HIT Consultant

MAY 9, 2023

During the month of the breach, a cybercriminal was able to access various confidential files, including patient data such as names, contact details, treatments, diagnoses, patient account numbers, their dentist’s names as well as billing details and health insurance data. As a result, patients feared an increased risk of fraud.

Ransomware 95

Ransomware Fraud Health Insurance HIPAA 95

HIT Consultant

JUNE 21, 2023

I was excited to attend this luminary event in Las Vegas and speak face-to-face with leaders in the healthcare field. Patients expect the convenience of digital healthcare, but healthcare providers and payers must balance service expectations with the need to protect patient’s privacy, reduce the risk of fraud, and maintain compliance.

Fraud 98

Fraud Health Insurance Compliance 98

Compliancy Group

MAY 27, 2022

The complaint further alleges that the affected patients have suffered anxiety and loss of time and now face a substantial risk of fraud and identity theft due to this data breach. Solara Medical will also implement a security information event and management (SIEM) tool with a 400-day lookback on activity logs.

HIPAA 98

HIPAA Ransomware Hospitals Health Insurance 98

American Medical Compliance

JANUARY 9, 2024

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. This type of theft is just one example of healthcare fraud. trillion in 2015. trillion in 2015.

Fraud 52

Fraud Medicare Medicare Compliance 52

HIPAA Journal

AUGUST 31, 2023

As well as supplying private customers, the company works with more than five hundred health plans, managed care organizations, and other agencies to provide access to meals for people covered by Medicare and Medicare. It is also providing credit monitoring, fraud consultation, and identity theft restoration services for a year.

Medicare 52

Medicare Medicare HIPAA Medicaid 52

Compliancy Group

OCTOBER 16, 2024

Compliance means adhering to various rules and standards that protect patient privacy, uphold safe working conditions, and prevent fraud, waste, and abuse of federal resources. Risk management procedures enable healthcare organizations to pinpoint their vulnerabilities to such hazards as security breaches or Medicare fraud.

Compliance 52

Compliance Compliance Officers Fraud Regulatory Compliance 52

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Compliancy Group

AUGUST 30, 2024

HIPAA The Health Insurance Portability and Accountability Act (HIPAA) of 1996 governs how healthcare organizations handle protected health information (PHI). This set of regulations relates to sharing, collecting, storing, and disposing of health records, patient data, and other sensitive information.

Compliance 52

Compliance Fraud Compliance Officers HIPAA 52

MedTrainer

FEBRUARY 1, 2024

These programs help to promote lawful and ethical conduct within healthcare organizations and minimize the risk of legal violations, such as fraud, abuse, and other unethical behaviors. Prevent Fraud and Abuse: Helps avoid improper billing and monitors for potential fraudulent or waste activities.

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 52

Healthcare IT Today

SEPTEMBER 19, 2023

This critical information can help identify or avoid serious adverse events, including hospital readmissions. For example, depending on whether physicians are sitting in their hospital office or their clinic office (and many doctors work in both), the insights they have into the medications their patients take can vary greatly.

Hospitals 139

Hospitals HIPAA Nurses Governance 139

Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

HIPAA Journal

JULY 24, 2023

The team’s roles are to investigate and audit the Department’s operations to prevent fraud, waste, and abuse within the Department, and also to audit and investigate potential crimes against the Department. Subsequent Acts of Congress increased the OIG’s regulatory authority to prevent crimes against the Department.

Fraud 52

Fraud Medicare Medicare Medicaid 52

Medisys Compliance

NOVEMBER 6, 2023

Compliance with Regulatory Guidelines Ensure that all claims are submitted per all applicable laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Fraud, Waste, and Abuse (FWA) laws.

Compliance 59

Compliance Medical Billing Outsourcing Medical Billing ACA 59

HIT Consultant

JANUARY 3, 2023

But they have also expanded the attack surface at these organizations and increased the level of risk and vulnerabilities that could result in direct loss of proprietary information, direct financial damage including theft and fraud, and potential loss of life (in addition to regulatory fines and brand damage) the healthcare sector faces.

Compliance 52

Compliance Ransomware Fraud Regulatory Compliance 52

Total HIPAA

DECEMBER 13, 2021

In the event of a breach, a company that has complied with the DPA can assert DPA compliance as a defense to any claim that may come up. This act offers safe harbor against data breach claims for companies who implement, maintain, and comply with one of several approved programs, designed to protect against data breaches.

HIPAA 59

HIPAA Compliance Fraud Health Insurance 59

MedTrainer

JANUARY 26, 2024

Tracking and reporting on employee compliance training and education can also decrease an organization’s liability in the event of noncompliance. By understanding what is required by role, you can structure training to be the most beneficial, which may mean reducing the number of courses your organization requires.

Compliance 52

Compliance Informed Consent Fraud HIPAA 52

Compliancy Group

AUGUST 17, 2023

By staying up-to-date with changing regulations, they help protect patients’ rights while preventing fraud or abuse. Their expertise in understanding complex regulations helps safeguard patient rights while preventing fraud or abuse.

Compliance 52

Compliance Fraud Health Insurance HIPAA 52

MedTrainer

OCTOBER 4, 2023

These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. These requirements are designed to protect patient rights, privacy, and safety, as well as to prevent fraud, abuse, and other improper practices within healthcare organizations.

Compliance 52

Compliance Fraud HIPAA Governance 52

Medisys Compliance

JUNE 23, 2024

Introduction In the ever-evolving landscape of healthcare, compliance with the Health Insurance Portability and Accountability Act (HIPAA) is crucial for protecting patient information and maintaining trust. Enacted in 1996, HIPAA is a federal law designed to safeguard patient health information (PHI) from fraud and abuse.

