Bill of Health

SEPTEMBER 2, 2022

Following the findings of “The Age of Fraud,” I’d hypothesize that this way in which we think of scams both feeds and is fed by the apparent misconception that they are a relatively bounded problem for older adults. Social views about fraud and scams would, no doubt, be difficult to change quickly.

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Fraud 299

HIPAA Journal

APRIL 16, 2025

A settlement has been agreed to resolve a class action lawsuit against Retina Group of Washington over a March 2023 data breach that involved unauthorized access to the protected health information of 455,935 individuals. Under the terms of the settlement, a $3.6

Ransomware 69

Ransomware Fraud Licensing HIPAA 69

Healthcare IT Today

JANUARY 2, 2023

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. We are going to see an increased demand for privacy-preserving technology in 2023, and therefore more investment in the space. during 2023. Check out our community’s healthcare Security and Risk predictions.

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Ransomware Fraud Compliance Telemedicine 108

HIPAA Journal

APRIL 23, 2024

Kisco Senior Living experienced its attack in June 2023, and Island Ambulatory Surgery Center suffered an attack in July. According to the notification letters mailed to the affected individuals in April 2024, a cyberattack was detected on June 6, 2023, when its network was disrupted.

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Ransomware Fraud Licensing HIPAA 110

Bill of Health

NOVEMBER 17, 2024

by Rebekah Ninan A recent lawsuit in the Southern District of New York has alleged that the health insurance company Anthem Blue and Cross Blue Shield violated state laws and committed fraud by maintaining “ghost networks” of mental health providers.

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Licensing COVID-19 Fraud Health Care Access 124

Healthcare IT Today

JANUARY 3, 2023

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. The deployment of automation and AI in healthcare organizations will expand in 2023 to handle the growing demand for digital healthcare services, especially in times of shortages of medical staff. Reducing fraud?

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Governance Fraud Medical Personnel COVID-19 100

AIHC

APRIL 22, 2025

37293733) is the federal governments primary tool for combating fraud against public programs. Healthcare fraud accounts for a significant portion of FCA activity. In 2023 alone, the DOJ recovered over $1.8 The False Claims Act (31 U.S.C. Importantly, the FCA also prohibits retaliation.

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Compliance HIPAA Compliance Officers Fraud 89

Provider Trust

APRIL 30, 2024

This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). MFCUs reported 1,143 total convictions in FY 2023—a marked decrease from 1,327 convictions in FY 2022.

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Fraud Medicaid Medicaid Licensing 52

Fierce Healthcare

APRIL 22, 2023

COVID fraud takedowns: Feds charge 18 people, including doctors, with raking in nearly $500B from scams hlandi Sat, 04/22/2023 - 20:51

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Fraud Doctors 81

Healthcare IT Today

MAY 6, 2023

Read more… Preventing Genetic Testing Fraud: 5 Actions for Health Plans. Medicare payments for genetic testing quadrupled from 2016 to 2019, which has unfortunately led to a rise in a rise in fraud, waste, and abuse. On the heels of ViVE and HIMSS, they also discuss whether in-person conferences are back.

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Fraud Doctors Medicare Medicare 88

HIT Consultant

JUNE 21, 2023

The success of the project has led the company to invest in further enhancing the new mobile solution to take payment at the point of delivery from October 2023. One of Apria’s priorities for the project was an easy installation, which is why they chose Pega’s low code, off-the-shelf solution to integrate into their existing system.

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Fraud Health Insurance Compliance 98

HIT Consultant

DECEMBER 18, 2024

In 2023, more than 133 million healthcare records were exposed or stolen due to data breaches. Identity theft, fraud, and long-term financial harm are just a few examples of the personal fallout patients may face following a data breach. million records.

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Ransomware Fraud Doctors HIPAA 105

Bill of Health

OCTOBER 30, 2023

By Bobby Stroup 2023 is the year of the emoji lawsuit. In another legal case, a “moon” emoji was found to be possible evidence of securities fraud. This year a “thumbs-up” emoji was found to be part of a legally binding contract. This legal evolution may seem a bit strange.

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Doctors Hospitals Fraud Health Insurance 290

Compliancy Group

FEBRUARY 16, 2024

This month, fraud in the medical industry has been making headlines fairly frequently. We also covered two Medicaid fraud schemes , one resulting in billions of dollars in billing for medical supplies that were never received. Each charge also comes with five years probation, while the fraud charge includes 18 months of house arrest.

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HealthIT Answers

MARCH 31, 2024

22 for civil fraud and false claims settlements and judgments recovered for taxpayers by the agency in fiscal 2023, or from Oct. The post Justice Department Sleeping at the Healthcare Fraud Wheel appeared first on Health IT Answers. By David R. Burda - Here are the DOJ stats released on Feb. 1, 2022, through Sept.

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Med-Net Compliance

SEPTEMBER 20, 2022

The defendant was also convicted for falsification of records designed to prevent detection of this fraud and aggravated identity theft for falsely corresponding with Medicare under the name of another physician. Million Healthcare Fraud Scheme appeared first on Med-Net. He is scheduled to be sentenced on Jan.

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Fraud US Department of Health and Human Services Medicare Medicare 59

Med-Net Compliance

OCTOBER 27, 2022

The psychologist was convicted of four counts of healthcare fraud. He is scheduled to be sentenced on April 18, 2023, and faces a maximum penalty of 10 years in prison on each count. The post Nursing Home Psychologist Convicted of Healthcare Fraud Scheme appeared first on Med-Net.

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

HIPAA Journal

OCTOBER 21, 2022

A pharmaceutical sales rep has pleaded guilty to conspiring to commit healthcare fraud and wrongfully disclosing and obtaining patients’ protected health information in an elaborate healthcare fraud scheme involving criminal HIPAA violations. Alario pleaded guilty to his role in the healthcare fraud scheme earlier this month.

