Heart Surgery Via Identify Theft
Posted by hope on August 22, 2008
This is troubling for several reasons.
Authorities say John Parsons, 57, of Oak Park stole the identity of a mentally disabled friend to pay for heart bypass surgery at Northwestern Memorial Hospital in Chicago in 2007. Parsons allegedly racked up about $350,000 in medical expenses billed to the friend’s Medicaid account.
This certainly demonstrates the lengths to which desperate people will go to get life-saving care they can’t afford. Its another example of why some kind of universal access guarantee is needed. But to me, the fact that someone committed fraud to save their own life isn’t the most troubling aspect of this situation.
Identity theft in itself is not the most troubling thing about it either. Not that identity theft per se is not a problem, or that victimizing someone with a cognitive disability isn’t troubling. It is, and this case highlights the need for that population to have someone carefully watching out for their affairs (as well as the need for the state Medicaid system to examine their protocols for verifying identity and eligibility). Fortunately, the victim in this case isn’t financially liable. Instead, the providers involved (hospital, surgeon, etc) will be on the hook since Medicaid won’t pay for fraudulent claims.
No, I think the most worrisome thing is the apparent carelessness of the people who did the procedure:
“You can’t just walk in with somebody’s Medicaid card like it’s a credit card and have heart surgery done,” said Jeff Nelligan, spokesman for the federal Centers for Medicare and Medicaid Services. “A doctor would need to know blood type, cardiac history, medical history and other comprehensive records that just couldn’t be faked. This doesn’t make sense.”
A surgical team (surgeon, nurses, anesthesiologist, etc) may have operated on someone without anyone having reviewed the patient’s medical records. With “never” events being such an issue that CMS, states and many insurers are implementing policies not to pay for them, and stories like this indicating at least some amount of carelessness on the part of health care providers — well, it kinda gives you the willies, doesn’t it?
