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.

Fraud 52

Fraud Compliance Governance Compliance Officers 52

Verisys

MARCH 6, 2025

Health Insurance Portability and Accountability Act (HIPAA) Ensuring patient privacy by constantly monitoring data handling practices. Department of Health and Human Services. 2025 Healthcare Compliance Outlook. Summary of the HIPAA Privacy Rule. link] GDPR.eu. GDPR compliance checklist for US companies. link] IBM.

Compliance 52

Compliance US Department of Health and Human Services Regulatory Compliance Fraud 52

Healthcare IT Today

MARCH 26, 2025

These flexibilities were extended through December 31, 2025, but regulators have indicated that stricter rules may soon follow. The rise of telehealth has also led to increased scrutiny over prescription fraud and misuse. However, the lack of finalized guidelines leaves many telehealth companies in a regulatory gray area.

FDA 52

FDA Compliance Licensing Fraud 52

HIPAA Journal

MARCH 26, 2025

According to Sunflower Medical Group, the unauthorized access was identified and blocked on January 7, 2025. The hacker was able to access names, addresses, dates of birth, Social Security numbers, drivers license numbers, medical information, and health insurance information.

HIPAA 74

HIPAA Health Insurance Fraud Licensing 74

HIPAA Journal

APRIL 27, 2025

The inflation multiplier for 2025 was set by the Office of Management and Budget (OMB) as 1.02598. Another increase is due to be applied on January 15, 2025, but will likely be applied much later. HIPAA Violation Cases 2025 Comprehensive Neurology Comprehensive Neurology is a small New York neurology practice.

HIPAA 85

HIPAA Ransomware Hospitals Compliance 85

Bill of Health

APRIL 15, 2025

Artificial Intelligence AI Medical Assistants: Solving Medical Illiteracy to Reduce Health Care Costs Solving medical illiteracy and reducing health care costs are now possible because of Artificial Intelligence (AI). Published April 15, 2025 Authors Robert James Horne Saverio V.

Doctors 162

Doctors Governance Informed Consent Nurses 162

Kaiser Health News

JULY 24, 2024

Health insurance agents who fraudulently enroll consumers in Affordable Care Act health plans could be subject to criminal charges — and civil penalties of $10,000 to $200,000 — under legislation introduced Wednesday by Sen. “The bottom line is to stop fraud and help the consumer,” she said. Ron Wyden (D-Ore.),

ACA 134

ACA Health Insurance Patient Advocacy Fraud 134

Hall Render

DECEMBER 20, 2024

operating margin in Q3 Ahead of anticipated AZ nursing shortage, NAU’s College of Nursing graduates first cohort IV fluid shortage still impacting southern Arizona hospitals Whos Who in Arizona Healthcare for 2025 ARKANSAS Arkansas hospital hit with immediate jeopardy warning amid leadership turmoil CHI St.

Nursing Homes 40

Nursing Homes Nurses Hospitals Fraud 40

Hall Render

MAY 13, 2022

US faces deficit of 450,000 nurses by 2025. Oscar Health To Exit Colorado, Arkansas. Prism pays $650K to settle Medi-Cal fraud claims filed in San Diego. Synergy Health Partners Acquires SoCal Anesthesia Solutions, Inc. Newsom Proposes $125M Package To Expand Access To Reproductive Health Care In California.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

MAY 17, 2024

NATIONAL A deep dive into health system and health plan Q1 earnings Amazon building ‘modern pharmacy’ of the future: Medical Officer Breaking down the FTC noncompete ban, its impact on healthcare CISA, HHS warn healthcare of Black Basta ransomware attacks CMS extends Medicaid waivers to 2025 Could providers be liable in Change outage?

Nurses 40

Nurses Nursing Homes Hospitals Ransomware 40

Hall Render

MARCH 14, 2025

Regional Health named one of the best places to work in Kentucky UK HealthCare taps chief revenue officer LOUISIANA Louisiana opens $33M mental health hospital Louisiana physician, wife to pay $450K for neurostimulator fraud scheme Louisiana physician charged for $6.6M billion budget?