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Fraud HIPAA FDA Health Insurance 60

The Health Law Firm Blog

JULY 17, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

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The Health Law Firm Blog

JUNE 26, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

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Fraud FDA Licensing Nurses 52

HIPAA Journal

APRIL 25, 2024

City of Hope National Medical Center identified suspicious activity within its network on October 13, 2023, and the forensic investigation confirmed there had been unauthorized access by a third party between September 19, 2023, and October 12, 2023.

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Fraud Health Insurance HIPAA Licensing 119

The Health Law Firm Blog

AUGUST 22, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

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Fraud FDA Licensing Nurses 52

The Health Law Firm Blog

AUGUST 8, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

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Fraud FDA Licensing Nurses 52

HIPAA Journal

FEBRUARY 22, 2023

On February 10, 2023, CentraState confirmed it had suffered a ransomware attack that disrupted its computer systems. On February 20, 2023, a lawsuit was filed in the Monmouth County Superior Court by attorney Benjamin Johns, which named Rita Sorrentino-Poggi of Manalapan as the plaintiff.

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Ransomware Fraud Health Insurance HIPAA 115

HIT Consultant

FEBRUARY 23, 2023

Because of the highly immutable data this type of healthcare data fabric or digital network provides, the instances of fraud and abuse could be significantly reduced. Let’s reinvent healthcare in 2023, not based on our current reality, but on a new way of thinking about interoperability , courageously embracing “possibility thinking.”

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COVID-19 Fraud Hospitals 96

Verisys

JANUARY 2, 2024

The post December 2023 Bad Actors Roundup appeared first on Verisys. Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Million Civil Settlement with Total Access Urgent Care Over False Claims Allegations Full story Former Co-Owners of New Jersey Marketing Company Sentenced to Prison in $8.8

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Fraud Licensing Doctors Medicare 52

AIHC

FEBRUARY 24, 2025

Part 2: When Criminal Behavior Infiltrates Your Audit Program Written by Carl J Byron , CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret) We Recommend Reading Part 1 Fraud Indicators and Red Flags When Audit Managers Knowingly Skew Audit Results as this article is Part 2, the rest of the story.

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Healthcare Law Today

DECEMBER 22, 2022

Department of Health and Human Services Office of Inspector General (HHS-OIG) Special Fraud Alert on telefraud, and the rise of asynchronous telehealth, among other topics. In July 2022, HHS-OIG published a Special Fraud Alert about arrangements with telemedicine companies to serve as an extra level of guidance to the industry at large.

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Telemedicine Fraud Doctors COVID-19 119

HIPAA Journal

MARCH 1, 2023

No evidence of misuse of plan member data was identified at the time of issuing notification letters; however, as a precaution against identity theft and fraud, complimentary credit monitoring and identity theft protection services were offered to affected individuals. Claims must be submitted no later than August 14, 2023.

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Fraud Ransomware Health Insurance HIPAA 113

AIHC

JUNE 14, 2024

Financial exploitation refers to 2 types of financial crimes committed against older adults: Financial abuse (committed by someone you know) Financial fraud (committed by a stranger) Both result in serious financial, physical, and emotional harm to older adults. As of August 2023, losses have already exceeded those in 2022 by 40%.

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Fraud Elder Abuse Governance Compliance 52

HIPAA Journal

JUNE 28, 2023

Individuals that have suffered identity theft, medical fraud, tax fraud, other forms of fraud, and other actual misuses of their personal information, can submit claims for documented, unreimbursed extraordinary losses that are reasonably traceable to the data breach of up to a maximum of $5,000.

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Hospitals Fraud Licensing HIPAA 101

HIPAA Journal

APRIL 17, 2025

The first unauthorized access occurred in February 2021 and continued until February 2023. The physical therapist used his KU Health credentials to access patient records, which included nude clinical before and after photographs, body measurements, and sensitive personally identifiable information.

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Fraud HIPAA Hospitals Health Insurance 48

Healthcare IT News - Telehealth

SEPTEMBER 25, 2023

By Bill Siwicki | September 27, 2023 News AI-enabled efficiencies can improve patient outcomes and reduce clinician burnout "By prioritizing healthy data management practices through the deployment of AI, IT leaders. By Mike Miliard | August 10, 2023 News Senator wants Google to answer for accuracy, ethics of generative AI tool Sen.

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Compliancy Group

FEBRUARY 12, 2024

Fraud in healthcare has run rampant in recent years, as evident by two incidents in which healthcare organizations billed insurance companies for things patients never received. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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Fraud Medicare Medicare US Department of Health and Human Services 52

HIPAA Journal

JULY 4, 2024

SkinCure Oncology has notified 13,434 patients about an email attack that occurred in June 2023, and the Wisconsin Department of Health Services has announced a breach of the personal information of 19,150 Medicaid recipients. SkinCure Oncology believes files in those email accounts were viewed and potentially obtained in the attack.

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Medicaid Medicaid Fraud Licensing 118

Provider Trust

MARCH 21, 2023

Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs. As Medicare Advantage continues to grow, the risk of provider-level fraud will also increase.

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Fraud Medicare Medicare US Department of Health and Human Services 52

American Medical Compliance

MAY 22, 2023

million to settle allegations that it paid kickbacks to healthcare providers committing fraud violations. US Efforts to Crack Down on Fraud Violations Kickbacks are illegal under the False Claims Act because they can lead to overuse or misuse of medical products, harming patients and increasing healthcare costs. DePuy Synthes, Inc.

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Fraud Compliance Governance Doctors 52