Health Care Law Brief

APRIL 12, 2023

405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. MA plans will be required to have a Utilization Management Committee that conducts annual reviews of policies to ensure compliance with the foregoing. 2010) (quoting S. Final Rule at p. 3d 173, 191 (D.D.C. rather than a ‘limited duty to inquire.”

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Health Law Advisor

MARCH 1, 2023

1] Originally enacted in 2010, the Online Prescribing Act has allowed health care providers to register with the State to prescribe and dispense certain FDA-approved drugs via online pharmacies and utilization of telehealth visits.

Telemedicine 52

Telemedicine COVID-19 Fraud Licensing 52

HIPAA Journal

JANUARY 24, 2023

The theft of protected health information places patients and health plan members at risk of identity theft and fraud, but by far the biggest concern is the threat to patient safety. That task has become increasingly difficult due to the increase in data breaches, which have tripled since 2010. million records in 2021 to 51.9

Ransomware 115

Ransomware HIPAA Hospitals Fraud 115

HIPAA Journal

MAY 18, 2023

The Department of Health and Human Services’ Office for Civil Rights is the main enforcer of HIPAA compliance; however, state Attorneys General also play a role in enforcing compliance with the Rules of the Health Insurance Portability and Accountability Act (HIPAA). million individuals and for delayed breach notifications. million 78.8

HIPAA 98

HIPAA Compliance Ransomware Hospitals 98

Innovaare Compliance

FEBRUARY 9, 2021

The Affordable Care Act of 2010 mandates the CMS to make quality bonus payments (QBPs) to Medicare Advantage (MA) organizations that achieve at least four stars in a 5-star quality rating system and, starting in 2012, the CMS incentivizes health plans to improve member experiences by increasing the QBP amount, based on their star rating.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Healthcare IT News - Telehealth

JULY 19, 2021

The practice was an early adopter of telehealth back in 2010, implementing it as a way to care for people unable to attend in-person sessions. Unsecure telehealth connections can open the door for fraud, phishing and ransomware attacks, with serious reputational and financial consequences. THE PROBLEM. " PROPOSAL.

COVID-19 157

COVID-19 HIPAA Ransomware Governance 157

Hall Render

NOVEMBER 28, 2023

Due to CMS’s increasing concern “about program integrity issues within the hospice community, particularly (though not exclusively) potential and actual criminal behavior, fraud schemes, and improper billing,” it proposed to increase the risk screening category into which hospices were placed. Hospice 36-Month Rule.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

C&M Health Law

JANUARY 25, 2023

hospitalizations and emergency department visits) and to audit Medicare claims to assess potential fraud. Section 1001 of the Act delays the 4% Statutory Pay-As-You-Go Act of 2010 (PAYGO) sequester for two years, through the end of calendar year 2024.

Medicaid 104

Medicaid Medicaid Medicare Medicare 104

Drug & Device Law

AUGUST 8, 2022

The unfortunate truth is that ECFMG was also a victim of this fake doctor’s fraud. So if compliance with an industry standard is a defense, this plaintiff went a step further and sued the organizations that created the standards. Smith, LLC , 2010 WL 11566367, at *7 (N.D. has no power to enforce compliance”), aff’d , 405 F.

Doctors 52

Doctors Fraud Licensing Compliance 52

Drug & Device Law

FEBRUARY 15, 2024

2022) (recognizing the following product defect liability theories: “(1) negligent design of the product; (2) negligent manufacture of the product; (3) negligent failure to warn about some aspect of the product; (4) breach of express or implied warranty; or (5) misrepresentation or fraud”). 09-cv-10248, 2010 WL 4982899, at *5-6 (E.D.

FDA 52

FDA Compliance Fraud Hospitals 52