The Health Law Firm

NOVEMBER 4, 2021

Board Certified by The Florida Bar in Health Law On October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged health insurance fraud scheme to rip off the league's benefit plan, according to an indictment filed in the Southern District of New York. By George F. Indest III, J.D.,

Fraud 40

Fraud Health Insurance 40

Innovaare Compliance

MARCH 24, 2024

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.

Fraud 52

Fraud Health Insurance Compliance Medicaid 52

Hall Render

FEBRUARY 4, 2022

billion from False Claims Act (“FCA”) cases in the federal fiscal year 2021, “the second largest annual total in False Claims Act history” and more than doubling the FCA recoveries for the DOJ from fiscal year 2020. Whistleblowers themselves received $237 million in 2021. Health Care Fraud Actions.

Fraud 40

Fraud Governance Medicare Medicare 40

HIPAA Journal

SEPTEMBER 8, 2022

The Michigan law firm, Warner Norcross and Judd LLP, has issued notification letters to 255,160 individuals advising them about an October 2021 security breach in which files containing their personal and protected health information were potentially accessed and exfiltrated from its systems.

Fraud 99

Fraud Health Insurance Ransomware HIPAA 99

HIPAA Journal

MARCH 25, 2022

The forensic investigation revealed the email accounts were accessed by unauthorized individuals between April 7, 2021, and June 2, 2021. AHA provided notice about the attack on January 6, 2021. UMC was a victim of a REvil ransomware attack in June 2021 that resulted in the theft of the protected health information of 1.3

Health Insurance 109

Health Insurance Licensing Ransomware Fraud 109

HIPAA Journal

SEPTEMBER 12, 2023

Seymour, IN-based Schneck Medical Center has settled a lawsuit with the Indiana attorney general, Todd Rokita, over a 2021 ransomware attack and data breach that affected 89,707 Indiana residents.

HIPAA 87

HIPAA Ransomware Health Insurance Fraud 87

HIPAA Journal

FEBRUARY 14, 2023

Hackers gained access to Umass Memorial Health’s email environment between June 24, 2020 and January 7, 2021, as a result of responses to phishing emails. Claims may also be submitted for extraordinary losses up to a maximum of $5,000, which can include documented, unreimbursed losses to fraud and identity theft.

Fraud 92

Fraud Licensing Health Insurance HIPAA 92

HIPAA Journal

SEPTEMBER 8, 2022

The Michigan law firm, Warner Norcross and Judd LLP, has issued notification letters to 255,160 individuals advising them about an October 2021 security breach in which files containing their personal and protected health information were potentially accessed and exfiltrated from its systems.

Fraud 69

Fraud Health Insurance Ransomware HIPAA 69

HIPAA Journal

JUNE 13, 2023

Point32Health is the second largest insurer in Massachusetts and serves more than 2.4 Point32Health was formed following the merger of Harvard Pilgrim Health Care and Tufts Health Plan in 2021. Harvard Pilgrim Health Care Inc. Harvard Pilgrim Health Care, Inc. million customers. and Point32Health, Inc.

Ransomware 96

Ransomware Fraud Health Insurance HIPAA 96

HIPAA Journal

APRIL 15, 2022

The incident involved the exposure and potential theft of the protected health information of 318,400 patients, including names, addresses, birth dates patient account numbers, medical record numbers, health insurance information, testing, diagnostic, treatment, and claims information.

Electronic Medical Records 116

Electronic Medical Records HIPAA Health Insurance Fraud 116

HIPAA Journal

JANUARY 16, 2023

A settlement proposed by Rehoboth McKinley Christian Health Care Services to resolve claims related to February 2021 cyberattack has been approved by a New Mexico federal judge. Patients were notified about the data breach in May 2021. In June 2021, a lawsuit – Charlie et al. District Court Judge Steven C.

Fraud 100

Fraud Health Insurance HIPAA Hospitals 100

HIPAA Journal

FEBRUARY 15, 2023

The medical device manufacturer Electromed has proposed a $850,000 settlement to resolve claims related to a June 2021 ransomware attack and data breach involving the protected health information of 47,200 individuals.

Ransomware 85

Ransomware Fraud Licensing Health Insurance 85

HIPAA Journal

FEBRUARY 16, 2023

The Nashville, TN-based health system, Advent Health Partners, has proposed a $500,000 settlement to resolve claims related to a September 2021 data breach involving the protected health information of 61,072 patients. Advent Health Partners detected a breach of its email environment in early September 2021.

