October 2007 - cypherpunks-legacy

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Escalating Health-Care Costs Fuel Medical Identity Theft
by R.A. Hettinga 11 Oct '07

11 Oct '07

<http://online.wsj.com/article_print/SB119206024712655344.html> The Wall Street Journal Escalating Health-Care Costs Fuel Medical Identity Theft Patients Are Told To Guard ID Cards Like Other Plastic By VICTORIA E. KNIGHT October 11, 2007; Page D3 When a wallet is lost or stolen, the first thing most Americans do is call their credit-card company. But if health-care ID or pharmacy cards are among the missing items, you should also alert your insurer. Medical identity theft -- in which someone uses your name and health insurance without your knowledge or consent to obtain medical treatment, prescription drugs or goods -- is on the rise. At least a half-million Americans have been affected, according to Pam Dixon, executive director of the World Privacy Forum, a San Diego research group that focuses on privacy issues. Medical identity theft can imperil your health and finances. Unfortunately, detecting this form of thievery isn't always easy for consumers, who are often unaware of its existence, and remedying the damage can be difficult. However, there are steps to take to protect yourself from becoming a victim, experts say. "You need to treat your medical ID card as if it were a Visa card with a million-dollar credit limit," says Nils Frederiksen, a spokesman for the Pennsylvania attorney general's office, which has successfully brought prosecutions against medical ID thieves. Escalating health-care costs and the growing ranks of the uninsured are fueling this fast-growing fraud. Before he was caught, Daniel Sullivan, an uninsured Pennsylvanian, racked up more than $144,000 in medical bills at five hospitals posing as an acquaintance whose insurance information he had stolen. In addition, drug addicts in search of their next high -- or treatment for methamphetamine-related illnesses -- are committing medical ID theft, according to a report published in May by the Department of Justice's National Drug Intelligence Center. With health-care benefits becoming an increasingly valuable commodity, criminal gangs are getting in on the act. Often it's an inside job where a worker in a hospital or doctor's office steals patients' identities en masse and sells them to criminals who then use them to obtain payment for fake procedures. "It's a very lucrative crime," says Mike Stergio, director of Aetna Inc.'s special investigation unit. The number of cases the health insurer is investigating has doubled in the past year. Mr. Stergio is currently investigating a case in which Aetna was hit with claims totaling $3.5 million over a two-week period for treatments supposedly provided to 400 of its members. The sheer volume of claims and suspicious patterns of procedures -- four colonoscopies in one family -- prompted the insurer to investigate and freeze payments. One of the biggest threats posed by medical identity theft is that victims can receive the wrong medical treatment based on the fraudulent information in their medical records. (You are allergic to penicillin, the imposter isn't.) In addition, theft can cause victims to fail pre-employment medical exams or become uninsurable. (What about that cancer diagnosis?) And their credit can become badly damaged. At a broader level, health-care fraud leads to higher health insurance premiums, higher taxes and higher co-payments. People are often unaware their identities have been stolen, since scammers usually change the home address to which medical bills are sent. And it can be hard to set the record straight because the law offers few protections. The Health Insurance Portability and Accountability Act grants all patients the right to access their medical records, generally within 30 days. However, the law's privacy provisions can actually hinder victims. In some instances, a request for access by the victim has been denied because the actual patient -- that is, the criminal -- was another person, according to the World Privacy Forum. "While victims of financial identity theft can put a security freeze on credit bureau reports, victims of medical identity theft sometimes can't even get access to their health files," Ms. Dixon told delegates at the American Health Information Management Association. The World Privacy Forum's Web site1 provides a detailed guide on how to gain access to your medical records and seek amendments, including sample letters that you can send to health-care providers. If your health plan gives you the option to monitor your benefits online, as Aetna does, sign up for a password-protected account, Mr. Stergio recommends. That way you can keep tabs on your health benefits in much the same way you do for financial transactions in your bank account. If you see a problem, contact your insurer immediately. Once alerted, insurers can remove information from your records that could affect payment for future treatment. For example, if the imposter had an appendectomy in your name and you later need one, the insurer won't pay again for the same operation. Also, any treatment an undetected thief receives in your name eats into your lifetime maximum benefits. Beware of "free" medical services or treatments. Sometimes illicit entities use the lure of free services to obtain patient names and insurance information for use in submitting fraudulent claims. Always question what is being offered and who is paying the cost. If you aren't satisfied with the answers, decline the offer. "If you go into a clinic for a free checkup and they ask to see your insurance card, run for the exit," says Byron Hollis, national antifraud director for the BlueCross BlueShield Association. The elderly are often the targets because they tend to be more trusting and carry Medicare cards, which to criminals are like gold. Other tips: Don't give your insurance information to telephone marketers or door-to-door solicitors. And make sure you aren't overheard or spied on when giving sensitive information to medical staff. It's also important to carefully read the explanation of benefits that your insurer sends you after you have received health-care services. Incorrect group or identity numbers are red flags, as are the names of medical facilities or procedures listed that you don't recognize. You can find more tips on reading your explanation of benefits at the BlueCross BlueShield Association's Web site2. Consumers should also monitor their credit reports for claims filed by health-care providers, says Adam Levin, co-founder of Identity Theft 911 LLC, a company that helps individuals and companies resolve identity theft problems. (1) http://www.worldprivacyforum.org/ (2) http://www.bcbs.com/ -- ----------------- R. A. Hettinga <mailto: rah(a)ibuc.com> The Internet Bearer Underwriting Corporation <http://www.ibuc.com/> 44 Farquhar Street, Boston, MA 02131 USA "... however it may deserve respect for its usefulness and antiquity, [predicting the end of the world] has not been found agreeable to experience." -- Edward Gibbon, 'Decline and Fall of the Roman Empire'

