UnitedHealth unit sued by Labor Department over systematic claims denials
Healthcare Dive
AUGUST 2, 2023
The government is alleging plan administrator UMR improperly denied thousands of ER and drug screening claims submitted between 2015 and 2018.
Government Delay Reduces False Claims Act Verdict – How Can This Protect Your Practice?
Hall Render
AUGUST 24, 2023
The Fifth Circuit Court of Appeals refused the defendants’ request to overturn the entire verdict but enforced the consequences of the government’s prejudicial delay by tying the conduct together with the government’s failure to toll the statute of limitations for many of its claims. The ruling in U.S. Aldridge v. Corporate Mgmt.,
Governance 
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Data linkage project seeks to improve First Nations maternal and child health outcomes
Healthcare It News
NOVEMBER 3, 2022
The Digital Infrastructure For improving First Nations Maternal and Child Health (DIFFERENCE) project has been awarded A$3 million in funding from the federal government's Medical Research Future Fund. Between 2015-2019, around 600 indigenous children aged 0-4 died, mostly infants. per 100,000 women).
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Safeguarding Against Medical Identity Theft Training
American Medical Compliance
JANUARY 9, 2024
Through Medicare, Medicaid, and the Children’s Health Insurance Program, the federal government and state governments offer health care coverage to nearly 100 million individuals. trillion in 2015. That is approximately one in three people in this nation, and it is anticipated that taxpayer spending will exceed $1.3
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Biosafety Labs, Public Safety, and Politics
Bill of Health
AUGUST 4, 2023
dollars (USD) and additional government losses at $11 billion USD due to controlling livestock movement and depopulating infected livestock. Alas not: Regulators cited Kansas State University in 2015 for repeatedly violating safety regulations at its existing biosafety level 3 research lab, the Biosecurity Research Institute.
Monthly Round-Up of What to Read on Pharma Law and Policy
Bill of Health
MAY 22, 2023
The selections feature topics ranging from an analysis of government and industry investments for recently approved drugs, to a discussion of court decisions on mifepristone, and an examination of the added therapeutic benefit associated with the top-selling brand-name drugs in Medicare. 2023 Apr 18;329(15):1283-1289. PMID: 37071095).
Dr. Eunice Brookman-Amissah: A Pioneer in Safe Abortion Law Reform
Bill of Health
MARCH 14, 2024
Mozambique’s 2015 reforms legalized abortion during the first 12 weeks of pregnancy for any reason and the first 16 weeks in cases of rape or incest. Mozambique’s 2015 reforms legalized abortion during the first 12 weeks of pregnancy for any reason and the first 16 weeks in cases of rape or incest.
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How health systems can better protect patient privacy
Healthcare It News
SEPTEMBER 21, 2023
Before what he referred to as the major ramp up in attacks against healthcare that began in 2015, there was "an appreciable minority of patients who were uncomfortable providing all their information to their doctors," he told attendees at the HIMSS Healthcare Cybersecurity Forum in Boston earlier this month.
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Disability-Inclusive Climate Action in Bangladesh: Gaps and Opportunities
Bill of Health
JULY 26, 2023
Other researchers have found that “ many persons with disabilities do not receive any humanitarian support from NGOs or the Government ” following natural disasters. Many have wheelchair access ramps, and are heralded as accessible by the Bangladesh government and international funders, yet they lack accessible toilets.
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More funds added for psychosocial telehealth to support ovarian cancer patients in Australia
Healthcare IT News - Telehealth
FEBRUARY 8, 2022
The Australian government has added A$2 million ($1.4 The government's additional funding, the group said, will help them continue providing psychosocial telehealth support services through its Teal Support Programme until the fiscal year 2023-2024. WHY IT MATTERS. The funding adds to the overall A$62.5
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HHS Shares Information on Advanced Persistent Threat Groups Linked with the Russian Intelligence Services
HIPAA Journal
MAY 23, 2022
Turla, aka Venomous Bear/Iron Hunter/KRYPTON/Waterbug, operates under the direction of the FSB and mostly targets industries such as academic, energy, government, military, telecommunications, research, pharmaceutical companies, and foreign embassies, and has been active since at least 2004. Mitigations.