HIPAA 93

HIPAA Fraud Licensing Health Insurance 93

HIPAA Journal

AUGUST 5, 2022

The cyberattack was discovered by VPN Solutions on or around October 31, 2021, and the forensic investigation confirmed that the information potentially compromised in the attack included names, addresses, dates of birth, diagnostic and treatment information, health insurance information, and Social Security numbers.

Electronic Medical Records 92

Electronic Medical Records Health Insurance Fraud HIPAA 92

HIPAA Journal

SEPTEMBER 29, 2022

Choice Health worked with its service provider to ensure the database was secured and additional data security measures have been implemented to prevent similar occurrences in the future.

Health Insurance 108

Health Insurance Medicare Medicare Fraud 108

HIPAA Journal

DECEMBER 27, 2022

On or around August 1, 2021, Morley Companies, a Saignaw, MI-based provider of business services, suffered a cyberattack in which hackers gained access to parts of its network. Morley Companies has agreed to settle a class action lawsuit filed on behalf of individuals affected by a major data breach that occurred on or around August 1, 2022.

Fraud 109

Fraud HIPAA Health Insurance 109

HIPAA Journal

AUGUST 4, 2022

A third-party cybersecurity firm was engaged to assist with the investigation and confirmed that a limited number of employee email accounts had been accessed by an unauthorized third party between October 5, 2021, and May 15, 2022, as a result of responses to phishing emails. OrthoArizona Notifies Patients About October 2021 Cyberattack.

Health Insurance 79

Health Insurance Fraud HIPAA 79

HIPAA Journal

JANUARY 25, 2023

Logan Health has agreed to settle a class action lawsuit related to a 2021 hacking incident that exposed the protected health information of 213,543 individuals. Under the terms of the settlement, Logan Health has agreed to create a fund of $4.3 million to cover claims from individuals affected by the breach.

Medical Billing 84

Medical Billing Fraud HIPAA Health Insurance 84

HIPAA Journal

MARCH 28, 2023

A New York law firm that suffered a LockBit ransomware attack has agreed to pay a financial penalty of $200,000 to the New York Attorney General to resolve alleged violations of New York General Business Law and the Privacy and Security Rules of the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA 103

HIPAA Ransomware Malpractice Health Insurance 103

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. According to the FBI, more than $43 billion was lost to these scams between June 2016 and December 2021, and in 2021 alone, the FBI Internet Crime Complaint Center received reports of losses of $2,395,953,296 to BEC scams.

Medicaid 77

Medicaid Medicaid Medicare Medicare 77

HIPAA Journal

MARCH 21, 2023

MRHS discovered unauthorized access to its computer systems on November 8, 2022, and determined hackers had exfiltrated files from its systems more than a year earlier on October 30, 2021. The lawsuits allege the victims of these breaches now face a substantial risk of fraud, identity theft, and other misuses of their personal data.

Hospitals 72

Hospitals Fraud Health Insurance HIPAA 72

HIPAA Journal

OCTOBER 6, 2022

Mon Health is facing a class action lawsuit over a hacking incident that allowed unauthorized individuals to gain access to its network for an 11-day period in December 2021. The lawsuit, which names Monongalia Health Systems Inc. and affiliated hospitals, Monongalia County General Hospital Co.,

HIPAA 93

HIPAA Fraud Hospitals Health Insurance 93

HIPAA Journal

APRIL 1, 2022

On January 24, 2022, SRHD announced that an employee email account had been compromised on December 21, 2021. Buffalo, NY-based Ciox Health provides health information management services to healthcare providers and insurers. CMMHC identified potentially malicious activity in its email environment on October 21, 2021.

Fraud 129

Fraud HIPAA Licensing Health Insurance 129

HIPAA Journal

DECEMBER 19, 2022

A review of the files on the compromised servers confirmed that protected health information such as patient names, dates of birth, Social Security numbers, driver’s license numbers, health insurance information, and diagnosis and treatment information had been exposed. The DOL and the U.S.

Fraud 95

Fraud Licensing HIPAA Health Insurance 95

HIPAA Journal

NOVEMBER 16, 2022

Unauthorized individuals have gained access to the email system of the Administrative Fund of the Detectives’ Endowment Association of the Police Department of the City of New York (NYCDEA) and potentially viewed or obtained the protected health information of 21,544 individuals.

