Strategies to Prevent and Reduce Medical Identity Theft Resulting in Medical Fraud

Medical identity fraud is a byproduct of identity theft; it enables imposters to procure medical treatment, thus defrauding patients, insurers, and government programs through forged prescriptions, falsified medical records, and misuse of victim\u27s health insurance. In 2014, for example, the United States Government lost $14.1 billion in improper payments. The purpose of this multiple case study, grounded by the Health Insurance Portability and Accountability Act as the conceptual framework, was to explore the strategies 5 healthcare leaders used to prevent identity theft and medical identity fraud and thus improve business performance in the state of New York. Data were collected using telephone interviews and open-ended questions. The data were analyzed using Yin\u27s 5 step process. Based on data analysis, 5 themes emerged including: training and education (resulting to sub-themes: train employees, train patients, and educate consumers), technology (which focused on Kiosk, cloud, off-site storage ending with encryption), protective measures, safeguarding personally identifiable information, and insurance. Recommendations calls for leaders of large, medium, and small healthcare organizations and other industries to educate employees and victims of identity theft because the problems resulting from fraud travel beyond the borders of medical facilities: they flow right into consumers\u27 residences. Findings from this study may contribute to social change through improved healthcare services and reduced medical costs, leading to more affordable healthcare