Verisys

JANUARY 2, 2024

Each month we will give a roundup of recent healthcare fraudsters and compliance busters. With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Secure your success by choosing Verisys.

Fraud 52

Fraud Licensing Doctors Medicare 52

Verisys

FEBRUARY 9, 2024

January 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Verisys

FEBRUARY 10, 2022

Did you know that for every 1,000 licensed healthcare practitioners there will typically be 20 with inactive licenses, 10 with a suspended license, and another six practitioners with either a restricted or revoked license, or on probation? By carefully screening the practitioner and continually monitoring his license.

Licensing 52

Licensing US Department of Health and Human Services Malpractice Compliance 52

Verisys

FEBRUARY 23, 2022

As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. Accordingly, maintaining compliance has become a key focus for healthcare facilities. Nine Responsibilities of Healthcare Compliance Officers.

Compliance Officers 52

Compliance Officers Compliance US Department of Health and Human Services Governance 52

Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. Further, Ms.

Licensing 52

Licensing Fraud Compliance Nurses 52

YouCompli

AUGUST 29, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. As FWA continues to emerge, and poses more of a risk to organizational compliance, professionals should become familiar with some of the potential areas of noncompliance associated with telehealth.

Fraud 52

Fraud Medicare Medicare COVID-19 52

YouCompli

JULY 26, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. As FWA in telehealth continues to emerge, and poses more of a risk to organizational compliance, professionals should become more familiar with it – and then work to curb it.

Fraud 52

Fraud Compliance Medicare Medicare 52

Healthcare IT Today

DECEMBER 20, 2022

Five former employees of Methodist Hospital in Memphis, TN, including a recently-licensed Registered Nurse, were indicted by a federal grand jury for allegedly selling medical information about car accident victims to personal injury attorneys and chiropractors. The doctor that was jailed for snooping in patient records. “Dr.

HIPAA 87

HIPAA Nurses Licensing Compliance 87

MedTrainer

FEBRUARY 27, 2024

And like any healthcare professional, HHAs must adhere to the compliance standards that govern quality care. It is arguably more important — and harder — to maintain a standard level of compliance when staff are working in client homes, rather than in a central facility. What is the Role of Home Health Aides?

Compliance 52

Compliance HIPAA Fraud Licensing 52

Verisys

FEBRUARY 24, 2023

At the emergency room, the doctors begin a series of tests to discover what’s wrong with her knee. It will take months for her to recover, and as she does, Sue will visit multiple clinics and doctors. Estimates range from 3% – 10% of the entire federal healthcare funding lost to fraud, waste, and abuse.

Fraud 52

Fraud Doctors Governance Licensing 52

Verisys

FEBRUARY 24, 2023

At the emergency room, the doctors begin a series of tests to discover what’s wrong with her knee. It will take months for her to recover, and as she does, Sue will visit multiple clinics and doctors. Estimates range from 3% – 10% of the entire federal healthcare funding lost to fraud, waste, and abuse.

Fraud 52

Fraud Doctors Governance Licensing 52

YouCompli

JULY 12, 2022

Key Point for Compliance Professionals: Medical necessity is the overarching criterion for the performance and billing of any service. National fraud takedown: $1.1 Department of Justice (DOJ) announced a national health care fraud enforcement action involving over $1.4 billion in false and fraudulent telehealth claims.

COVID-19 52

COVID-19 Medicare Medicare Telemedicine 52

Health Law Blog

MAY 22, 2018

Substance Abuse Treatment Center Fraud Scheme Results in Guilty Plea. The Department of Justice recently announced the guilty plea of two individual alcohol and substance abuse treatment center owners for their participation in what DOJ labeled a “multi-million dollar health care fraud and money laundering scheme.”

Fraud 52

Fraud Overpayments Overpayment Licensing 52

Verisys

DECEMBER 5, 2023

State licensing boards verify practitioner license type and status. As compliance requirements change to keep up with ever-evolving, accelerating fraud schemes and high expectations for quality care and outcomes, they place increasing demands on healthcare facilities. Credentials Verification Organizations to the Rescue?