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The Retail Credit Card Addiction
by R.A. Hettinga 11 Oct '07

11 Oct '07

<http://www.eweek.com/print_article2/0,1217,a=216690,00.asp> EWeek The Retail Credit Card Addiction October 8, 2007 By Evan Schuman Major retailers, just like any large business, do not like being told by partners what they can and can't do. But when the credit cards told merchants that they must retain credit card information to deal with returns and chargebacks, they balked, but then agreed. Like any good business, they tried taking an unpleasant requirement and turning it into a business advantage. Consider suppliers being forced to use RFID (radio-frequency identification) who then use it to better track their own product movement or e-tailers who reluctantly comply with accessibility rules and then discover that it costs them less in programming and development and their pages load faster. Retailers started using the credit card numbers to identify purchases with specific consumers, given that they had to store them anyway. It turned out to be a convenient link into CRM (customer relationship management) systems, especially for customers who weren't using the traditional retailer-issued loyalty card. On the e-commerce front, some (relatively few, but some) online merchants were using the mandatory credit card retention to allow customers to make purchases more quickly. This has been going on for quite a few years. A relatively logical proposal floated by a major industry group is now threatening to rock the credit card boat, potentially exposing just how much retailers are now addicted to plastic numbers. Last week, the National Retail Federation formally launched its campaign to get credit card companies to permit retailers to not store credit card numbers. The move was masterminded by the NRF's CIO, Dave Hogan, who has floated this idea to the industry for months. (I remember him eloquently and passionately making his case for changing how credit cards are dealt with about two months ago, as I listened to him on a cell phone at a Toyota dealership, thinking this was one of the more surrealistic things to listen to while getting a car door rehinged.) Hogan's idea, in its simplest form, is that retailers should stop being required to save credit card information. If the credit card firms want it saved, they are quite free to save it themselves. After all, Hogan argued, "it makes more sense for credit card companies to protect their data from thieves by keeping it in a relatively few secure locations than to expect millions of merchants scattered across the nation to lock up their data for them." Indeed, it does make sense. But Hogan's idea, while alluring and almost seductive (in an ultrageek-like data protection way), has several logistical roadblocks. For example, at best, the Hogan proposal could sharply minimize how long the sensitive credit card data is in the retailer's system, but it's not likely to eliminate it. For magstripe cards (contactless is a different situation), the numbers are going to be seen by the store employee (who is always the biggest security weakpoint) and will then be almost certainly entered into the retailer's system, en route to a processor for approval. Even if the number is dumped the instant the verification number comes back, it's still there long enough to be sniffed or captured by a Trojan Horse. Indeed, that's one of the things that TJX said happened to them. A contactless card could bypass the cashier, which helps a little. But to bypass the retailer's network entirely would require either a third-party service or to have the processors or the card companies install their own devices at the point of sale. That's clearly a dramatic-and incredibly expensive-move by quite a few players in the payment space. Less dramatic approaches would be upgrading security to protect that small window of vulnerability or to all but eliminate them. Page 2: The Retail Credit Card Addiction That gets us into the other reality issues surrounding this kind of payment procedure change. Few retailers handle their own payment process. So even if a major retailer made a decision to not store card numbers any more, they would likely need their POS vendor and various other technology partners to upgrade to handle the change. Prat Moghe, founder of data auditing vendor Tizor and a member of the PCI Security Vendor