Healthcare IT Today

JANUARY 19, 2021

The Federal Trade Commission (FTC) announced a consumer fraud settlement against a company that displayed a ‘HIPAA Compliant’ seal on its website.

Fraud 145

Fraud HIPAA Compliance Hospitals 145

Compliancy Group

FEBRUARY 25, 2025

Details of the healthcare fraud plea are provided below. The elaborate healthcare fraud conspiracy involved a multi-step process: First, Schreck would offer to connect pharmacies, durable medical equipment (DME) suppliers, and marketers with telemedicine companies. A healthcare fraud conspiracy fee, essentially.

Fraud 52

Fraud Medicare Medicare Doctors 52

Compliancy Group

APRIL 18, 2025

Healthcare regulatory compliance means healthcare organizations are meeting a wide range of laws and standards that includes everything from billing and safety to data protection and patient rights. This compliance means ensuring patient safety, protecting their privacy, and making sure quality care is delivered. With annual U.S.

Regulatory Compliance 52

Regulatory Compliance Compliance Fraud HIPAA 52

AIHC

FEBRUARY 17, 2025

When Audit Managers Knowingly Skew Audit Results Written by Carl J Byron , CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret) Fraud cannot be eliminated. No system is completely fraud-proof, as any system can be bypassed or manipulated. on fraud detection and prevention in healthcare.

Fraud 52

Fraud Compliance Overpayments Overpayment 52

MRO Compliance

MAY 8, 2025

With a need for a federal data privacy law, the session focused on the critical need for updating health data policies to better protect personal health information (PHI) and ensure compliance within the evolving digital ecosystem. He emphasized the need for a national framework for compliance to minimize exceptions and streamline processes.

HIPAA 130

HIPAA Compliance Fraud 130

American Medical Compliance

MARCH 6, 2025

Fraud, Waste, and Abuse (FWA) remain critical challenges in the healthcare industry, impacting patient care, financial integrity, and regulatory compliance. Whether you’re a season professional or new to compliance training, this course will help you navigate FWA-related challenges with confidence and accountability.

Fraud 52

Fraud Medicare Medicare Compliance 52

MedTrainer

MAY 3, 2024

Healthcare fraud, waste, and abuse is a costly problem for both public and private payers. The National Health Care Anti-Fraud Association estimates financial losses due to healthcare fraud could be as much as $300 billion annually. Keep in mind that these are just examples of provider fraud!

Fraud 94

Fraud Compliance Compliance Officers Licensing 94

Compliancy Group

NOVEMBER 6, 2024

Unfortunately, the complexity of healthcare compliance makes following the rules and being aware of updates challenging. Workforce compliance management entails implementing policies and procedures that align with these regulations. Staying compliant with healthcare regulations is everyone’s responsibility in the organization.

Compliance 52

Compliance Compliance Officers Fraud Health Insurance 52

Compliancy Group

OCTOBER 28, 2024

Health and Human Services (HHS) Department’s efforts to eliminate fraud, waste, and abuse. Its compliance program guidance (CPG) has improved the efficiency and effectiveness of Medicare and many other federal programs. However, in smaller facilities with staffing challenges, a compliance officer may need to fulfill other roles.

Nurses 52

Nurses Compliance Nursing Homes Compliance Officers 52

Compliancy Group

JANUARY 23, 2025

A classic example is Medicare fraud. Providers who bill Medicare for services they did not actually provide and who present the bill with the knowledge that the service was not performed have committed Medicare fraud. The DOJ has focused much of its anti-fraud efforts on pursuing these cases, litigating several of them in 2024.

Fraud 98

Fraud Medicare Medicare Regulatory Compliance 98

Compliancy Group

NOVEMBER 1, 2024

When you work in healthcare, you must comply with the most rigorous regulations that safeguard patient health and privacy, protect workers, and prevent fraud, waste, and abuse of federal funds. Anyone in this industry should know the healthcare compliance laws and regulations that guide how they do their jobs and provide quality care.

Compliance 52

Compliance HIPAA Electronic Medical Records Fraud 52

American Medical Compliance

JUNE 21, 2024

Fraud, waste, and abuse (FWA) in healthcare present significant challenges, causing substantial financial losses, eroding public trust, and compromising the quality of patient care. Unlike fraud, waste is not necessarily intentional but results from inefficiencies.

