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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received.

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Telehealth and RPM – 2023 Health IT Predictions

Healthcare IT Today

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. An end to the Public Health Emergency (PHE) is likely to be announced and end mid-January followed by a grace period of approximately 5 months. Ankit Gupta, CEO at Bicycle Health.

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Significant Upcoding Risks Emerge with Medicare Advantage

YouCompli

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

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How to Prevent Medicare Advantage Fraud, Waste, and Abuse

Provider Trust

US Department of Health and Human Services (HHS) Office of Inspector General Christi A. Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs.

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Reactions to the Ascension Healthcare Ransomware Attack and Suggestions for Healthcare Organizations

Healthcare IT Today

Mike Semel, President and Chief Security Officer of Semel Consulting The Ascension health system data breach can’t be easily separated from the United Healthcare Change Health breach that recently caused a huge financial and medical impact across the healthcare sector and may have breached the personal information for a third of Americans.

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Virtual 40th National HIPAA Summit – Early Bird Discount Ends 2/3

HIPAA Journal

Attendees will gain valuable insights into health information privacy, healthcare cybersecurity, HIPAA enforcement, and a wealth of information to help them maintain HIPAA compliance and take healthcare data privacy and security to the next level. Jillson, JD – Counsel to the Director, Bureau of Consumer Protection, U.S.

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From Evolution to Innovation, from Health Care to Health: How Health Plans With Collaborators Are Re-Defining the Industry

Jane Sarashon

As a constant observer and advisor across the health/care ecosystem, for me the concept of a “health plan” in the U.S. Furthermore, health plan members now see themselves as medical bill payers, seeking value and consumer-level services for their health insurance premium investment. is getting fuzzier by the day.