Health Care Law Brief

JUNE 5, 2023

In 2013, Jelly Bean contracted with the Florida Health Kids Corporation (“ FHKC ”)—a state-created entity that offers health and dental insurance for Florida children—to create, host, and maintain HealthyKids.org, where, in part, parents and others could apply for state Medicaid insurance coverage for eligible children.

Fraud 52

Fraud Due Diligence Medicaid Medicaid 52

Healthcare Compliance Blog

JANUARY 14, 2022

Custom shoe inserts for diabetic patients can be covered by Medicare and Medicaid. The United States alleges that between 2013 and 2018 the shoe company sold diabetic shoe inserts that were represented to be custom made for an individual’s foot but were actually made using generic foot models. General Legal Duties and Antitrust Laws.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

HIPAA Journal

MARCH 15, 2023

FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida. FHKC contracted with Jelly Bean Communications Design on October 13, 2013, to provide web design, programming, and hosting services.

Health Insurance 76

Health Insurance HIPAA Due Diligence Fraud 76

Healthcare Compliance Blog

MAY 9, 2022

It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.?Under Discussion Points: Review your policies and procedures for operating an effective compliance and ethics program to ensure that identifying and reporting of false claims is included.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Compliance 59

Med-Net Compliance

OCTOBER 19, 2022

The settlement resolves allegations that between 2013 and 2020, the company paid remuneration to its home health medical directors in Oklahoma and Texas for the purpose of inducing referrals of Medicare and TRICARE home health patients. The corporate officers were previously the CEO and COO of the company.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Medicaid 59

Innovaare Compliance

FEBRUARY 7, 2022

Health plans (collectively, “plan sponsors”) that contract with the Centers for Medicare & Medicaid Services (CMS) to provide health services to eligible Medicare beneficiaries are responsible for legal, contractual, and fiduciary obligations whether performed by the plan or those to whom the company delegates those obligations.

Compliance 52

Compliance Medicare Medicare Medicaid 52

McGuire Wood

OCTOBER 2, 2023

According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. Further, if ancillary services are involved, there should be analysis to confirm compliance with the Stark Law and the AKS. This settlement includes more than $5.928 million in restitution, essentially a payment of 1.49

Fraud 52

Fraud Governance Compliance Medicare 52

Healthcare IT News - Telehealth

JULY 18, 2022

"In addition, in 2012, UVA Health launched a remote patient monitoring program to improve patient compliance and clinical outcomes, and to reduce hospital readmissions, hospital length of stay and emergency department visits. "In 2019, UVA Health created a multi-stakeholder strategic plan for telemedicine. MARKETPLACE.

COVID-19 156

COVID-19 Telemedicine Electronic Medical Records Hospitals 156

HIPAA Journal

OCTOBER 21, 2022

In 2013, HHS confirmed that paper-to-paper, non-digital faxes are not covered transactions). Consequently, when data breaches occurred due to a lack of compliance by Business Associates, there was no accountability. Despite the benefits, the cost of implementing NPIs was forecast ( in 2008 ) to be between $1.5 billion and $11.5

HIPAA 101

HIPAA Compliance Medicare Medicare 101

Verisys

NOVEMBER 14, 2023

Proven software and technology which continuously monitors these sources will ensure that your healthcare organization is in compliance at all times. With thousands of federal and state sources to screen for debarments, sanctions, exclusions, and disciplinary actions, manual monitoring of your provider population is virtually impossible.

Licensing 52

Licensing Medicaid Medicaid Governance 52

HIPAA Journal

DECEMBER 31, 2022

To best answer the question what is a HIPAA violation, it is necessary to explain what HIPAA is, who it applies to, and what constitutes a violation; for although most people believe they know what a HIPAA compliance violation is, evidence suggests otherwise. What is HIPAA and Who Does It Apply To? Other Types of HIPAA Law Violation.

HIPAA 135

HIPAA Due Diligence Compliance Fraud 135

HIPAA Journal

FEBRUARY 23, 2022

The preamble could give the impression that the Administrative Simplification provisions of HIPAA Title II will improve accessibility to and affordability of the Medicare and Medicaid programs, or that the development of a health information system would streamline the provision of healthcare between providers.

