article thumbnail

Supreme Court Ruling Narrows Reach of Identity Theft Law

HIPAA Journal

The Supreme Court unanimously ruled that it could not support “such a boundless interpretation” of the Identity Theft Penalty Enhancement Act of 2004. Under the letter of the law, small-scale fraud and large-scale fraud carry the same sentence for aggravated identity theft.

Fraud 97
article thumbnail

Everything You Need To Know About NPI Numbers

Verisys

Tracking actions to a standardized identifier provides transparency that can identify and impede fraud. NPI Helps Prevent Healthcare Fraud Tracking actions to a standardized identifier provides transparency that can identify and impede fraud.

Fraud 97
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. Those providers who were not prepared to manage the new reimbursement often resorted to “enhancing” revenue through “creative” means.

article thumbnail

Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. Those providers who were not prepared to manage the new reimbursement often resorted to “enhancing” revenue through “creative” means.

article thumbnail

New York Court of Appeals Rules that an Insurer May Withhold Payments to a Medical Service Corporation Improperly Controlled by Non-Physicians without A Finding of Fraud

NY Health Law

2004): Non-physicians paid physicians to use their names to established medical service corporations, the non-physicians operated them and billed the physicians nominally in charge at inflated rates so that the profits from the medical practice were channeled to the non-physicians. v Mallela , 372 F3d 500, 503 (2d Cir.

Fraud 52
article thumbnail

Navigating Dual Purpose Communications After SCOTUS (Almost) Weighs in on Attorney-Client Privilege: 5 Practical Tips for Healthcare Attorneys

Healthcare Law Blog

This topic always involves a legal angle, such as Stark Law or Anti-Kickback compliance, or state fraud and abuse law considerations. C-02-1786 JSW (EMC), 245, 248, 2004 U.S. 23, 2004). [4] For example, consider physician compensation. However, it almost always involves a business angle too. Are bonuses involved? 3d 413 (2d Cir.

article thumbnail

Everything You Need To Know About NPI Numbers

Verisys

23, 2004, established the NPI as this standard. Tracking actions to a standardized identifier provides transparency that can identify and impede fraud. NPI Helps Prevent Healthcare Fraud . In addition to standardizing provider identifiers, verification of the NPI is one of the necessary elements in preventing fraud in Medicare.

Fraud 52