HIPAA Journal

DECEMBER 19, 2022

Avem Health Partners, an Oklahoma City-based provider of administrative and technology services to healthcare organizations, has recently started notifying its healthcare clients about a data breach that occurred at one of its vendors, 365 Data Centers. Emory Healthcare was notified about the privacy breach by the U.S.

Fraud 91

Fraud Licensing HIPAA Health Insurance 91

Healthcare IT Today

MAY 5, 2023

The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient. In 2021, a U.S.

Fraud 62

Fraud Medicare Medicare Overpayments 62

HIPAA Journal

AUGUST 5, 2022

In a substitute breach notification, First Choice explained that unusual activity was detected within its technological environment on March 27, 2022. Affected individuals were notified about the breach by mail on August 1, 2022, and have been offered complimentary identity theft protection services through IDX.

Electronic Medical Records 88

Electronic Medical Records Health Insurance Fraud HIPAA 88

Health Law RX

AUGUST 1, 2022

While this new flexibility increased access to care, it also increased opportunities for fraud. On July 20, 2022, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a Special Fraud Alert cautioning Practitioners about potential fraudulent telemedicine contracts ( Fraud Alert ).

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Fraud Telemedicine Nurses Governance 59

Compliancy Group

AUGUST 31, 2022

Department of Justice’s (DOJ) Civil Cyber Fraud Initiative (CCFI). Details of DOJ Cyber Fraud Initiative Settlements. Even after staff raised concerns about the privacy of protected medical information, CHS did not take adequate steps to store the data exclusively on the EMR system. million from the total settlement.

Fraud 52

Fraud HIPAA Governance Electronic Medical Records 52

Healthcare Law Blog

MAY 8, 2023

Department of Health and Human Services (“HHS”) is responsible for detecting and preventing fraud, waste, and abuse in federal health care programs. Upon request from health care providers and others, the OIG periodically issues advisory opinions concerning the application of fraud and abuse laws to existing or proposed business arrangements.

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Fraud COVID-19 Public Health Compliance 52

Health Law Checkup

MARCH 13, 2023

In separate announcements over the past several weeks, DOJ dangled two new “carrots” in front of companies involved in fraud investigations and criminal cases.

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Fraud Compliance 52

Verisys

FEBRUARY 24, 2023

A Story About Provider Data, And Why It Has Become So Complex While leaving her house to visit her grandson, Sue falls and twists her knee. Many health plans struggle to maintain correct, complete, and current information about providers in their network with today’s complex health landscape. Why Has Provider Data Become So Complex?

Fraud 52

Fraud Doctors Governance Licensing 52

Verisys

FEBRUARY 24, 2023

A Story About Provider Data, And Why It Has Become So Complex While leaving her house to visit her grandson, Sue falls and twists her knee. Many health plans struggle to maintain correct, complete, and current information about providers in their network with today’s complex health landscape. Why Has Provider Data Become So Complex?

Fraud 52

Fraud Doctors Governance Licensing 52

Bill of Health

SEPTEMBER 2, 2022

But if scams are not a bounded problem of those who are in some sense more psychologically vulnerable (as older adults are thought of in, at least, the popular imagination ), we might want to rethink scams — what they are, how we fight them, and how we treat and think about their victims. But perhaps it’s worth trying.

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Fraud 293

HIPAA Journal

JUNE 8, 2023

There is a trend for breach notification letters to only contain the bare minimum information to meet regulatory requirements; however, Alvaria breach notifications include comprehensive details about the attack including the name of the ransomware group responsible.

Ransomware 52

Ransomware Fraud HIPAA Health Insurance 52

HIPAA Journal

DECEMBER 23, 2022

It has been another bad year for healthcare data breaches, with some of the biggest HIPAA breaches of 2022 resulting in the impermissible disclosure of well over a million records. In addition to the high number of data breaches, 2022 stands out for the sheer number of healthcare records breached, which currently stands at 49.8

HIPAA 79

HIPAA Ransomware Health Insurance Compliance 79

Healthcare IT Today

SEPTEMBER 24, 2022

Major and Lynn also talked about where the data comes from and how it integrates with clinicians’ everyday workflows. Read more… How AI Can Help Spot Telehealth Fraud. As telehealth use has increased, so have instances of telehealth fraud. Critically, professor Vincent J.

