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

Healthcare IT Today

APRIL 25, 2024

On the morning of February 21, 2024, a ransom group, BlackCat, directed a cyberattack at Change Healthcare, owned by healthcare conglomerate UnitedHealth. As of mid-March, 117 other healthcare organizations have experienced a cybersecurity breach in 2024, potentially affecting around 13 million patients, according to the HHS.

Ransomware 103

Ransomware Compliance Fraud Governance 103

AIHC

MAY 17, 2023

This article addresses various forms of fraud and how criminals’ prey on compromised citizens. There are many factors which can influence our health, and in turn, there are just as many schemes which are actually considered health care fraud. SNAP Fraud Food assistance is generally referred to as SNAP or food stamps.

Health Outcomes 52

Health Outcomes Fraud Compliance Governance 52

HIPAA Journal

FEBRUARY 8, 2024

Azura Vascular Care said individuals who had sensitive information exposed such as Social Security numbers have been offered complimentary identity protection, credit monitoring, and fraud resolution services.

Ransomware 79

Ransomware Electronic Medical Records Licensing Health Insurance 79

Hall Render

NOVEMBER 10, 2023

Beginning in 2024, OIG plans to publish industry segment-specific CPGs (“ICPGs”) for a variety of providers, suppliers, and other participants in health care industry subsectors or ancillary industry sectors relating to the federal health care programs. The GCPG is the first of many CPGs expected to be released by OIG in the coming years.

Compliance 40

Compliance Compliance Officers Fraud Governance 40

Health Law Advisor

JULY 14, 2023

These include an initiative for the Department of Defense (DOD) to publish an updated cyber strategy by first quarter of fiscal year 2024 (1Q FY24) (i.e., October 1 – December 31, 2023); a Department of Justice (DOJ) initiative to work with interagency partners to propose legislation to disrupt and deter cybercrime by 4Q FY23 (i.e.,

Regulatory Compliance 52

Regulatory Compliance Fraud Compliance Governance 52

C&M Health Law

DECEMBER 18, 2023

Starting in 2024, OIG will publish industry segment-specific compliance program guidance (ICPGs) for different types of providers, suppliers, and other participants in health care industry subsectors. Policies and procedures should be updated regularly and easily accessible to relevant individuals. (2)

Compliance 52

Compliance Compliance Officers Governance Overpayments 52

Healthcare Law Blog

MAY 31, 2022

As the metaverse market continues to grow, with some estimates potentially approaching $800 billion in 2024 (or a $300 billion increase from 2020 estimates), technology leaders in various industries, including healthcare, have begun to expand their presence in this new platform. [1] Healthcare Laws.

FDA 90

FDA HIPAA Medicare Medicare 90

AIHC

APRIL 10, 2024

Does your organization have materials for patient education and risks of identity theft and medical fraud? Be sure to use web sites that give you information that is accurate such as Centers for Medicare and Medicaid Services , Health and Human Services, Office of Civil Rights and U S Government Agencies.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

HIPAA Journal

SEPTEMBER 5, 2023

The EU Digital Services Act is due to come into force for most “intermediary” service providers that offer a service to EU citizens from February 17, 2024. The Act will impact a number of US-based healthcare IT companies and may influence future federal and state legislation in the United States.

Compliance 55

Compliance HIPAA Governance Fraud 55

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ ranks second nationwide in hospital patient safety, with 7 Central Va.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

AIHC

APRIL 10, 2024

Does your organization have materials for patient education and risks of identity theft and medical fraud? Be sure to use web sites that give you information that is accurate such as Centers for Medicare and Medicaid Services , Health and Human Services, Office of Civil Rights and U S Government Agencies.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

Hall Render

NOVEMBER 15, 2023

The Arrangement contains safeguards that lower the risk of fraud and abuse under the federal AKS. To maintain compliance, providers must ensure that internal operational policies support the billing decisions that adhere to both government and commercial payers’ requirements.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Healthcare Law Blog

MAY 16, 2022

Except as noted below, the requirements of the Final Rule are effective January 1, 2024. Enrollee Participation in Dual Eligible Special Needs Plan (“D-SNP”) Governance (§ 422.107). With a few exceptions, the Final Rule is a wholesale codification of the proposed rule. 423.100 [3].