HIPAA 92

HIPAA Fraud Health Insurance Medicaid 92

HIT Consultant

APRIL 20, 2022

As part of this VBC mode l, hospitals and health systems must store, track, and analyze a large amount of quality-related data for compliance and reimbursement purposes. Analysts looked at the health care costs of individuals enrolled in commercial insurance, Medicare, and Medicaid in the United States. About Tom Zaubler, MD.

Medicare 98

Medicare Medicare Telemedicine Medicaid 98

Medval Compliance Blog

MARCH 10, 2022

Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. Rulemaking around Civil Money Penalties for Section 111 Reporting originally started after the SMART Act was passed in December 2013 with an Advanced Notice of Proposed Rulemaking (ANPRM).

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Innovaare Compliance

MARCH 4, 2024

Until the enactment of the Medicare Modernization Act (MMA) in 2006 [1] , the Centers for Medicare & Medicaid Services does not cover most outpatient prescription drugs under Part B (“Part B drugs”). Since 2013, CMS has required drug plan sponsors to report the PRC on PDE.

Medicare 52

Medicare Medicare Nurses Medicaid 52

Verisys

JANUARY 18, 2022

Proven software and technology which continuously monitors these sources will ensure that your healthcare organization is in compliance at all times. ISO 27001:2013 (information security). Verisys’ owned and maintained Fraud Abuse Control Information System (FACIS) is a provider data supersource. ISO 9001:2015 (quality management).

Licensing 52

Licensing Medicaid Medicaid Governance 52

Healthcare Law Blog

MAY 31, 2022

However, traditional healthcare players, subject to the Health Insurance Portability and Accountability Act (“HIPAA”), may also find themselves innovating in this space (and grappling with how to stand up a HIPAA compliance program in the metaverse). 1] “Metaverse may be $800 billion market, next tech platform,” Bloomberg Intelligence (Dec.

FDA 90

FDA HIPAA Medicare Medicare 90

HIPAA Journal

JULY 24, 2023

Healthcare providers participating in federal healthcare programs are advised to regularly check the HHS OIG Exclusions List to avoid penalties for non-compliance with §1128 of the Social Security Act. HHS OIG alleged that the organization had billed New York Medicaid for services furnished by the personal assistant.

Fraud 52

Fraud Medicare Medicare Medicaid 52

AIHC

JANUARY 28, 2022

For more information on filing compliance cost reports, attend the Medicare Cost Report Camp in March 2022 presented by KraftCPAs and sponsored by the American Institute of Healthcare Compliance. This is calculated based on the hospital’s relative share of uncompensated care nationally.

Medicare 52

Medicare Medicare Hospitals Payment Systems 52

Healthcare Law Blog

MARCH 25, 2022

15,411 (March 11, 2013) ); Second, the risk scores for each enrollee in a plan are aggregated to determine the plan’s average risk score ( see id. at 15,432 ); and.

ACA 52

ACA US Department of Health and Human Services Health Insurance Medicaid 52

HIPAA Journal

JANUARY 2, 2023

HIPAA compliance is about reducing risk to an appropriate and acceptable level. It is therefore important for HIPAA-covered entities to conduct regular HIPAA compliance reviews (this is required by the HIPAA law) to make sure HIPAA violations are discovered and corrected before they are identified by regulators.

HIPAA 109

HIPAA Compliance Hospitals Medicare 109

HIPAA Journal

DECEMBER 14, 2022

The last update to the HIPAA Rules was the HIPAA Omnibus Rule in 2013, which introduced new requirements mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The compliance date for the CMS rule was July 1, 2021. The compliance date for the CMS rule was July 1, 2021.

HIPAA 128

HIPAA COVID-19 COVID-19 Vaccine Compliance 128

HIPAA Journal

JANUARY 9, 2023

The Health Insurance Portability and Accountability Act was signed into law in 1996 and while there have been some significant HIPAA updates over the last two decades, the last set of major HIPAA updates occurred in 2013 with the introduction of the HIPAA Omnibus Final Rule. It is now 10 years since the last major HIPAA update took effect.

HIPAA 113

HIPAA COVID-19 COVID-19 Vaccine Compliance 113