Massachusetts Physicians Who Don't Meet Meaningful Use EHR Criteria Could Lose Their Medical Licenses in 2015
The Health Law Firm
MARCH 26, 2014
Board Certified by The Florida Bar in Health Law Effective January 2015, Massachusetts physicians who wish to renew their licenses must demonstrate that they utilize electronic health records (EHRs) that meet the requirements of the federal government's meaningful use program. Smith, R.R.T.,
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Telemedicine M&A trends moving into 2024
Healthcare IT News - Telehealth
DECEMBER 18, 2023
target company, consistent with the 2015-2022 trend where more than 70% of deals involved an American target company. You need to go back as far as 2015 to see such a low level of fundraising activity. government-led seed fund National Science Foundation, and the U.S. As with M&A, the U.S. with $610 million in volume.
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HIMSS22 EUROPE: “We need to co-create and work together with patients.”
Healthcare It News
JUNE 18, 2022
The young person’s advisory group, Kids Barcelona, was set up in 2015 and currently has 20 members of which 80% are patients and 20% are from the local community. Each month meetings are held at which members can contribute their opinions about projects at the hospital.
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Georgia Rehabilitation Center Submitted 808 False Claims to Medicaid/Tricare
Healthcare Compliance Blog
APRIL 27, 2022
A Georgia district court has issued a summary judgment against a state rehabilitation center for 808 false claims billed to Medicaid and Tricare between November 2015 and June 2020. 2, 2015–July 31, 2016, and a range of $11,181–$22,363 for violations committed after Jan. Issue: All submitted claims must be accurate and truthful.
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Russian National Indicted for Scripps Health Ransomware Attack; 11 TrickBot/Conti Actors Sanctioned
HIPAA Journal
SEPTEMBER 13, 2023
A federal grand jury in the Middle District of Tennessee returned an indictment charging Galochkin and co-conspirators Rudenskiy, Tsarev, and Zhuykov with conspiring to use Conti ransomware to attack businesses, nonprofits, and governments in the United States from 2020 until June 2022 when the Conti operation was disbanded.
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HSCC & HHS Release Guide to Help Healthcare Organizations Adopt the NIST Cybersecurity Framework
HIPAA Journal
MARCH 9, 2023
The framework was released by NIST in 2015, updated in 2018, and the NIST CSF 2.0 The NIST CSF has become the standard cybersecurity framework for government agencies and private sector companies for managing cybersecurity risks. is due for release later this year.
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NLRB Issues Final Rule Broadening Standard for Determining Joint-Employer Status
Hall Render
NOVEMBER 27, 2023
In 2015, the NLRB departed from its longstanding, common law-based standard for determining whether two entities are joint employers under the NLRA in Browning-Ferris Industries of California, Inc. d/b/a BFI Newby Island Recyclery , 362 NLRB 1599, 1600 (2015), affd. d/b/a BFI Newby Island Recyclery , 362 NLRB 1599, 1600 (2015), affd.
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2021 HIPAA “Wall of Shame” Healthcare Data Breaches Up 7.5%
Compliancy Group
JANUARY 25, 2022
This is the second-largest number of records reported breached on the government site since 2015. The 2015 total included the largest single healthcare data breach on record – health insurer Anthem’s 77.8 Protected health information (PHI) from more than 45.7 million individuals. million patient records. .
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3 Compelling Reasons — Beyond the Law — to Expand Consumer Access to Personal Records
HIT Consultant
DECEMBER 19, 2023
These safeguards become even more demanding as consumers and government agencies call for increased transparency and access to personal data. Do we have a data governance team in place, and is it effective? In 2007, Tom joined the board of Harmony Healthcare IT and became CEO in 2015. Healthcare is no exception.
False Claims Lawsuit Filed Against Alabama Psychiatrist for Improper Prescribing of Nuedexta to Nursing Home Resident
Healthcare Compliance Blog
FEBRUARY 8, 2022
From 2015 through 2019, the pharmaceutical company that manufactures Nuedexta paid the Alabama psychiatrist more than $400,000 to make speeches about Nuedexta. Routine audits should be conducted, and the results of the audits should be reported at the compliance and ethics committee meetings and in reports to the governing body.
The History of Healthcare Compliance
MedTrainer
JANUARY 12, 2024
Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. What is Healthcare Compliance?