Fraud 79

Fraud Nurses Hospitals 79

Innovaare Compliance

MAY 26, 2022

On April 15, 2022, the Centers for Medicare & Medicaid Services (CMS) released potential fraud, waste and abuse (FWA) trending data collected from Medicare Advantage Prescription Drug Plans (plan sponsors) for fourth quarter 2021. The post CMS Reminder of Medicare Fraud, Waste and Abuse Vigilance appeared first on Inovaare.

Fraud 52

Fraud Medicare Medicare Medicaid 52

Healthcare Law Blog

APRIL 13, 2022

On March 18, 2022, AdvaMed announced updates to the Code of Ethics on Interactions with Health Care Professionals (“Code”), a voluntary code that provides medical technology companies with guidance on ethically compliant interactions and relationships with healthcare professionals. The changes will take effect on June 30, 2022.

Fraud 52

Fraud Medical Device Industry Compliance COVID-19 52

Med-Net Compliance

OCTOBER 21, 2022

The Office of Inspector General (OIG) has recently posted the False Claims Act (FCA) settlements for FY 2022 Q1–Q4 on the risk spectrum. The government’s primary civil tool for addressing healthcare fraud is the FCA. The post OIG Posts False Claims Act Settlements for FY 2022 Q1–Q4 on the Risk Spectrum appeared first on Med-Net.

Fraud 59

Fraud Compliance Medicare Medicare 59

Healthcare Law Blog

JULY 25, 2022

On July 20, 2022, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert warning physicians and other practitioners to exercise caution when entering into telemedicine arrangements that have certain suspect characteristics. for more than $1.2

Telemedicine 52

Telemedicine Fraud Compliance 52

Bill of Health

FEBRUARY 21, 2024

While Alabama may seem like an extreme example, the (un)intended consequences of the case, which originally sought to redress mistakes made in providing fertility care, can inform the ongoing debate about the role of law in assisted reproduction. Fertility Fraud TRIP Bills “Fertility fraud” bills are an illustrative example of TRIP laws.

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Fraud Licensing Medicaid Medicaid 257

HIPAA Journal

MARCH 7, 2023

The cyberattack in question occurred on December 1, 2022. Hackers gained access to the medical groups’ IT systems, preventing access to certain servers on December 2, 2022. Affected individuals were notified about the data breach in February 2023 and were offered complimentary credit monitoring services.

Fraud 106

Fraud Health Insurance HIPAA Doctors 106

Healthcare It News

DECEMBER 5, 2022

" Community also said that the investigation has not found evidence that misuse or fraud has occurred as a result of the breach, and it "cannot say with certainty what information was involved." million of its patients know about its third-party data breach. In August, Novant Health announced it had let 1.3

Fraud 263

Fraud HIPAA Compliance Hospitals 263

Healthcare Law Today

DECEMBER 22, 2022

In a recent episode of the Blue Cirrus Radio Show , Chair of Foley & Lardner’s national Telemedicine and Digital Health Industry Team, Nathaniel Lacktman, spoke with hosts Joe Coletti and Michelle Hager from Blue Cirrus Consulting about telehealth advocacy, the U.S. Some of the brightest digital health companies ask these questions.

Telemedicine 119

Telemedicine Fraud Doctors COVID-19 119

YouCompli

JANUARY 4, 2022

As a compliance officer, it’s time to go back through your compliance documentation over the past two years and think about how you’re going to unwind from these changes,” she said. Find out more about YouCompli. . Subscribe to get the latest articles about healthcare regulatory changes.

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Compliance Compliance Officers HIPAA Fraud 40

HIPAA Journal

JANUARY 23, 2024

Holmes, along with former company president Ramesh Balwani, were charged with criminal fraud for making false claims about the company’s technology and misleading investors. Balwani was convicted of conspiracy to commit wire fraud against Theranos’s patients and investors and was sentenced to 12 years and 11 months in prison.

Fraud 70

Fraud FDA Medicaid Medicaid 70

Healthicity

JANUARY 10, 2023

Over the last several years, the medical research community has seen many high-profile announcements about researchers resigning or being fired over not properly disclosing financial interests, especially those related to foreign influence (see [link] ). Reporting of Monetary Donations in Research.

Fraud 52

Fraud Medicare Medicare Compliance 52

HIPAA Journal

MARCH 30, 2023

On November 14, 2022, a hacker gained access to Rise’s network and accessed files containing sensitive patient data, including names, email addresses, phone numbers, provider information, diagnoses, expected delivery dates, and health insurance information.