Fraud 105

Fraud Compliance Medicaid Medicaid 105

Compliancy Group

MARCH 5, 2025

When it comes to HIPAA compliance vs. ISO 27001, many businesses opt for both because the HIPAA Security Rule and the ISO 27001 framework can be used for data risk management. Lets examine the differences and similarities between HIPAA compliance vs. ISO 27001 and consider how you can simplify your approach to compliance.

HIPAA 52

HIPAA Compliance Fraud Health Insurance 52

Health Law Attorney

NOVEMBER 22, 2024

On November 20, 2024, the Office of Inspector General (OIG) released its updated Industry-Specific Compliance Program Guidance (ICPG) for nursing facilities, marking an important step in its broader compliance initiative. This shift reflects OIG’s recognition of the direct relationship between care quality and compliance.

Nurses 52

Nurses Compliance Fraud Governance 52

Verisys

MARCH 6, 2025

What Is AI in Healthcare Compliance? Imagine having a tireless assistant who handles the nitty-gritty of regulatory compliance so healthcare teams can focus on what matters mostpatient care and privacy. AI in healthcare compliance taps into the power of machine learning, natural language processing, and automation.

Compliance 52

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

HIPAA Journal

APRIL 30, 2025

The exclusion list was established to prevent fraud, waste, and abuse in federally funded healthcare programs.If There are many different reasons for exclusion, including fraud convictions, patient abuse and neglect, felony drug convictions, submission of false claims, and participation in illegal kickback schemes.

Nurses 73

Nurses Fraud Compliance Licensing 73

Healthicity

MAY 5, 2025

In this episode of Deeper Than the Headlines , CJ Wolf walks us through the details behind a headline thats making waves: A Minnesota couple indicted in connection with allegations around a $15 million medical billing fraud case.

Fraud 59

Fraud Medical Billing Compliance 59

American Medical Compliance

MARCH 15, 2024

Among the various areas of compliance, Fraud, Waste, and Abuse (FWA) compliance stands out as a critical pillar. The Department of Justice recently revealed charges against 78 individuals involved in healthcare fraud schemes. In this comprehensive guide, we delve into FWA compliance in healthcare.

Compliance 105

Compliance Fraud HIPAA Health Insurance 105

Verisys

MARCH 6, 2025

In the healthcare industry, compliance with regulatory standards is not merely a requirement but a cornerstone of safe, effective, and ethical patient care. When healthcare organizations fail to meet compliance standards, the consequences can be severespanning legal and financial realms. What is Non-Compliance in Healthcare?

Compliance 52

Compliance HIPAA Licensing Governance 52

Verisys

APRIL 8, 2025

Youll learn how each level works, what databases they include, and how to choose the right option for your organizations compliance and patientsafety goals. FACIS Level 1M meets and exceeds the minimum standards set forth by the Office of Inspector General (OIG) Compliance Program Guidance. The post What is FACIS?

Fraud 52

Fraud Medicaid Medicaid Compliance 52

Compliancy Group

DECEMBER 9, 2024

Jefferson Dental has also notified patients that they may place an initial or extended fraud alert on their credit files at no cost. How Compliancy Group Can Help Healthcare organizations that use Compliancy Groups healthcare compliance tracking software, the Guard, are better equipped to prevent, manage, and recover from security incidents.

Ransomware 98

Ransomware Licensing HIPAA Compliance 98

HIPAA Journal

MARCH 30, 2023

The seven elements of a compliance program are integrated processes organizations in all industries can adopt to help them develop a culture of compliance in the workplace. While the seven elements of a compliance program apply to all industries, they originated in the healthcare industry in the 1990s.

Compliance 110

Compliance Compliance Officers Fraud HIPAA 110

Compliancy Group

AUGUST 28, 2024

Human resources (HR) professionals have a stake in their organizations’ healthcare compliance practices. Regardless of company size or number of employees, thorough HR compliance training ensures that your practice, hospital, or company protects patients and workers.

Compliance 97

Compliance Fraud Regulatory Compliance HIPAA 97

American Medical Compliance

AUGUST 7, 2024

Notably, many of these incidents are preventable and could have been avoided with proper compliance measures. Compliance with healthcare regulations is crucial not only for avoiding legal repercussions but also for ensuring high standards of patient care and safety. It ensures its confidentiality and maintains security.