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False Information Is Material Regardless of the Validity of Underlying Eligibility Requirements
Hall Render
AUGUST 22, 2023
Rather, liability under the FCA may still be established if any misrepresentations made by a provider influenced decision-makers and resulted in the submission of false claims to the government. In United States v. Walgreen Co. , Here, the claims containing truthful information did not satisfy the eligibility requirements.
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Centene Corporation Signs Definitive Agreement to Divest Apixio to New Mountain Capital
Healthcare IT Today
MAY 15, 2023
“Apixio has been a trusted business partner since our relationship began in 2015,” said Sarah M. Centene focuses on long-term growth and value creation as well as the development of its people, systems, and capabilities so that it can better serve its members, providers, local communities, and government partners.
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IT preparedness is key to managing outbreak of COVID-19, says CIO of SNUBH
Healthcare IT News - Telehealth
APRIL 30, 2020
Seoul National University Bundang Hospital (SNUBH), which is the first fully digitalized-paperless health care institution in South Korea, was designated by the government on 1 March as a “public safety hospital,” an institution that separates the treatment process of respiratory patients to prevent COVID-19 spread with the facility.
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Norton Healthcare Facing Class Action Lawsuit Over BlackCat Cyberattack
HIPAA Journal
JULY 27, 2023
The stolen information included names, addresses, email addresses, dates of birth, Social Security numbers, government identification ID numbers, driver’s license numbers, payment/financial institution information, health insurance providers, medical treatment information, medical diagnoses, medications, medical images, and lab test results.
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Report: How Apple Is Advancing Digital Healthcare Transformation
HIT Consultant
JULY 26, 2022
Since the release of the Health app in 2014 and Apple Watch in 2015, Apple has introduced a wide array of innovative health and fitness features, with the goal to provide users with easy-to-understand, meaningful insights so they can be empowered to live a healthier life. Supporting public health and government initiatives.
Not-So-Charitable Donations: DOJ Achieves a $20 Million Settlement for a Backdoor Donation Scheme for Increased Medicaid Contributions
C&M Health Law
APRIL 21, 2022
Florida Medicaid is administered by the state but jointly funded by both the state and federal governments. The federal government’s Federal Financial Participation (FFP) share is paid according to statements of expenditures submitted by the state and per the formula described in sections 1903 and 1905(b) of the Medicaid Act.
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Addressing the Mental Health Crisis in Kids: Collaboration and Technology Are Key
Healthcare IT Today
OCTOBER 19, 2022
Beyond the fact that DotCom Therapy has been successfully delivering services since 2015, a review of two dozen studies in 2019 found that phone and video therapies were equally effective at treating conditions like anxiety, depression, and post-traumatic stress disorder as in-person therapy.
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Canvas Medical Achieves ONC Certification, Raises $24MM to Power Clinicians and Developers Building and Scaling Digital Health Companies
Healthcare IT Today
JULY 19, 2022
Founded in 2015, Canvas is reimagining the EMR for the future of healthcare. With this funding, Canvas will continue to invest in bringing additional enterprise-grade capabilities to market, including security and governance features that put Canvas at the cutting-edge of extensibility and interoperability. About Canvas Medical.
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Will CMS’s Proposed Rule on “Identified Overpayments” Increase Reverse FCA Cases?
Healthcare Law Today
JANUARY 2, 2023
For example, in a 2015 case, DOJ attorneys stated in a court conference, “[T]his is not a question. of a case where the hospital is diligently working on the claims and it's on the sixty-first day and they're still scrambling to go through their spreadsheets, you know, the government wouldn't be bringing that kind of a claim.
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New Report Reveals Massive $2.4 Billion Marijuana Impact on Colorado Economy
The Health Law Firm
DECEMBER 16, 2016
Board Certified by The Florida Bar in Health Law On October 27, 2016, the Marijuana Policy Project issued a report for 2015 stating that the state-legal medical marijuana industry had a $2.4 Indest III, J.D., billion economic impact on the Colorado economy.
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GAO: HHS Should Establish Mechanism for Obtaining Feedback on HIPAA Data Breach Reporting Process
HIPAA Journal
JUNE 28, 2022
The Government Accountability Office (GAO) has recommended that the Department of Health and Human Services (HHS) establish a feedback mechanism to improve the effectiveness of its data breach reporting process.