Governance 52

Governance Licensing Malpractice Medicaid 52

Verisys

MARCH 1, 2022

State licensing boards verify practitioner license type and status. As compliance requirements change to keep up with ever-evolving, accelerating fraud schemes and high expectations for quality care and outcomes, they place increasing demands on healthcare facilities. Credentials Verification Organizations to the Rescue?

Governance 52

Governance Licensing Malpractice Medicaid 52

HIPAA Journal

DECEMBER 23, 2022

The databases contained extensive patient information, such as contact information, health insurance information, medical record numbers, Social Security numbers, driver’s license numbers, and medical information. Doctors’ Center Hospital – Ransomware Attack Involving 1.2 Million Records.

HIPAA 79

HIPAA Ransomware Health Insurance Compliance 79

Hall Render

OCTOBER 20, 2023

nursing home advocate: industry in ‘death spiral’ from lack of health care providers, low pay Georgia medical center named one of the ‘most beautiful hospitals in the U.S.’ grant to train 140 ‘complex care’ nurses Health Foundation of Central Mass. doles out $1M in funding AG reaches $2.5M

COVID-19 Vaccine 40

COVID-19 Vaccine Nursing Homes COVID-19 Nurses 40

Hall Render

JULY 1, 2022

North Alabama doctor’s medical license suspended after investigation into overdose death. Balderas Joins $230M Settlement Against Pharmaceutical Company Over Allegations Of Medicaid Fraud. Report: Arizona hospitals not in full compliance with pricing transparency laws. billion fraud. It wasn’t just COVID.

US Department of Health and Human Services 40

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

Hall Render

SEPTEMBER 29, 2023

million into USF Health’s new nursing simulation lab UF Health to open ER in former Lake County CVS Nurse Practitioner Convicted of $200M Health Care Fraud Scheme Florida joins 3 other states in adopting new, paid maternity leave for state workers GEORGIA Albany nonprofit addresses medical debt with D.C. officials, helps South Ga.

US Department of Health and Human Services 40

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

Hall Render

MARCH 24, 2023

Sanders pushes funding boost for rural health care Struggling to survive, the first rural hospitals line up for new federal lifeline ALABAMA AARP report puts spotlight on caregiving issues, expenses in Alabama All of Us Research Program launching new enrollment location in Dothan Local partnership to provide cancer screening for rural patients Medical (..)

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

MARCH 8, 2024

NATIONAL 34.5% NATIONAL 34.5% of Health Services announces first-ever chief heat officer Valley exec on track to raise $2B for pediatric health system Gov.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

MARCH 31, 2023

in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? What happens if it disappears? 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

US Department of Health and Human Services 40

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

Hall Render

DECEMBER 29, 2023

bill would allow IVF therapy for same-sex veteran marriages; VA denies coverage Cancer-killing gel, minimally-invasive brain shunts: Here are recent startups spun out of area hospitals UMass Memorial named one of top U.S. system turns profit for 1st time in 4 years Mass. How a Michigan health system is responding. NORTH DAKOTA N.D.

Nursing Homes 40

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

Hall Render

SEPTEMBER 1, 2023

ALABAMA American Family Care opens new health care center in Northeast Birmingham doctors secure $13.9M facility near Calvin University Health care industry groups back Whitmer’s call for prescription drug cost review board Michigan Doctor to Pay $6.5 The auditor says it needs improvements. hospital company for $1.2B

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

SEPTEMBER 23, 2022

Healthcare Compliance Will Be a Challenge in Post-PHE World. Aspen U surrenders nursing program license. Aspen University in Phoenix surrenders nursing program license, failing to meet NCLEX first-time pass rate. The Top Doctors Making a Difference in Delaware in 2022. million to resolve Medicare fraud claims.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

SEPTEMBER 16, 2022

Full 4th Circuit to tackle Medicaid fraud standard under False Claims Act. Medical Impact of Roe Reversal Goes Well Beyond Abortion Clinics, Doctors Say. Massachusetts nurse pleads guilty in $100M fraud scheme. Health care industry in Nebraska ‘thankful’ after licensing backlog averted.

