Healthfirst Fraud Scheme Affects 5300 Members

Another healthcare company breach was disclosed this week.  The Department of Justice (DOJ) alerted the non-profit managed care provider, Healthfirst that approximately 5,300 of its members had information compromised as a result of a fraud scheme. The information did not include social security numbers or credit card details, but did include names, addresses, dates of birth, health insurance information, Medicare and Medicaid ID numbers, diagnosis codes, and other information.

Healthfirst is mailing letters to members that were affected and is offering one year of identity and credit monitoring services. It also is providing access to a confidential assistance line and identity theft specialists.

Everyone who is notified they were part of this incident is advised to take advantage of any free credit monitoring services that are offered and any other assistance offered, should it be needed. In addition, it is recommended that all members check the benefits statements that arrive after medical services are provided. If anything is suspicious, contact the healthcare provider first to make sure it was a mistake. If it is still unclear, let the insurance provider know.

Other ways to protect identity and prevent healthcare fraud are:

• Should you lose your healthcare card or should it be stolen, report it right away.
• Don’t provide the information on the card to anyone other than a healthcare provider, a clinic, or hospital when you are receiving care.
• Don’t let anyone else borrow your card.
• Keep records of your healthcare so you can reconcile it against your benefits statements if needed.
• Once you no longer need the medical bills and paperwork, shred it in a crisscross shredder.

 In 2013, Healthfirst had informed the DOJ that it was victim of fraud and ultimately the perpetrator was charged. However, during the investigation of that incident, the DOJ discovered that the same person also gained access to member information and notified Healthfirst in May of this year. The information was accessed via the payer’s online portal.