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Global Healthcare Cyberattacks Increased by 74% in 2022
HIPAA Journal
JANUARY 10, 2023
With that increase, healthcare rose to become the third most attacked industry globally behind the government/military with 1,661 attacks a week (+46%) and education/research with 2,314 attacks a week (+43%). In the United States, healthcare ranked second with 1,410 attacks per week, which is an 86% increase from 2021.
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Navigating the intersections of population health and precision medicine
Healthcare It News
AUGUST 31, 2021
When President Barack Obama announced during the 2015 State of the Union Address that the government was launching the Precision Medicine Initiative, a debate began about whether and how precision medicine and population health management could coexist in the U.S. Population health and precision medicine defined. health system.
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Supreme Court Hears Arguments on False Claims Act Scienter Standard
Healthcare Law Blog
APRIL 19, 2023
The issue is a significant one for both the government and relators on one side, and potential defendants on the other, as False Claims Act (FCA) liability imposes treble damages and penalties exceeding $20,000 per claim as well as relators’ attorneys’ fees and costs. The Court’s questioning did not signal the likely decision.
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Is Your Organization HITECH Compliant?
AIHC
NOVEMBER 6, 2023
government introduced the 21st Century Cures Act, which builds upon the HITECH Act and aims to promote innovation in HIT and improve patient access to healthcare services. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is the government enforcement agency over both HIPAA and HITECH. In 2020, the U.S.
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Telehealth fraud: Tampa pharmacy owner faces 10 years for $931M conspiracy
Healthcare IT News - Telehealth
JANUARY 27, 2021
"Telemarketing fraud is a major threat to the integrity of government and commercial insurance programs," said Derrick L. The group was charged with a conspiracy to defraud pharmacy benefit managers out of $174,202,105 by submitting $931,356,936 for fraudulent prescriptions purchased from a telemarketing company.
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Examining the Climate Change-Migration Nexus from a Disability Lens
Bill of Health
JULY 18, 2023
floods and heat waves) have the potential to trigger migration decisions or prompt governments to plan for the relocation and resettlement of affected populations as some environments become uninhabitable. Yet, climate-induced slow onset pressures (e.g., sea level rise and desertification) and rapid onset events (e.g.,
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Managing Healthcare Compliance in Georgia
MedTrainer
NOVEMBER 27, 2023
Georgia Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Georgia Department of Public Health (DPH) plays a crucial role in safeguarding the health and well-being of Georgians. Keep reading for resources, tips, and regulations unique to healthcare compliance in Georgia.
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Healthcare Industry Warned About Risk Posed by APT41 Threat Group
HIPAA Journal
SEPTEMBER 28, 2022
APT41 – also known as Double Dragon, Barium, Winnti, Wicked Panda, Wicked Spider, TG-2633, Bronze Atlas, Red Kelpie – conducted targeted campaigns on the healthcare sector in 2014, 2015, 2016, 2018, 2019, and 2020.
Insured, Sick and Broke – The Latest on the State of U.S. Health-Insured Consumers’ Financial Health
Health Populi
MAY 5, 2019
Historically, since the advent of employer-sponsored health care during World War II, the payor was the employer, the union, a government agency, another plan sponsor. adults experienced medical financial hardship between 2015 and 2017. The study analyzed data from the 2015-2017 National Health Interview Survey conducted by the CDC.
DOJ Releases FY 2021 False Claims Act Recoveries: A Record-Shattering Year for Health Care and Life Sciences Enforcement, with Over $5 Billion Collected
Health Law Advisor
FEBRUARY 3, 2022
According to DOJ’s statistics, the government paid out $238 million to relators in FY 2021, the lowest number since FY 2008. As it relates to the health care and life sciences industries, the $452 million collected in FY 2021 is the largest recovery since FY 2015 and the second largest recovery in reported history. KEY TAKEAWAYS.
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Is Your Medical Credentialing Taking Too Long?
Verisys
NOVEMBER 14, 2023
A healthcare facility’s accountability and overall reputation are dependent upon rigorous credentialing processes compliant with governing regulatory bodies, such as the National Committee for Quality Assurance. It is critical for hospitals and health systems to know that everyone on the staff is compliant and in good standing at all times.
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