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Another Resolution by DOJ Pursuant to its Civil Cyber-Fraud Initiative Highlights Continued Efforts to Hold Companies Accountable for Ensuring Data are Secured

Health Care Law Brief

In 2013, Jelly Bean contracted with the Florida Health Kids Corporation (“ FHKC ”)—a state-created entity that offers health and dental insurance for Florida children—to create, host, and maintain HealthyKids.org, where, in part, parents and others could apply for state Medicaid insurance coverage for eligible children.

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8 Common Provider Credentialing Mistakes and How to Avoid Them

Verisys

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.

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Settlement Agreed with Florida Children’s Health Insurance Website Contractor to Resolve False Claims Act Allegations

HIPAA Journal

FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida. The company provides web hosting functions and services for its clients, one of which was the Florida Healthy Kids Corporation (FHKC).

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What is a HIPAA Violation?

HIPAA Journal

Two of the HIPAA violation categories are designated for Covered Entities and Business Associates that can demonstrate reasonable due diligence, whereas the other two are for entities guilty of willful neglect. What are the 3 types of HIPAA violations? The three types of HIPAA violations are administrative, civil, and criminal.

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Understanding Compliance for Healthcare Vendors

Provider Trust

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.

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CMS Releases CY2024 Final Rule for PACE Organizations

Healthcare Law Blog

On April 12, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released a final rule updating key regulations pertaining to Programs of All-Inclusive Care for the Elderly (“PACE”) (the “ Final Rule ”). Overall, these changes, summarized below, will offer significant administrative and operational flexibilities.

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How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

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.