Health Care Law Brief

JUNE 5, 2023

We previously wrote about the United States Department of Justice’s (“ DOJ ”) Civil Cyber-Fraud Initiative (“ CCFI ”), which “aims to hold accountable entities or individuals that put U.S. FHKC shut down its website’s application portal shortly thereafter.

Fraud 52

Fraud Due Diligence Medicaid Medicaid 52

HIPAA Journal

MARCH 15, 2023

FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida. While Jelly Bean Communications Design acted as a business associate under HIPAA, the action was taken over violations of the False Claims Act under the Department of Justice’s 2021 Civil Cyber-Fraud Initiative.

Health Insurance 74

Health Insurance HIPAA Due Diligence Fraud 74

Verisys

JULY 20, 2023

3: Allowing a physician to treat patients before credentialing is completed Courts have held hospitals liable when a physician falsifies credentials, and the hospital fails to do its due diligence in verifying them. Therefore, due diligence requires background checks to identify current and historical adverse actions.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

HIPAA Journal

DECEMBER 31, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was introduced to simplify the administration of healthcare, eliminate wastage, prevent healthcare fraud, and ensure employees could maintain healthcare coverage between jobs. What is HIPAA and Who Does It Apply To? What is considered a HIPAA violation?

HIPAA 134

HIPAA Due Diligence Compliance Fraud 134

Provider Trust

MAY 17, 2022

Federal regulators such as the HHS-OIG, the Department of Justice (DOJ), the Centers for Medicare and Medicaid Services (CMS), and others have regulations and guidelines regarding the prohibition of reimbursements of federal healthcare dollars (Medicaid, Medicare, CHIPS, TriCare, and others) to excluded vendors.

Compliance 52

Compliance Medicare Medicare Due Diligence 52

Provider Trust

MAY 18, 2022

In addition, the suit involved alleged submission of false claims for reimbursement to the Massachusetts Medicaid Agency. Bay Mental Health Centers (hereinafter referred to as “South Bay”) employee involving false claims for reimbursement of services provided by unlicensed and improperly supervised social workers and counselors at South Bay.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

Hall Render

JANUARY 11, 2023

For example, reimbursement under Medicare and Medicaid for certain telemedicine services was significantly increased due to the COVID-19 pandemic. State law – App developers should also be mindful of the numerous state laws that may apply to the provision of health services through their apps.

Compliance 40

Compliance HIPAA FDA Due Diligence 40