Health Care Law Brief

FEBRUARY 8, 2024

billion to fund Medicaid, $4.8 In addition to the 1115 Waiver, which funds the Medicaid Hospital Global Budget for financially distressed safety net hospitals transitioning from volume-based reimbursement models to value-based models, the HMH Bill would also establish the Healthcare Safety Net Transformation Program (“HSNT Program”).

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

HIPAA Journal

SEPTEMBER 9, 2022

That process concluded on June 24, 2022. Those emails contained patient information such as names, dates of birth, Social Security numbers, medical information, health insurance information, driver’s license numbers, and state ID numbers. The Columbia, SC-based nonprofit Federally Qualified Health Center, Genesis Health Care Inc.,

Licensing 102

Licensing Health Insurance Fraud HIPAA 102

Provider Trust

JANUARY 18, 2023

In October 2022, the South Carolina Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old South Carolina woman named Alyssa Beth Steele for working as a registered nurse despite not having a license. Pursuant to federal regulations, the SCMFCU is authorized to investigate and prosecute any acts of Medicaid provider fraud.

Nurses 52

Nurses Licensing Fraud Medicaid 52

HIPAA Journal

OCTOBER 7, 2022

On August 5, 2022, Anthem discovered that an unauthorized individual had gained access to a database and downloaded files containing plan members’ protected health information, including names, addresses, dates of birth, phone numbers, email addresses, Medicare ID numbers, and Medicaid ID numbers.

HIPAA 101

HIPAA Health Insurance Medicaid Medicaid 101

Hall Render

MAY 17, 2022

All acute care hospitals licensed under RCW 70.41 and all psychiatric hospitals licensed under RCW 71.12 The expanded requirements of the charity care law become effective July 1, 2022, but hospitals are required to take action prior to July 1, 2022, so that they can be in compliance as of the effective date.

Hospitals 40

Hospitals Licensing Medicaid Medicaid 40

HIPAA Journal

JULY 4, 2023

ARx Patient Solutions Reports Email Account Breach from 2022 The Kansas-based healthcare provider, ARx Patient Solutions, has recently notified the Maine Attorney General about a security breach that has affected 41,116 individuals, including individuals who used the ARx Patient Solutions Pharmacy.

Medicaid 74

Medicaid Medicaid Health Insurance Licensing 74

HIPAA Journal

MAY 19, 2022

The settlement has received preliminary approval from the court and a final hearing for the settlement has been scheduled for September 12, 2022. The deadline for submitting a claim is August 8, 2022, and the deadline for objecting to the settlement or requesting to be excluded from the settlement is August 22, 2022.

Licensing 112

Licensing HIPAA Health Insurance Medicaid 112

HIPAA Journal

APRIL 13, 2022

The theft occurred on or around January 27, 2022, and was discovered by RHD on February 16, 2022. The data was uploaded to the leak site on March 17, 2022. Wellstar Health learned about the security breach on February 7, 2022, with the forensic investigation confirming that the breach was limited to two email accounts.

Ransomware 116

Ransomware Licensing HIPAA Health Insurance 116

HIPAA Journal

MAY 25, 2022

The break-in was discovered on March 4, 2022, with the subsequent investigation confirming on April 22, 2022, that six boxes of paper documents had been stolen from the facility, which included files relating to patients served by SAC Health in 1997 and between 2006 and 2020. Lifespan Services Suffers Ransomware Attack.

Ransomware 127

Ransomware Fraud HIPAA Licensing 127

Healthcare IT Today

NOVEMBER 2, 2023

Since January 2022 , the Centers for Medicare & Medicaid Services (CMS) and other federal agencies have had their eyes on California with the launch of the nation’s largest-ever program to transform the healthcare system for vulnerable communities.

Medicaid 96

Medicaid Medicaid Licensing Medicare 96

HIPAA Journal

MARCH 6, 2023

The types of information exposed varied from individual to individual and may have included names, addresses, medical information, health insurance information, Medicaid identification numbers, driver’s licenses, account and routing numbers, and Social Security numbers.

Electronic Medical Records 77

Electronic Medical Records HIPAA Licensing Nurses 77

HIPAA Journal

FEBRUARY 16, 2022

The system contained patients’ names, birth dates, insurance card numbers, driver’s license numbers, and copies of patients’ insurance cards and driver’s licenses. The security breach was detected on or around January 9, 2022, when certain systems were rendered inaccessible.