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

FEBRUARY 23, 2024

On February 22, 2024, the Department of Justice (“DOJ”) announced that it recovered over $2.68 Whistleblowers continue to be one of the federal government’s greatest assets in FCA cases, with qui tam actions accounting for over $2.3 Health Care Fraud Actions Medicare Advantage. billion of the $2.68

Compliance 71

Compliance Governance Medicare Medicare 71

Hall Render

JULY 28, 2023

million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Provider Trust

FEBRUARY 3, 2023

The government and private whistleblowers have increasingly targeted PE firms’ portfolio companies and the firms themselves. Government Oversight On December 29, 2022, President Biden signed the Consolidated Appropriations Act into law. Are you buying a distressed asset with a lack of focus on compliance and regulations?

Compliance 52

Compliance Fraud Nurses Telemedicine 52

Healthcare Law Blog

MARCH 3, 2023

federal government. Among the Act’s many provisions are certain measures that extend the telehealth flexibilities announced in the early days of the PHE through the end of 2024. On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (the “Act”), [1] a $1.7 including the home of an individual. [2]

Fraud 52

Fraud Nurses Telemedicine COVID-19 52

AIHC

FEBRUARY 16, 2024

The American Institute of Healthcare Compliance (AIHC TM ) has released a 2024 Corporate Compliance Officer training program which is not only based on the new GCPC, but goes beyond to address quality, safety, HIPAA and other high-risk areas. The government eventually found out and stopped the financial incentives. The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

The American Institute of Healthcare Compliance (AIHC TM ) has released a 2024 Corporate Compliance Officer training program which is not only based on the new GCPC, but goes beyond to address quality, safety, HIPAA and other high-risk areas. The government eventually found out and stopped the financial incentives. The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Hall Render

JANUARY 19, 2024

Bipartisan Ky. hospital company Kansas City Orthopaedic Institute appoints new CEO Kansas City University’s new research center aims to answer: ‘How do we keep people well?’

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

FEBRUARY 2, 2024

in federal funds for hospitals State of the State 2024: Arkansas health care faces challenges Study ranks Arkansas at the absolute bottom for dental health A mosaic of medical staffing solutions: Groups work to increase health care workforce in Northwest Arkansas CHI St. ‘We 5 highest paid anesthesiologists in Washington, DC D.C.’s

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

DECEMBER 22, 2023

fraud scheme UConn Health is in financial trouble. Yale New Haven sale key to Prospect hospitals’ survival, CEO says YNHH sale ‘paramount’ to CT Prospect hospitals’ survival, CEO says Connecticut hospital cut ED visits by nearly 50% Hartford HealthCare unveils new ‘health desk’ model Connecticut physician sentenced for $2.6M

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

MARCH 3, 2023

Clair Health partners with Duquesne University College of Osteopathic Medicine UPMC sees lower operating income in 2022 as economic headwinds persist UPMC settles lawsuit with federal government for $8.5

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

OCTOBER 13, 2023

Vincent Partners With Park Plaza Mall on Community Health Programs Former Arkansas Medical Board Chair Brian Hyatt Arrested for Medicaid Fraud New Provider in Arkansas Focuses on No-Rush Health Care Walker Foundation Pledges $1M to UAMS Radiation Oncology Center Five nonprofits to split $5.9 Luke’s receives $1.5

Nurses 40

Nurses Hospitals Nursing Homes Doctors 40

Hall Render

AUGUST 4, 2023

10 Providers prepare for new vaccine threats as mandate officially sunsets Senate committee passes HHS appropriations bill for FY 2024 Stark law changes ramp up in 2023 The gap between strong hospitals and struggling systems is growing This trend could reduce the number of ASCs UnitedHealthcare Invests $11.1M To Address SDOH Needs U.S.