Health Insurance 91

Health Insurance Fraud HIPAA 91

HIPAA Journal

MAY 1, 2023

Unauthorized system activity was detected on or around December 10, 2022, and the forensic investigation determined its systems had been accessed by unauthorized individuals between December 5, 2022, and December 10, 2022. Affected individuals were notified about the breach by mail on or around April 7, 2023.

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Fraud HIPAA 67

HIPAA Journal

MARCH 21, 2023

It has only been a few days since the Miami-based healthcare administration and managed care solutions provider, Independent Living Systems (ILS), issued notification letters about a data breach affecting 4,226,508 individuals but a lawsuit has already been filed in response to the data breach.

Fraud 98

Fraud Health Insurance Medicaid Medicaid 98

HIPAA Journal

JULY 25, 2023

Vanderbilt University Medical Center (VUMC) in Nashville, TN, has confirmed that the medical records of transgender patients have been provided to Tennessee Attorney General, Jonathan Skrmetti, in connection with an investigation of medical billing fraud. VUMC was obligated to comply and did so,” said VUMC spokesperson, John Howser.

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Fraud HIPAA Medical Billing Doctors 70

HIPAA Journal

OCTOBER 18, 2022

According to the breach report sent to the HHS on October 3, 2022, unauthorized individuals gained access to its email environment which contained patient information. This post will be updated when further information about the breach becomes available. Eventus WholeHealth Announces Email Account Breach.

Fraud 93

Fraud HIPAA Health Insurance Governance 93

HIPAA Journal

MARCH 21, 2023

The lawsuits are currently pending in the District Courts in Arkansas and were filed in response to two data breaches that were discovered in 2022. 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.

Hospitals 68

Hospitals Fraud Health Insurance HIPAA 68

Kaiser Health News

APRIL 16, 2024

Instead, call center agents were encouraged to be “vague” about the money mentioned in the ads, which was actually the subsidies paid by the government to insurers toward the ACA plans. “Unfortunately, there’s so much fraud that legitimate agents who are really trying to help people are also being pushed out.”

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ACA Health Insurance Governance Medical Billing 138

HIPAA Journal

JUNE 14, 2022

Kaiser Permanente said it was alerted to a security incident involving its email system on April 5, 2022. To date, no reports have been received about any actual or attempted misuse of individuals’ ePHI. Notifications were sent to affected individuals on June 3, 2022, who have been advised to be vigilant for potential fraud.

Fraud 112

Fraud HIPAA 112

Hall Render

DECEMBER 6, 2022

Specific detail about the exception is outlined below. The $5,000 limit is adjusted annually for inflation and will increase from the 2022 limit of $5,270 to $5,702 beginning January 1, 2023 for the 2023 calendar year. If you have any questions or would like any additional information about this topic, please contact: Gregg M.

COVID-19 40

COVID-19 Hospitals Overpayments Overpayment 40

Hall Render

JULY 29, 2022

429 hospitals with 5 stars from CMS: 2022. 192 hospitals with 1 star from CMS: 2022. 7 Best Hospitals in Arizona for Cancer 2022-2023. Top Hospitals in Florida for Cancer 2022-2023. News & World Report’s 2022-2023 Best Hospitals List. Community Hospital of Anaconda seeks public input about health care needs.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

JULY 1, 2022

Balderas Joins $230M Settlement Against Pharmaceutical Company Over Allegations Of Medicaid Fraud. Why fixing Colorado’s health care system is becoming more about housing and less about insurance. billion fraud. Q&A: Why this health system asks about equity in burnout surveys. billion fraud.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nurses Hospitals 40

HIPAA Journal

AUGUST 2, 2023

Notification letters will be sent to the affected individuals in the coming weeks and credit monitoring, fraud consultation, and identity theft restoration services will be offered. Karakurt is a relatively new threat group that has no qualms about attacking healthcare organizations.

Licensing 71

Licensing Electronic Medical Records Ransomware Health Insurance 71

Hall Render

AUGUST 12, 2022

What to know about vaccines, spread. Doctor loses at least four homes, sentenced to federal prison for healthcare fraud amounting to $38M. million in restitution in complex telemedicine fraud scheme. Report Raises Concern About Mental Health Among Children In Hawaii. QC dermatologist to pay $1.66M for fraud claim.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40