Nurses 40

Nurses Nursing Homes Medicaid Medicaid 40

Hall Render

DECEMBER 13, 2024

million loss, scraps 145 positions Health systems lock in acquisitions as year draws to a close Kaiser mental health workers’ strike leaves some patients struggling for care Kaiser Permanente Northern California rated highest for quality care MMCC Arranges $4.7M operating margin in Q3 JLL Arranges $13.4M

US Department of Health and Human Services 40

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

Hall Render

OCTOBER 25, 2024

Million in Tucson Steward Arizona behavioral hospital gets interim manager Former AZ Department of Health employee charged in Medicaid fraud indictment Arizona hospital performs kidney transplant using robotic technology ARKANSAS NIH Director “blown away” by health care efforts in Arkansas Arkansas Gov.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

AUGUST 9, 2024

million Mercy Iowa City Creditors Finally Getting Paid Northwest Iowa hospital, MercyOne in Primghar, to close next month Steindler Orthopedic opens clinic in Cedar Rapids Radiologist breaks ground on $250M health campus CSA opens new location as it seeks to retain workers, deliver services Iowa nursing homes owe taxpayers $10.7

US Department of Health and Human Services 40

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

Jane Sarashon

MARCH 6, 2025

I’ll review these studies in this post, and discuss several potential impacts we should keep in mind for peoples’ health and care in 2025 and beyond. You’ll read updates from Ipsos, West Health-Gallup, the University of Michigan, and finally the wonky (but very informative) Fed Beige Book from the Federal Reserve.

Medical Billing 105

Medical Billing Medicaid Medicaid Medicare 105

Hall Render

OCTOBER 11, 2024

California’s ban on toxic IV bags marks a shift for health care plastics California Enacts Health AI Bill and Protections for Neural Data California finalizes earthquake requirements for hospitals: 5 things to know California hospital taps chief physician enterprise officer California officials announce settlements with L.A.

US Department of Health and Human Services 40

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

Hall Render

JUNE 7, 2024

for behavioral and mental health services SOUTH CAROLINA Could SC’s health agency merger bill be revived, or will it have to wait until 2025? million bird flu shots to U.S. million bird flu shots to U.S. Mary’s temporarily closing psychiatric residential treatment facility by June 7 R.I. to get $40.7M

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Hospitals Nursing Homes 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

Hall Render

SEPTEMBER 20, 2024

Louis-based innovation nonprofit gets $14M federal grant to produce drug ingredients St. Louis-based cancer drug company launches clinical trial with European partner Big St. to settle oncology suit Montana VA hosting Host PACT Act claims clinics in Pablo, Browning Mt.

US Department of Health and Human Services 40

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

Hall Render

JUNE 28, 2024

Pritzker joins health officials, advocates to redouble HIV/AIDS prevention efforts Illinois Man Indicted on Several Fraud Charges Linked to COVID Pandemic INDIANA Franciscan Alliance sued by Indy physician for breach of contract, interfering in practice Hamilton County hospital surge comes amid closings elsewhere IU Health’s $2.3B

US Department of Health and Human Services 40

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

C&M Health Law

JANUARY 25, 2023

Section 4113 also requires HHS to conduct a study on program integrity related to telehealth services under Medicare Part B, including to review telehealth’s impact on future utilization of health care services (i.e., hospitalizations and emergency department visits) and to audit Medicare claims to assess potential fraud.

Medicaid 104

Medicaid Medicaid Medicare Medicare 104

Hall Render

DECEMBER 29, 2023

hospitals for maternity care UMass Memorial Medical Center to reinstate caregiver mask mandate Massachusetts health system sees over $17M FY ’23 profit Mass. system turns profit for 1st time in 4 years Mass.

Nursing Homes 40

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

Hall Render

MARCH 8, 2024

city pays hospital system $450K to settle over $1M in EMS claims 18 Wisconsin hospitals named to Newsweek’s World’s Best Hospitals in the U.S.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

AUGUST 16, 2024

Luke’s Behavioral Health ARKANSAS LaDonna Johnston Named CEO of Unity Health Update: Hearing to Approve Sale of Wadley Regional Medical Center Rescheduled How Arkansas Children’s is diversifying its workforce Sale hearing for Steward Health, Debtors’ Hospitals in Louisiana and Arkansas moved to Aug.

