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False Claims Act Retaliation Decision Calls into Question the Heightened Burden for Employees Whose Duties Include Compliance and Fraud Investigation

Hall Render

The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C. This category of individuals is sometimes called a “fraud alert employee.”

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U.S. Healthcare Compliance Frameworks: A Guide for International Vendors

Compliancy Group

When unauthorized parties gain access to this information, identity theft, fraud, and diminished care often result. Prevent fraud: All parties must comply with laws that prevent fraud and misconduct, such as ordering necessary tests or treatments or billing for services not provided.

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DOJ Recouped $2.2 Billion Under FCA in 2022

Hall Render

This has been a growing trend in health care enforcement, and health care fraud remained the leading source of all FCA cases in 2022. Health Care Fraud Actions Medicaid. million to resolve allegations that it paid kickbacks to physicians who attended its programs in connection with its multiple sclerosis drugs between 2009 and 2014.

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HIPAA Compliance Guide: All Your Questions Answered

Total HIPAA

The Security Rule establishes administrative, physical, and technical safeguards that entities who come into contact with PHI must implement. HITECH Act (2009). The HITECH Act of 2009 expanded the definition of HIPAA compliance and solidified the fines and penalties for parties who violate the law. Administrative Safeguards.

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What Duplicate Patient Notes Reveal About Health Care and Its Records

Healthcare IT Today

Still, through various contacts in the health IT field, I put together some tentative answers to two questions that arise naturally when reading the study: Why do duplicates occur so often? I heard one anecdote suggesting that pulling forward could lead to fraud. Most failed to respond, probably because they were busy.

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How Can Health IT Help Reform the CDC?

Healthcare IT Today

(President Biden, in his State of the Union speech, warned “we remain vigilant” while calling for an end to the emergency, but quickly switched the subject from the urgency of public health to prosecuting fraud.) For data reporting, Diameter Health improved lab data to adhere to standard and interoperable formats.