HIPAA 87

HIPAA Licensing Health Insurance Fraud 87

HIPAA Journal

FEBRUARY 13, 2023

iCare Acquisitions has proposed a $3 million settlement to resolve claims from individuals affected by a 2021 data breach that affected almost 3.3 million 20/20 Eye Care Network and 20/20 Hearing Care Network health plan members.

HIPAA 72

HIPAA Fraud Health Insurance 72

HIPAA Journal

DECEMBER 7, 2022

Urology of Greater Atlanta Notifies Almost 80,000 Patients About August 2021 Data Breach. Urology of Greater Atlanta has now confirmed that it was the victim of a cyberattack that was detected on August 29, 2021. The VA concluded that there was a low risk of misuse of that information.

COVID-19 Vaccine 83

COVID-19 Vaccine COVID-19 Department of Veterans Affairs Licensing 83

HIPAA Journal

MAY 25, 2022

SAC Health said it is unaware of any actual or attempted misuse of patient data as a result of the break-in; however, as a precaution against identity theft and fraud, affected individuals have been offered complimentary credit monitoring services. Notification letters were sent to those individuals on May 3, 2022.

Ransomware 126

Ransomware Fraud HIPAA Licensing 126

HIPAA Journal

NOVEMBER 21, 2022

The Wisconsin-based dermatology practice, Forefront Dermatology, has agreed to settle a class action lawsuit filed on behalf of patients whose protected health information (PHI) was compromised in a ransomware attack in late May 2021. Forefront Dermatology has affiliated practices in 21 states and Washington D.C.

Ransomware 65

Ransomware Fraud HIPAA Licensing 65

Health Care Law Brief

JUNE 24, 2022

The Department of Health and Human Services (“HHS”), Office for Civil Rights (“OCR”), recently issued new regulatory guidance relating to covered entities’ HIPAA-compliant use of remote communication technologies for audio-only telehealth services.

HIPAA 52

HIPAA Fraud Compliance COVID-19 52

HIPAA Journal

SEPTEMBER 28, 2022

The attack exposed the protected health information of 542,776 current and former Wolfe Clinic patients. Wolfe Clinic used the myCare Integrity medical records platform, which was accessed by an unauthorized party on or around December 4, 2021, who deleted databases and system configuration files.

Electronic Medical Records 77

Electronic Medical Records Ransomware Fraud HIPAA 77

HIPAA Journal

MAY 18, 2023

The information exposed included names, addresses, dates of birth, Social Security numbers, health insurance information, diagnoses/conditions, medications, test results, and procedure information. Asian Health Services did not find any evidence to indicate patient data had been compromised but the possibility could not be ruled out.

Ransomware 74

Ransomware Fraud HIPAA Health Insurance 74

HIPAA Journal

OCTOBER 14, 2022

2021 saw 714 data breaches of 500 or more records reported to the OCR – an 11% increase from the previous year. Large health systems store millions of patient records and even relatively small healthcare providers may store the records of hundreds of thousands of patients. How do Hackers Make Money from Stolen Medical Data?

Ransomware 112

Ransomware HIPAA Health Insurance Hospitals 112

HIPAA Journal

DECEMBER 23, 2022

Eye Care Leaders is a North Carolina provider of an electronic health record solution (myCare Integrity) to ophthalmology practices across the country. Affected providers started to be notified in March that hackers had gained access to its databases in December 2021. 119 pediatric practices were affected by the data breach.

HIPAA 82

HIPAA Ransomware Health Insurance Compliance 82

Compliancy Group

JANUARY 25, 2022

With at least six weeks before final numbers are in, the Department of Health and Human Services HIPAA Breach Reporting Tool website is reporting 713 major healthcare data breaches in 2021, an increase of more than 7.5 By the Numbers: Major Healthcare Data Breaches Increase in 2021. million records in 2021.

HIPAA 98

HIPAA Ransomware Governance Compliance 98

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. percent of the gross domestic product (GDP) on healthcare, which was almost two times the average of other high-income countries, while the health outcomes in the U.S. Why this Trend of Value-Based Care?

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. percent of the gross domestic product (GDP) on healthcare, which was almost two times the average of other high-income countries, while the health outcomes in the U.S. Why this Trend of Value-Based Care?

Medicare 52

Medicare Medicare Medicaid Medicaid 52