Ransomware 123

Ransomware Hospitals Licensing HIPAA 123

HIPAA Journal

MARCH 10, 2022

The breach was detected on January 20, 2022, and immediate action was taken to secure its systems, and an independent computer forensics company was engaged to conduct a forensic investigation to determine the nature and scope of the breach. Notification letters were sent on January 28, 2022. DataHealth. Dr. Douglas C.

Ransomware 126

Ransomware Licensing Health Insurance Hospitals 126

NY Health Law

FEBRUARY 13, 2024

On January 9, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finally approved New York State’s 1115 waiver amendment to establish the New York Health Equity Reform (NYHER) Program. Workforce: Workforce investments with a goal of equitable and sustainable access to care in Medicaid.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

Bill of Health

FEBRUARY 23, 2023

Over 1,500 state anti-public health bills – introduced to thwart emergency powers, dismiss emergency declarations, prohibit masks, eliminate vaccine mandates, and restrict social distancing – were introduced between January 1, 2021 – May 20, 2022. Yet, only 185 of these bills actually passed. The bill was never fully enforced.

COVID-19 176

COVID-19 Public Health COVID-19 Vaccine Governance 176

Hall Render

SEPTEMBER 16, 2022

Full 4th Circuit to tackle Medicaid fraud standard under False Claims Act. Louis County Couple Sentenced for Defrauding Medicaid. Study finds Montana underpays Medicaid providers by tens of millions. Health care industry in Nebraska ‘thankful’ after licensing backlog averted. Amazon wants to add payer strategy muscle.

US Department of Health and Human Services 40

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

HIPAA Journal

MARCH 25, 2022

Notification letters were sent to affected individuals on February 22, 2022. The files contained first and last names, Social Security numbers, drivers’ license information, dates of birth, health insurance information, medical treatment information, and financial account information.

Health Insurance 110

Health Insurance Licensing Ransomware Fraud 110

Healthcare Law Blog

MARCH 20, 2023

For example, an overwhelming sixty percent (60%) of recently-surveyed licensed psychologists reported having no openings for new patients, with many having a volume of patient requests that outweighs their ability to even maintain a waitlist. [1] 6] Increase provider reimbursement strategies. Redefining the workforce.

Medicaid 52

Medicaid Medicaid Licensing ACA 52

HIPAA Journal

OCTOBER 17, 2022

RAA said the review and cataloging of the affected files took until July 2022 to complete, then it took until September 2022 to verify up-to-date contact information. RAA explained in a substitute breach notice on its website that the delay in issuing notifications was due to the time taken to investigate the incident.

Licensing 57

Licensing HIPAA Health Insurance Medicaid 57

HIPAA Journal

NOVEMBER 15, 2022

Anesthesiology firms started reporting data breaches to the Department of Health and Human Services’ Office for Civil Rights in September 2022, with the notification letters to patients indicating there had been a data breach at their anesthesia management services organization. The notification letters failed to name that company.

HIPAA 84

HIPAA Fraud Licensing Health Insurance 84

HIPAA Journal

MAY 16, 2022

According to the April 29, 2022, notification on the healthcare provider’s website, “We recently discovered unauthorized access to our network occurred between May 31, 2021, and June 1, 2021.” On March 15, 2022, RiverKids discovered an unauthorized individual had gained access to the email account of an employee.

Health Insurance 108

Health Insurance Ransomware HIPAA Licensing 108

Healthcare IT News - Telehealth

JANUARY 23, 2023

With Congress providing telehealth waivers as part of its omnibus spending bill at the close of 2022, delaying the "telehealth cliff" for two years, HIMSS says it's now ready to make the case for permanent reimbursement of virtual care. Creating standards synergy for 'Interoperability 3.0'

Medicare 158

Medicare Medicare Governance Medicaid 158

HIPAA Journal

JULY 21, 2022

Final approval of the settlement was received on June 13, 2022. Claims must be submitted by October 6, 2022. A lawsuit – Jones v. The Methodist Hospitals, Inc. – Claims for reimbursement of documented economic losses of up to $3,000 can be submitted and/or claims of up to $300 can be submitted for reimbursement of lost time.

Hospitals 69

Hospitals Licensing HIPAA Medicaid 69

Verisys

JUNE 13, 2023

Centers for Medicare & Medicaid Services : The US Department of Health and Human Services has issued a final rule update concerning guidelines for COVID-19 vaccination requirements for Long-Term Care Facilities (LTC) and Intermediate Care for Individuals with Intellectual Disabilities (ICFs-IID).

