubt that the subject of healthcare costs is a hot topic and will continue to be for a long time to come.

Govtech.com article, here.

Here is a story, I did in May that covers the ties between healthcare fraud, organized crime and illegal immigration:

Medicare Fraud arrests might expose ties to medical identity theft and organized crime

Medicare Fraud arrests might expose ties to medical identity theft and organized crime

Ever wonder why our social services are going bankrupt? Here is a story, from a FBI press release, showing how $101 million was paid out in fraudulent health care claims.

Reading the release also made me wonder, where all the names to claim services, came from?

From the FBI release:

On May 22, 2007, a Miami federal grand jury returned a 46-count indictment against eight defendants in United States v. Mabel Diaz, et al., No. 07-20398-Cr-Ungaro. The indictment charges Mabel and Banner Diaz, wife and husband, with operating All-Med Billing Corp. (All-Med), a Miami medical billing company, and executing a scheme to submit tens of millions of dollars in fraudulent claims to Medicare from 1998 to 2004 for reimbursement for durable medical equipment (DME) and related services. The indictment alleges that All-Med submitted approximately $80 million in false claims on behalf of 29 DME companies. The claims were allegedly fraudulent in that the equipment had not been ordered by a physician and/or had never been delivered to a Medicare patient. As a result of the submission of the fraudulent claims, Medicare paid the DME companies approximately $56 million. The indictment also seeks forfeiture of the fraud proceeds and here substitute assets, including real estate of the Diazes. The Diazes were additionally charged with conspiracy to launder the proceeds of the alleged All-Med billing fraud scheme. Also charged in the All-Med billing fraud scheme was All-Med employee Suleidy Cano.

If you read down further on the release, the names of all the people being charged are Hispanic.

While I suppose, not all criminals with Hispanic names, cater to illegal aliens, a large number of them seem to. Despite this, there seems to be no information, whether or not; this activity had any ties to illegal immigrant activity, or if people’s identities were stolen to facilitate these crimes.

There is also very little information as to exactly how these crimes were committed. It would make sense that they would have to use names and other personal information to claim the “services,” paid for with taxpayer money.

Digging a little deeper, I found another press release dated the day before from the FBI describing a similar health care fraud scheme – where the employees involved were described as illegal aliens.

This case occurred on the other side of the country (Southern California). Please note that all the names listed on this press release were of Hispanic origin, also.

In the Los Angeles case, the taxpayers were only ripped off for a little more than $9 million. Small potatoes compared the amount in the Miami case. Of course, I wonder how much more of this is going on, where no one has been caught?

Some of these illegal aliens were posing as nurses, which could be pretty scary, if they were dispensing any real medical services. Even scarier, is the very real harm bogus information in a medical record can cause. If you think about it, bogus information in a medical history could be life-threatening.

The World Privacy Forum has studied this subject (in detail) and stated in a 56 page report:

This report discusses the issue of medical identity theft and outlines how it can cause great harm to its victims. The report finds that one of the significant harms a victim may experience is a false entry made to his or her medical history due to the activities of an imposter. Erroneous information in health files can lead and has led to a number of negative consequences for victims. Victims do not have the same recourse and help for recovery from medical identity theft as do victims of financial identity theft. This report analyzes statistics in health care and identity theft, and estimates that approximately a quarter million to a half million individuals have been victims of this crime.

The report also states:

Medical identity theft is deeply entrenched in the health cares system. Identity theft may be done by criminals, doctors, nurses, hospital employees, and increasingly, by highly sophisticated crime rings.

If the FBI is issuing two press releases about this activity, one could deduct that they might have been investigating some of these “highly sophisticated crime rings.”

Not sure if the impending immigration bill is the reason some of the surrounding issues aren't being talked about, but a lot of criminal activity is tied to the trade in human flesh.

On a personal note, I want to see honest immigrants find a better life, and continue the American tradition of adding value to the most diverse society in the world. The problem is that a lot of organized criminal groups have profited in the illegal immigrant trade for years, and no one has come up with a way to weed out this hidden activity, very effectively (my opinion).

Of note, the honest and hard working illegal immigrants are often victimized in this process, which is largely controlled by organized crime.

With millions of identities compromised, it isn’t going to be easy. Assuming someone else's identity has become too easy, especially for those with criminal connections.

FBI press release on Florida arrests, here.

FBI press release on Southern California arrests, here.

World Privacy Forum report on medical identity theft, here.

QuackWatch has a good site, which covers this type of fraud in great detail, here.

In case you wanted to learn more, the U.S. District Court of Southern Florida is happy to sell you the information, here.

The Virginia WatchDog goes after government sites that post too much personal information. A lot of great information about this subject, and examples of effective action taken by the Watchdog herself, BJ Ostergren can be found, here.

BJ and I had about an hour long conversation recently, where she demonstrated how easy personal information can be data-mined from these sites. I found BJ to be a fascinating person, but more of that, later.

This site and their important work will be the subject of some future posts.

My previous rants about organized crime controlling the traffic in human flesh can be read, here.

Organized groups with Hispanic names aren't the only immigrant groups ripping off the taxpayers. Here is a recent post, I did about another immigrant group that seems to focus on stealing public funds:

Eurasian organized crime loots public coffers