US Department of Health and Human Services 40

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

Hall Render

MARCH 22, 2024

Banner Health to expand clinical AI to 33 hospitals, 6 states Banner reports $282.8M family sues hospital over life-altering injuries Calif. Banner Health to expand clinical AI to 33 hospitals, 6 states Banner reports $282.8M family sues hospital over life-altering injuries Calif.

Nursing Homes 40

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

Hall Render

AUGUST 11, 2023

But that wasn’t the whole story. The new abortion ban could make that worse. Mahaska Health receives state grant to promote rural health care Receiver sought for Iowa City hospital that’s alleged to be in a ‘financial freefall’ Reynolds announces $2.2

US Department of Health and Human Services 40

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

Hall Render

FEBRUARY 16, 2024

CALIFORNIA 8 ASCs opening in Florida, California and New York A bankrupt California hospital left a health care desert. CALIFORNIA 8 ASCs opening in Florida, California and New York A bankrupt California hospital left a health care desert. million operating loss Judge Keeps FCA Case Against Kaiser Permanente Alive Kaiser Permanente reports $4.1B

US Department of Health and Human Services 40

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

Hall Render

MARCH 3, 2023

on 7th medical office building acquisition in a year Baptist Health expanding in Nassau and St. million for youth mental health care KENTUCKY Pike County nursing home officials release statement following loss of Medicare agreement Three Humana executives drop $11.2M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

MAY 19, 2023

Supplemental Grant for Rural Health Programs UAMS to Study Affordable Care Act’s Impact on Breast Cancer Treatment Arkansas Children’s Hospital Auxiliary Donates $1.4 Supplemental Grant for Rural Health Programs UAMS to Study Affordable Care Act’s Impact on Breast Cancer Treatment Arkansas Children’s Hospital Auxiliary Donates $1.4

Nurses 40

Nurses COVID-19 Hospitals Nursing Homes 40

Hall Render

FEBRUARY 18, 2022

License wait times reach crisis levels for healthcare workers. Only 14% of Hospitals Met Price Transparency Rule Compliance. Doctors: Pediatric COVID cases appear to be trending down. Florida physician convicted of $110M fraud. Lack of ICU doctors presents challenges for healthcare in Idaho. billing fraud.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

JULY 21, 2023

gives nod to 39 new medical cannabis businesses seeking a license Rose Health founder Kavi Misri launches new venture to help employers keep workers healthy 6 people hit by car in D.C. Million St. Here are arguments for and against. hospital parking garage Arlington named ‘America’s fittest city’ DC ranked No. 11th in mental health, No.

US Department of Health and Human Services 40

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

Hall Render

FEBRUARY 24, 2023

doctor talks importance of diversity in health care Illinois hospital CEO dismissed amid board investigation Illinois paid sick leave legislation heading to Gov. area health care real estate A proposed noncompete ban could upend business for health providers D.C.

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

JUNE 30, 2023

after home health provider reneges on Option deal Will the doctor see you now? Here’s why. Report: Amazon Pauses 50-State Virtual Care Service Expansion UnitedHealth acquires Amedisys for $3.3B Maybe not amid the changing healthcare landscape in the US. Here’s how new laws aim to fix that.

US Department of Health and Human Services 40

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

Hall Render

AUGUST 26, 2022

Compliance with Oct. Doctors warn Indiana’s new abortion laws may worsen OB care deserts. 2022 Top Doctors: Recognizing some of the best doctors in Las Vegas. Oklahoma doctor raises concerns about life-threatening virus, polio. Rhode Island Nurse Surrenders License for Submitting Falsified COVID Vaccine Card.

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

MAY 5, 2023

healthy village’ George Washington University medical residents vote overwhelmingly to form a union Kaiser Permanente’s Mid-Atlantic president, Ruth Williams-Brinkley, to retire Kaiser Permanente to spend billions on new value-based care nonprofit based in the D.C. of Iowa Health Care denies sharing patient data with Facebook, but are they right?

US Department of Health and Human Services 40

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