US Department of Health and Human Services 40

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

Hall Render

AUGUST 16, 2024

Luke’s Behavioral Health ARKANSAS LaDonna Johnston Named CEO of Unity Health Update: Hearing to Approve Sale of Wadley Regional Medical Center Rescheduled How Arkansas Children’s is diversifying its workforce Sale hearing for Steward Health, Debtors’ Hospitals in Louisiana and Arkansas moved to Aug.

US Department of Health and Human Services 40

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

Hall Render

JANUARY 17, 2025

OrthoIndy to merge with Evansville, Fort Wayne practices St. accepted bid Dr.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

AUGUST 23, 2024

hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., Healey silent on Steward hospital aid funds Here are the highest-paid hospital executives in Mass.

US Department of Health and Human Services 40

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

Hall Render

AUGUST 26, 2024

hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., Healey silent on Steward hospital aid funds Here are the highest-paid hospital executives in Mass.

US Department of Health and Human Services 40

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

Hall Render

AUGUST 11, 2023

Vincent doctors in Portland vote to form a union OHSU bomb threat is just the latest incident for workers in an increasingly violent profession Oregon AG Rosenblum joins Washington in opposing Idaho abortion travel ban Oregon health tech firm sued in federal court over data breach Oregon COVID hospitalizations drop Oregon Health Authority puts $1.5

US Department of Health and Human Services 40

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

Hall Render

JANUARY 3, 2025

in Medicare fraud settlement 10 behavioral health policy changes taking effect in 2025 An uncertain era for Stark law: 12 updates in 2024 CMS launches campaign to support nursing home staffing rule CMS taps 4 states for behavioral innovation model: 5 things to know Epic files to dismiss antitrust lawsuit Healthcare company to pay $15.2

Nursing Homes 40

Nursing Homes Fraud Nurses Hospitals 40

Hall Render

OCTOBER 4, 2024

in Lebanon site for new ‘medicine foundry’ Methodist Hospital to come tumbling down after IU Health opens new hospital Behavioral Health Commission wraps up two-year study with $50M ask $120M more needed for Indiana’s behavioral health infrastructure, report says Marathon Health expands network to 720 locations Elevance Health to make $11.9M

US Department of Health and Human Services 40

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

Hall Render

APRIL 26, 2024

health dept. Vincent discord reignites after hospital revokes doctors’ privileges New Mexicans to Know: Army veteran Nancy Parson brings passion for health care to Las Cruces Army veteran Nancy Parson brings passion for health care to Las Cruces Missed deadlines lead to $11.5M processed 1.5

Nursing Homes 40

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

Hall Render

NOVEMBER 1, 2024

fraud scheme Blue Cross Blue Shield, Phoenix Children’s at odds over contract renewal Former Tucson Heart Hospital to become El Rio Health clinic California company will manage troubled St. Vincent’s acquisition on Nov.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

JANUARY 10, 2025

million recovered for Kent County Memorial Hospital workers denied overtime Connecticut ASC postpones surgeries after car damages building Connecticut judge nixes appeal for new ASC Connecticut psychiatrist settles fraud allegations CT OHS fines Johnson Memorial Hospital $153.5K A new state-sponsored group will help.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

MARCH 1, 2024

in 2023 income Ransomware group leader told hackers to attack hospitals, FBI, HHS say The 23 health systems pushing Congress to act on virtual care Three examples of how AI is going to change medicine U.S. R1 RCM posts $3.3M

Nursing Homes 40

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

Hall Render

MAY 24, 2024

Chicago children’s hospital completes cyberattack recovery CommonSpirit posts $365M quarterly loss, -3.9% Chicago children’s hospital completes cyberattack recovery CommonSpirit posts $365M quarterly loss, -3.9%

US Department of Health and Human Services 40

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

Hall Render

SEPTEMBER 27, 2024

Jaya Raj fosters relatable health care ARKANSAS 5 ASC legal cases, controversies in 1 month UAMS Report Shows Financials Improved in Fiscal Year 2023 Clinical Transaction Checks In at $1.5M million to help others replicate Kentucky’s lung cancer screening success SUN Behavioral will provide Clark County schools mental health $5.7

Nurses 40

Nurses Hospitals Nursing Homes Medicare 40