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FierceHealthPayer: Anti-Fraud: What are some early indicators SIUs can watch for signaling that reports of potential fraud, waste and abuse may become significant or urgent cases? Mike Little: Assessing allegations early is a challenge, but taking some specific and general steps can help SIUs determine if a case may become a priority. The first specific step is assessing the allegation. What's involved, and what's the scope of the issue? Could it be part of a larger problem or national scheme with the potential for media attention? Also check if patient safety is at risk. Financial harm at the expense of patients is an area that becomes urgent very quickly. And different case steps are necessary if patient safety issues are involved as opposed to financial issues alone. Are there signs that unlicensed individuals are at work? This can raise questions about your company's credentialing and due diligence processes that affect patient safety. And lastly, determine if employees from your organization may be implicated. That may cause reputational harm and indicate internal control weaknesses. But insurers and the federal government can no longer wait for complaints to arrive because often by then there's been significant loss. So SIUs should also take general steps to spot trends and risks. These steps involve knowledge. First, plug into a healthcare fraud task force. These exist nationwide and include other SIUs and federal and state law enforcers and regulators. These groups are the wave of the future in terms of public and private partnerships. There's a great deal of information shared about what's happening at other companies or in other segments of the community.

LANCASTER - Local law enforcement officials say identity theft is a nightmare that can ruin its victims' lives. Unfortunately for Maryanne Sicat, of Lancaster, she is living that nightmare. "For the last three years, I've been trying to clean up my credit and fix my finances and rebuild financially because I had my identity taken and used at several places," she said. Sicat has received bills from stores and utility companies for goods and services she did not purchase. Also, she was buying a television in 2013 at a big-box store and her telephone number came up under the name of a California man. "One time is OK," Sicat said. "The second store makes you wonder. But then every single store that I went to Christmas shopping, it was the same thing. So that's why I started checking into it more." She has the name of the person she thinks is using her information but has no idea how the person got her phone number. So Sicat filed a complaint with the Federal Trade Commission and the Lancaster Police Department, and she has become another identity fraud statistic. The FTC said identity fraud is the top complaint it has dealt with in the past 13 years. It received 369,132 such complaints in 2012, or 18 percent of its total complaints. Identity fraud dwarfed complaints about debt collectors, which was in second place with 199,721, according to information the FTC provided. Fairfield County Sheriff Dave Phalen said there have not been a large number of identity fraud and identity theft cases locally. However, that is little consolation to Sicat and others like her. "Everything's on credit," she said. "So you can't do anything. You can't buy anything. It's embarrassing, and it's extremely frustrating because it makes me paranoid. I don't trust anybody." What is identity fraud? Detective James Nicolia, of the Fairfield County Sheriff's Office, said identity fraud is when a person uses another's identity for financial gain o