Compliance 105

Compliance HIPAA Medicaid Medicaid 105

American Medical Compliance

AUGUST 15, 2024

In the healthcare industry, where sensitive financial and personal information is regularly processed, maintaining secure Payment Card Industry (PCI) compliance is critical. PCI compliance not only protects patient payment data but also ensures that healthcare organizations meet stringent regulatory requirements.

Compliance 105

Compliance Payment Systems Fraud 105

American Medical Compliance

FEBRUARY 21, 2025

AMC (American Medical Compliance) has achieved a major milestone by expanding into the UAE, Saudi Arabia, and the broader Middle East, reinforcing its position as a key player in global healthcare compliance.

Compliance 71

Compliance ADA Governance Medical Billing 71

Hall Render

MARCH 4, 2025

Department of Health and Human Services (HHS) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursing home members of the health care compliance community. Medical Directors in Nursing Homes 42 CFR 483.70(g) See 42 C.F.R. See 42 C.F.R.

Compliance 52

Compliance Nursing Homes Nurses Medicare 52

Compliancy Group

DECEMBER 13, 2024

Maintaining healthcare compliance includes being vigilant for warning signs of potential waste, abuse, and fraud due to identity theft. The term red flag refers to warning signs of fraud, waste, and abuse due to identity theft and other unlawful acts. Specific indications or red flags can tip you off to nefarious activities.

Compliance Officers 94

Compliance Officers Compliance Electronic Medical Records Fraud 94

Compliancy Group

MARCH 12, 2025

A healthcare organization that does not follow proper methods of obtaining reimbursement from federal payor programs such as Medicare may run afoul of federal fraud, waste, and abuse laws. Some denials result from noncompliance with federal fraud, waste, and abuse laws. Such noncompliance can result in non compliance fines.

Fraud 52

Fraud Compliance Medicare Medicare 52

HIT Consultant

NOVEMBER 21, 2024

billion annually to maintain HIPAA compliance with patient data. The ability to create a smart contract for a healthcare claim and remittance introduces automation, transparency, and auditability while removing fraud from the process of healthcare payments.

Fraud 97

Fraud HIPAA Compliance 97

Healthicity

SEPTEMBER 26, 2024

In the latest episode of Compliance Conversations , host Dr. CJ Wolf sits down with Rebecca Busch , a healthcare compliance expert with over four decades of experience.

Fraud 52

Fraud Compliance Nurses Compliance Officers 52

HIT Consultant

NOVEMBER 4, 2024

By implementing thorough cybersecurity measures and adhering to regulatory compliance, healthcare providers can fortify their systems and ensure the confidentiality and integrity of critical health information. However, protecting patient identity is equally crucial. billion and $2.45

Ransomware 98

Ransomware Regulatory Compliance Compliance Fraud 98

HIT Consultant

AUGUST 17, 2023

Erin Rutzler, VP of Fraud, Waste, and Abuse at Cotiviti As behavioral health claim volumes continue to increase, there’s a growing need for health plans to be vigilant in spotting fraud, waste and abuse. But not every plan has access to a large SIU to combat fraud, waste and abuse in behavioral health.

Fraud 98

Fraud COVID-19 Medicare Medicare 98

American Medical Compliance

FEBRUARY 9, 2024

Compliance officers’ responsibilities extend far beyond merely checking boxes and ticking off regulatory requirements. In fact, 61% of the compliance teams from a Thomson Reuters report also work on long-range strategies for their companies by putting regulatory and legislative changes as a top priority.

Compliance Officers 102

Compliance Officers Compliance Patient Advocacy Regulatory Compliance 102

Healthcare IT News - Telehealth

JUNE 28, 2021

At the same time, he said, "it's important that these new policies that have this great potential to improve care aren't compromised by fraud or abuse or misuse." " VanLandingham explained that the healthcare fraud space gets "tens of thousands of complaints." in Venetian Lido 3104.

US Department of Health and Human Services 200

US Department of Health and Human Services Fraud Compliance Medicaid 200

Healthicity

NOVEMBER 1, 2022

Medicaid Fraud Control Units.

Fraud 98

Fraud Nurses Medicare Medicare 98

Hall Render

NOVEMBER 21, 2023

The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. This category of individuals is sometimes called a “fraud alert employee.” Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C.

Fraud 72

Fraud Compliance 72