COVID-19 Vaccine 52

COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

HIPAA Journal

MARCH 14, 2022

A subset of patients also had their Social Security numbers, driver’s license numbers, and/or financial account information exposed. Labette Health said on March 11, 2022, written notifications were sent to affected individuals out of an abundance of caution.

Electronic Medical Records 131

Electronic Medical Records Health Insurance HIPAA Licensing 131

Hall Render

APRIL 22, 2022

21 top management risks in healthcare for 2022. $1B Supreme Court tosses Medicaid work requirement cases. Report: Black Women’s Health in AR in “Critical State” Arkansas Children’s Names Jefferson, Rumpel as 2022 Marion B. San Francisco’s Laguna Honda Hospital Loses Medicaid, Medicare Funding.

COVID-19 40

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

C&M Health Law

SEPTEMBER 11, 2023

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. HPRD from licensed practical nurses, and 2.38 On September 1, 2023, the U.S. HPRD consisted of 0.75

Nursing Homes 98

Nursing Homes Nurses Medicaid Medicaid 98

HIPAA Journal

AUGUST 12, 2022

WNJ said Priority Health was notified about the breach n June 6, 2022 – Almost 8 months after the security incident was detected. The email account breaches were detected on June 7, 2022, when suspicious email account activity was detected. PHI Exposed in Attempted BEC Attack on Living Innovations.

Licensing 65

Licensing Health Insurance HIPAA Medicaid 65

Healthcare Law Today

DECEMBER 7, 2022

On Friday, December 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued an FAQ regarding the Good Faith Estimate (GFE) and Convening Provider/Facility requirements in the Federal No Surprises Act. a physician or other health care provider acting in the scope of a license) and health care facilities (i.e.,

Licensing 52

Licensing Telemedicine Medicaid Medicaid 52

HIPAA Journal

APRIL 8, 2022

The email accounts were compromised between January 10 and 11, 2022. That review was completed on March 16, 2022. That process was completed on January 27, 2022, the affected clients were notified, and authorization was received to send notification letters.

Medical Billing 115

Medical Billing Licensing Health Insurance Medicaid 115

Healthcare IT Today

AUGUST 17, 2022

They reported the breach to have occurred January 20, 2022. Looks like the review of the breach happened from June 13, 2022 and August 3, 2022 which seems like a long time to wait to notify patients of a potential breach of their information. Resolute Health Hospital. The Hospitals of Providence Memorial Campus.

Licensing 82

Licensing Hospitals Health Insurance Medicaid 82

HIPAA Journal

SEPTEMBER 14, 2022

The attack was detected on July 3, 2022, and immediate action was taken to contain the attack and prevent further unauthorized access to its network. TennCare, Tennessee’s state Medicaid program, has recently notified approximately 1,700 patients about the accidental exposure of some of their protected health information.

Ransomware 88

Ransomware Licensing HIPAA Health Insurance 88

HIPAA Journal

OCTOBER 10, 2022

The error was detected on August 8, 2022, and the file was removed from the meeting minutes and replaced with a file that did not provide access to PHI. DHS said the breach affected 12,358 Wisconsin Medicaid members, who have now been notified and offered complimentary 12-month memberships to a credit monitoring service.

Medicaid 57

Medicaid Medicaid Governance Fraud 57

Med-Net Compliance

NOVEMBER 8, 2022

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections). Train appropriate staff to accurately document and report direct care hours worked.

Nursing Homes 59

Nursing Homes Nurses US Department of Health and Human Services Licensing 59

MRO Compliance

JUNE 1, 2022

This review is part of the Star rating system, which according to RAC Monitor was developed by the Centers for Medicare & Medicaid Services (CMS) to rate health plan performance for Medicare Advantage programs and Medicare risk adjustment initiatives. HEDIS audits are important for Medicare and Medicaid health plans.

Medicare 130

Medicare Medicare Compliance Medicaid 130

Hall Render

JUNE 10, 2022

CMS updates Medicaid eligibility standards. California nurses plan for potential 2nd strike of 2022. New Hampshire hospital leaders’ licenses suspended amid probe of missing fentanyl. Dansville doctor agrees to pay $600K for falsely billing Medicare, Medicaid. FTC looks to restrict use of noncompetes. NEW JERSEY.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

AIHC

MARCH 12, 2024

The government commission for this report from Gladstone AI was made in 2022. We can argue that there needs to be some type of controls to guide artificial intelligence, but hopefully the government will dive deeper, and quickly seek additional recommendations.

Ransomware 59

Ransomware Governance Compliance HIPAA 59