Physician Identity Theft – Beware, You Can Be The Next Victim!

What is Physician Identity Theft?

Physician Identity Theft happens when employees in the medical industry such as doctors, dentists, nurses, etc. are targeted by identity theft. Many healthcare professionals have been victimized by identity theft in the United States. In most cases, their personal information was used to fraudulently obtain federal and state tax refunds.

The number of identity theft incidents has increased significantly this year, raising questions about the security of employees in the healthcare industry. According to the American Medical Association (AMA), the exact number of physicians affected by the crime is not known, but several cases have been found in Indiana, Connecticut, New Hampshire, Maine, and North Carolina.

Physician Identity Theft is becoming more common as physicians are a lucrative target for identity theft. This is due to the fact that they have the potential for huge tax refunds due to their high-income levels. Physician Identity Theft can be very devastating for the physician victim. According to the Centers for Medicare & Medicaid Services (CMS), all physicians are vulnerable to identity theft.

Physician Identity Theft

How The Crime Takes Place?

Generally, there are two common ways in which Physician Identity Theft can occur:

In the first technique, a criminal uses a physician’s identity to open a fake clinic. The criminal then starts billing for services without providing them. In a recent case in Dallas, Texas, a criminal opened a fake medical supply company and submitted more than $1,028,000 in false claims to the Medicare program. He later pleaded guilty to aggravated identity theft.

In a second technique, a criminal uses a physician’s identity to order prescriptions, medical equipment, medical services, etc. It appears as if a physician ordered them for a patient. A technician at a medical clinic in Seattle, Washington forged prescriptions on a physician’s stolen prescription pads to acquire and distribute controlled substances.

Consequences of Physicians Identity Theft

The physicians who lost their identities can face overpayment demands from private and public payers. They can also face tax evasion charges for earnings they never received and a hit on their credit score.

If providers and patients learn that physicians are under investigation, their reputations may also suffer.

Preventive Measures

  • Keep your medical information Report if there are any changes, such as opening and closing of offices, moving between group practices, etc.
  • Check and review all the billing notices. If you find any items or services which have not been provided, report it immediately.
  • If you are using any insurance policies related to identity theft, use them smartly. Read more about Identity Theft Insurance.
  • Protect your information. Before giving out your information to prospective employers or companies, make sure that they’re legitimate.
  • Train your staff properly. Educate your employees about how to use and distribute medical information through prescription pads, electronic health records, etc.
  • Educate your patients also. Inform patients to be on the lookout for fraudulent activities and immediately report when they find it.
  • Protect your prescription pads, electronic health records, and other important documentation.
  • Instruct your staff to monitor strange activities, such as calls from doctors, pharmacies, clinics, etc. that involve unknown patients, prescriptions, etc.
  • According to the Centers for Medicare and Medicaid Services (CMS), it is advised that physicians confirm there have not been any inadequate changes to their enrollment information. Physicians should update their enrollment information at
  • Make use of Electronic Funds Transfer (EFT) to receive your reimbursements.
  • The AMA recommends that the personal information of physicians and other health care professionals should be stored electronically in encrypted form only.

Physician Identity Theft

Restoring Your Identity

Physicians who have been victims of identity theft find difficulty clearing their names and getting their financial status back.

  • You can get help through the Center for Program Integrity’s Provider Victim Validation/Remediation Initiative. This program was assists physician victims of identity theft.
  • If you have suffered financial liability as a result of medical identity theft, then you can contact the respective program integrity contractor in your state.
  • Contact all payers and place a fraud alert on your credit reports and a credit freeze on all your personal and business accounts.
  • Notify the American Medical Association (AMA) and National Specialty Society or your state medical association regarding any potential security breach of your personal data.
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