Alliance, estimated that it could take five years to make such a change with a large retail chain, at which point the move might be silly because of other unknown changes that will impact the payment world of early 2013. Even if Moghe's five-year plan might be exaggerated, his point that these things take a lot of time is a fair one. Another strong Moghe point is that credit card data-while essential-is a very small part of the confidential consumer data that the average large retailer retains. His take is that, even if successful, this kind of a credit card process change wouldn't improve retail data protection as much as it may seem. Let's let get to what the proposal is. The proposal is that the card companies back off and stop requiring the retailers to retain the number. If the proposal went a step further and suggested that the PCI rules be changed to explicitly ban a retailer from retaining those numbers, that might change the issue. If the rule change merely permits retailers to do either, the huge headaches associated with this major a change-not to mention the costs-are likely going to cause very few retailers to take advantage of the change. Hence, it could result in a very modest improvement in credit card information security. But if the rules forbid such data retention, that would force action. Must importantly, it would get POS vendors to make the change, which would quickly migrate to all of retail. It could be similar to Y2K, where even companies who did nothing eventually became Y2K compliant as they upgrade to Y2K-complaint apps. What has been the reaction of the PCI Council and the major credit cards? Thus far, nothing meaningful, at least not publicly. Privately, PCI Council folk have said that this is really a credit card issue-as opposed to a council issue-which is true. Credit card companies have not yet reacted strongly, although some have "generously" pointed out that their rules do not technically mandate that a retailer retain these numbers. That's technically true. If a retailer wants to forfeit the ability to challenge any customer who disputes a charge, they're free to do so. Not surprisingly, retailers aren't jumping at that offer. Retailers today say they do generally care about security, but when it comes to spending money or changing procedures, the get pragmatic. "Yes, we care about security, but we're not fanatics," they tend to say. Retail group lobbies to stop credit card data from being stored. Click here to read more. The PCI certification, which many retailers have yet to pass, is something that retailers are doing, but they're pursuing it because they have to. That results in bare-minimum kind of attitudes, where merchants will do as little as they can to barely comply to the letter of the requirements. Consider, for example, the difference between the extensive review processes that surround a typical large software or supplier contract and the one that covers the hiring of a PCI auditor. The contract awards for software or a new line of merchandise to sell can take a year, dozens of meetings and extensive oversight, whereas retailers often select their auditors using evaluation sophistication that's not much more complicated than rock/paper/scissors. There's no argument that security procedures surrounding credit card need to be improved, and Hogan's proposal is a very positive step in the right direction. But whether it's practical and politically palatable is a different issue. The bigger question, though, is whether retailers will make the effort. Any kind of meaningful change will require some pain, both in terms of investment dollars and a lot of procedural changes. How much will the retail CFO put up with for something that has very little chance to bring in any profits? Retail Center Editor Evan Schuman has tracked high-tech issues since 1987, has been opinionated long before that and doesn't plan to stop any time soon. -- ----------------- R. A. Hettinga <mailto: rah(a)ibuc.com> The Internet Bearer Underwriting Corporation <http://www.ibuc.com/> 44 Farquhar Street, Boston, MA 02131 USA "... however it may deserve respect for its usefulness and antiquity, [predicting the end of the world] has not been found agreeable to experience." -- Edward Gibbon, 'Decline and Fall of the Roman Empire'

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11 Oct '07

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