Health Care

An emerging area of focus for The University of Texas Center for Identity is healthcare and entitlement program abuse. As medical and healthcare identity theft continues to rise, identity authentication is the single most critical factor in mitigating losses due to provider and recipient abuse and fraud.

The Center for Identity and The University of Texas are uniquely positioned to address this identity issue. With some of the most highly ranked academic disciplines in the United States, the Center for Identity draws from University resources to address the multifaceted problems associated with identity management in public policy settings.

The Center focuses on detecting fraud and abuse from recipients and providers through analysis of enrollment practices for identity management. The primary objective of this research is to break the "pay-and-chase" cycle – moving law enforcement agencies from a prosecution enforcement model to a more proactive prevention model. Our research on fraud and abuse prevention focuses on validating the identity of both recipients and providers during a transaction, thereby significantly reducing the number of identity thefts that occur in enrollment processes.

Additional research will focus on ongoing risk mitigation related to recency and frequency of medical treatments. In essence, our research seeks to identify the optimal policies and tactics for both providers and recipients. We then analyze and describe best practices for how to monitor ongoing treatments and medical benefit claims. Resolving key research questions, such as what, when, and how identity credentials are used to authenticate medical benefit claims, will reduce the damages caused by medical identity theft. Using this research to help break the "pay-and-chase" cycle, we can reduce the number of identity theft victims, and strengthen public policies for identity management, protection, and security.