Recovering from Medical Identity Theft in Nebraska: A Guide for Patients and Providers

Medical identity theft is one of the most dangerous forms of fraud. It happens when someone uses your name, Social Security number, or health insurance information to see a doctor, get prescription drugs, or file claims with your insurance provider. Unlike credit card fraud, which only affects your wallet, medical identity theft literally affects your health. The imposter's medical conditions, blood type, and allergies get mixed into your permanent medical file.

If you live in Nebraska and fall victim to this crime, a future doctor could rely on the imposter's tainted medical history, prescribing you the wrong medication or delaying necessary treatment. Furthermore, you may find yourself hounded by aggressive medical debt collectors for surgeries you never had. You must act aggressively to amend your records under federal privacy laws and state statutes.

Step-by-Step Guide for Patients in Nebraska

Untangling medical records requires dealing with hospital billing departments, health insurance companies, and federal regulators.

Step 1: Dealing with Hospital Billing and Debt Collectors

Often, the first sign of medical identity theft is a massive, unexpected bill from a hospital like Nebraska Medicine or Bryan Health. If you are contacted by a debt collector, you must immediately send a written dispute letter via certified mail. Under the 15 U.S.C. § 1692g, this pauses the collection. You should also request a complete accounting of disclosures from the hospital's billing department to see exactly where your insurance was billed. You can demand that the hospital flag your account for fraud and freeze any unpaid balances pending an investigation.

Step 2: Amending Records Under HIPAA

Under the federal Health Insurance Portability and Accountability Act (HIPAA), you have the right to access your medical records and demand corrections. You must write to the healthcare provider's privacy officer, explaining the identity theft and identifying the incorrect entries. If the hospital refuses to amend the record, you can file Form HHS-700, FED, Department of Health and Human Services, Health Information Privacy Complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, Washington. It is critical to legally force the provider to separate the imposter's medical history from yours.

Step 3: Medicare and Medicaid Fraud Implications for Seniors

Seniors in Nebraska are prime targets for Medicare fraud. If an imposter maxes out your Medicare benefits on fraudulent medical equipment or treatments, you could be denied coverage when you actually need a wheelchair or surgery. If you suspect Medicaid fraud, you must report it directly to the Nebraska Department of Health and Human Services, Lincoln. They have a dedicated Medicaid Fraud Control Unit that will investigate the provider or the imposter abusing your benefits.

Step 4: Protecting Your Prescription History

Addicts often use stolen identities to obtain opioids or other controlled substances. If an imposter fills prescriptions in your name, you could be flagged by the Nebraska Prescription Drug Monitoring Program (PDMP) as a drug seeker. This could result in your own doctor refusing to prescribe you legitimate pain medication. You must contact your local pharmacy and the PDMP administrators to report the fraud and have your profile investigated and cleared.

How Much Does it Cost?

Recovering from medical identity theft involves time and administrative effort, but direct legal costs can be managed.

• Requesting Medical Records: Under Neb. Rev. Stat. § 71-8404, Nebraska caps copy costs at a handling fee of no more than $20 plus up to $0.50 per page, and copies must be provided free of charge when supporting public benefit or disability claims.
• Filing Complaints: Filing a complaint with the HHS Office for Civil Rights or the Nebraska DHHS is completely free.
• Attorney Assistance: If a hospital refuses to correct your record and you need an attorney to draft a demand letter, expect to pay $300 to $800. If you are sued by a debt collector for the fraudulent debt, hiring a defense lawyer may cost $2,000 to $5,000, though you may recover these fees if you win.

How Long Does the Process Take?

Correcting medical identity theft takes considerably longer than fixing a stolen credit card. Under HIPAA, a healthcare provider has up to 60 days to respond to your request to amend your medical records. Resolving fraudulent bills with your health insurance company and debt collectors typically takes 3 to 6 months of back-and-forth communication.