Has anyone ever reported SSI fraud on a patient?

[Mommy2be]

I know I see it all the time, and it is starting to get ridiculous. I am nervous about reporting patients due to providing too much information that would violate HIPPA. Need advise and input on reporting SSI fraud on patients!

[imintrouble, BSN, RN]

Decent guide here: http://www.medscape.org/viewarticle/585562_2

I don't really like the idea (personally) of departing from my role as pt advocate except in cases of abuse/neglect, etc. Then my conscience allows (in the case of children/elderly/disabled) or in order to protect the public (depending on the situation). I would even feel uncomfortable with a state law for mandatory reporting of rape/assault/domestic violence without the victim's permission. Seems it might have a chilling effect on those who wish to seek care.

I agree with both sides of this argument, but my personal code of honor, (sounds pompous I know) recoils at keeping someone elses illegal secret.

What if the person seeking care, committing fraud, relies on "nursing ethics"

to get away with whatever they're attempting to get away with?

[FuturePsychNP]

I'd first have to determine the legality of doing so, and then I'd have no qualm whatsoever with reporting it. I'm always the first to demand police involvement when I observe something unlawful or suspect among our patients.

[Mulan]

Mulan, I realize it can be frustrating but it's part of our Code of Ethics, it's actually common to many Health Care professions' code of ethics including Doctors, Psychiatrists, and others. The Nurse/Patient open and trusting communication relationship is a basic premise of our profession, if that's not something you can uphold maybe it would be wise to consider a Nursing role where you have to deal with such challenges.

First of all, you don't need to chastise or try to put me down, that only reflects badly on you.

I still bet you would feel differently about it if it were YOUR social security number that was being used.

[applewhitern, BSN, RN]

I have heard people on the phone, trying to sell their food stamps. I would be afraid to report abuse, because of HIPAA and other reasons.

[MunoRN, RN]

First of all, you don't need to chastise or try to put me down, that only reflects badly on you.

I still bet you would feel differently about it if it were YOUR social security number that was being used.

That was actually the diplomatic, highly edited, grinning-through-clenched-teeth response.

There's a natural desire to drastically alter standards and laws when something affects you rather than someone else. If I'm watching my kid's basketball game and my kid gets fouled, there's a part of me that thinks the punishment should be the death penalty, not free throws, but in the end I know that's selfish and the same rule should apply whether it's my kid or someone else's. Same goes for Nurse-Patient confidentiality, so no, I wouldn't act any differently.

[Mulan]

That was actually the diplomatic, highly edited, grinning-through-clenched-teeth response.

There's a natural desire to drastically alter standards and laws when something affects you rather than someone else. If I'm watching my kid's basketball game and my kid gets fouled, there's a part of me that thinks the punishment should be the death penalty, not free throws, but in the end I know that's selfish and the same rule should apply whether it's my kid or someone else's. Same goes for Nurse-Patient confidentiality, so no, I wouldn't act any differently.

There is a big difference between a kids basketball game and using someones social security number/identity theft.

[LadyFree28, BSN, LPN, RN]

First of all, you don't need to chastise or try to put me down, that only reflects badly on you.

I still bet you would feel differently about it if it were YOUR social security number that was being used.

^SSA fraud has NOTHING with fake social security numbers, and if it is tried, it is found it IMMEDIATELY...

Also General Assistance, Food Stamps (which is called SNAP) Social Security Disability are ALL separate programs and INTENSE verification is needed...it is not a walk in the park. You ARE NOT ELIGIBLE if it is found that you CANNOT verify the information provided.

I think some posters are having various conversations on separate issues.

SSA programs have NOTHING to do with General Assistance programs...they have different requirements, however, some are eligible for some of the programs. There is CONSTANT monitoring and verification being done. If there is shady activity even performed, including fraud, it is CAUGHT.

People who are suspected defrauding the system have every reason to be investigated, IF they are committing fraud.

[LadyFree28, BSN, LPN, RN]

I have heard people on the phone trying to sell their food stamps. I would be afraid to report abuse, because of HIPAA and other reasons.[/quote']

^Selling food stamps because they need to pay their light bill probably...it's not right, but reportable. Reporting is anonymous.

[MunoRN, RN]

There is a big difference between a kids basketball game and using someones social security number/identity theft.

Not really, ethics are pretty universal. Just as with Nurse-Patient confidentiality, the severity of different situations will vary widely, that doesn't mean the expectation to follow those ethics vary so long as it's not one of the exceptions to our ethical obligations.

[Mulan]

Not really, ethics are pretty universal. Just as with Nurse-Patient confidentiality, the severity of different situations will vary widely, that doesn't mean the expectation to follow those ethics vary so long as it's not one of the exceptions to our ethical obligations.

Exactly who is it that you are using as your avatar?

[MunoRN, RN]

Exactly who is it that you are using as your avatar?

Carl Spackler

[Mulan]

Identity Theft And Your Social Security Number (SSA Publication No. 05-10064, ICN 463270)