COVID-19 40

COVID-19 Hospitals Nursing Homes Nurses 40

Hall Render

NOVEMBER 27, 2023

11 Plan To Slash $1.5B face growing challenges to stay open KENTUCKY BehaVR merges with New York City-based Fern Health For years, a powerful Louisville hospital sued people for unpaid bills. renovation St. renovation St. cash Tenet’s $2.4B

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Hall Render

OCTOBER 27, 2023

Million Health Care Fraud Conspiracy in Idaho Orthopedic activity in the 5 most underserved states St. Ransomware attacks against hospitals put patients’ lives at risk, researchers say States, FTC continue to target noncompetes: 3 updates The best hospital in each state, per Newsweek What to know about Stark law’s $9.2M

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Hall Render

MARCH 31, 2023

County-owned buildings facing potential earthquake risk Gilead drops option to buy cancer therapeutics company Health and Life Organization Inc. buys industrial property in Rancho Cordova for $5.12 in Financing for Medical Office Building in Utica, New York Jacobi hospital saw 20% of its nurses quit in 2022.

US Department of Health and Human Services 40

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

Hall Render

APRIL 12, 2024

in billing fraud Arizona system names new CEO Banner Health CEO Peter Fine to retire after 24 years, handing the reins to health system president Four UArizona bioscience startups selected for Flinn Foundation program Gov. s health, hospital chief says Raising Ky.’s

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Healthcare IT Today

JANUARY 17, 2024

As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. 2024 will likely see continued hype regarding A.I. With the clinician shortage expected to continue – and possibly even worsen – in 2024, automation is key from the start of the clinician’s staffing journey (i.e.

Governance 109

Governance Nurses Compliance Public Health 109

Hall Render

JANUARY 26, 2024

medical facilities named among best hospitals in America for 2024 Some hospitals in major Mass. Children’s National Hospital taps Clearway to deliver $2.8M New Ranking UMMS to get $100M in state funding for new Eastern Shore hospital University of Maryland Shore Regional Health Planning $539.5M

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

NOVEMBER 17, 2023

Jill Biden will lead new initiative to boost federal government research into women’s health Joint Commission says acute, critical access hospitals must join safety network Lawsuit claims UnitedHealth AI wrongfully denies elderly extended care Most Rural U.S. Compensation is key Is spine surgery expansion next for ASCs?

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

APRIL 26, 2024

lays off 1,000 workers New York ASC sued following July data breach New York governor reaches deal to keep SUNY Downstate open See who tops the 2024 Independent Living Communities List New York health system names network VP of revenue cycle SUNY Downstate gets $300M in New York 2025 budget Changing demographics in nursing homes across N.Y.

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

DECEMBER 8, 2023

Francis Kansas hospital not rushing replacement for CFO fired for hiding fraud conviction KENTUCKY $6.5M operating loss in fiscal 2024’s opening quarter Trinity Health opens $8.7M NATIONAL 8.5M Records Impacted By Welltok Data Breach Stemming From MOVEit Hack 60% of employed physicians required to sign noncompetes 6.9 NATIONAL 8.5M

US Department of Health and Human Services 40

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

New Jersey Healthcare Blog

JULY 22, 2022

Effective May 2, 2022 and expires November 21, 2024. 907(b), the Department of Human Services, Division of Mental Health and Addiction Services readopted rules that govern the provision of mental health services at inpatient psychiatric hospital units known as short-term care facilities (STCFs). See N.J.A.C. 13:48-4.1, See N.J.A.C.

COVID-19 Vaccine 40

COVID-19 Vaccine Licensing COVID-19 Public Health 40

Hall Render

APRIL 14, 2023

But hospitals say they can’t afford to pay California hospital nurses to receive raises of up to 30% California pharmacist pleads guilty to multi-year Medicare fraud scheme Carmichael-based Eskaton pays $5.5 Where does it leave medication abortion in Pa.,

Nursing Homes 40

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