Medical Billing 45

Medical Billing HIPAA Compliance US Department of Health and Human Services 45

Total HIPAA

OCTOBER 28, 2019

“Audit logs are records of events based on applications, user, and systems. A federal grand jury indicted a former MedStar Ambulance paramedic on counts of identity theft and fraud. In the event of a security incident , audit trails and logs should be reviewed as soon as possible.

HIPAA 52

HIPAA Compliance Fraud Hospitals 52

Hall Render

FEBRUARY 4, 2022

Of that, $5 billion relates to health care fraud involving drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians. Health Care Fraud Actions. That figure does not include even more funds recovered for state Medicaid programs.

Fraud 40

Fraud Governance Medicare Medicare 40

Compliancy Group

AUGUST 2, 2023

These regulations include privacy laws such as HIPAA (Health Insurance Portability and Accountability Act) and cybersecurity standards like HITRUST (Health Information Trust Alliance).

Compliance 52

Compliance Regulatory Compliance Governance Fraud 52

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

MedTrainer

JULY 31, 2024

It also supports financial compliance by implementing accurate billing practices and fraud prevention mechanisms, which are crucial for maintaining the organization’s financial health. Compliance ensures that healthcare organizations adhere to state, federal, and international laws and relevant standards and regulations.

Governance 52

Governance Compliance HIPAA Regulatory Compliance 52

HIPAA Journal

APRIL 27, 2025

The practice claimed the complainant would not pay a $25 administrative fee for mailing the records (certified mail) and that the request was denied because the practice believed she would use the information to commit insurance fraud. Advocate Health Care Network will pay a record $5.55 The case was settled for $1,300,000.

HIPAA 85

HIPAA Ransomware Hospitals Compliance 85

Total HIPAA

SEPTEMBER 11, 2019

HIPAA” is the Health Insurance Portability and Accountability Act of 1996. This federal regulation set standards for safeguarding Protected Health Information , or PHI. HIPAA is regulated by the Department of Health and Human Services (HHS) Office of Civil Rights (OCR). Level Two: Offenses Committed Under False Pretenses.

HIPAA 52

HIPAA Compliance US Department of Health and Human Services Health Insurance 52

Healthcare IT Today

DECEMBER 15, 2023

In Europe, this is GDPR (General Data Protection Regulation), in America, it’s HIPAA (Health Insurance Portability and Accountability Act). Problems and Solutions for Data Protection According to Check Point Research, health organizations worldwide experienced a 38% increase in cyberattacks last year compared to 2021.

Electronic Medical Records 122

Electronic Medical Records Doctors HIPAA Hospitals 122

HIPAA Journal

MAY 18, 2023

Recently, Murfreesboro Medical Clinic & SurgiCenter in Tennessee halted operations for two weeks while recovering from a cyberattack, and a 2022 survey indicated 25% of healthcare organizations would be forced to temporarily halt operations in the event of a ransomware attack. The notification process was completed on April 10, 2023.

Ransomware 73

Ransomware Fraud HIPAA Health Insurance 73

HIT Consultant

AUGUST 13, 2023

Here are seven identified cybersecurity vulnerabilities that can reveal a patient’s data and expose these healthcare organizations to fraud and fines: Limited budgets. Poor Cyberhealth and the Seven Deadly Sins The landing pad in healthcare for cybercriminals is long and wide and they have many ways to creep into the network and cause chaos.

Ransomware 98

Ransomware Fraud Health Insurance Public Health 98

AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

Compliance 52

Compliance Fraud Medicare Medicare 52

HIT Consultant

DECEMBER 18, 2023

In Europe, this is GDPR (General Data Protection Regulation), in America, it’s HIPAA (Health Insurance Portability and Accountability Act). Problems and Solutions for Data Protection According to Check Point Research, health organizations worldwide experienced a 38% increase in cyberattacks last year compared to 2021.

Electronic Medical Records 105

Electronic Medical Records Doctors HIPAA Pharmaceutical Industry 105

MedTrainer

NOVEMBER 15, 2023

The OIG also enforces standards for healthcare providers and suppliers to prevent fraud and imposes penalties for non-compliance. Medicaid: a joint state and federal program that provides health coverage to some people with limited income, including families and children, pregnant women, the elderly, and people with disabilities.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

HIT Consultant

AUGUST 25, 2024

United HealthGroup, the parent company of Change Healthcare, estimates that losses so far have topped $872 million , including a $22 million ransom payment and other direct and indirect costs related to the event. How did hackers breach United HealthGroup’s systems?

Hospitals 110

Hospitals Ransomware HIPAA Compliance 110

Health Populi

OCTOBER 8, 2019

Fraud and abuse, waste between $59 bn and $84 bn; and, Administrative complexity, wasting about $266 bn each year. Thus, administrative complexity, which includes billing and coding waste, and physician time spent reporting on quality measures, accounted for the largest component of waste in American health care. health care.

Prescription Drug Pricing 108

Prescription Drug Pricing Medicare Medicare ACA 108

HIPAA Journal

FEBRUARY 24, 2023

In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was signed into law and one of its requirements was for the Department of Health and Human Services (HHS) to develop a national patient identifier system. These are not uncommon events and occur repeatedly throughout the healthcare system.

HIPAA 111

HIPAA Governance Public Health Fraud 111

Hall Render

DECEMBER 20, 2024

expert says RSV is off the charts Ochsner Health named to U.S. presence Beth Israel Lahey Health reports $249M operating loss, -2.8% margin in FY 2024 Brown University Health, formerly Lifespan, eyes expansion into Mass. 1 for flu in the U.S.,

Nursing Homes 40

Nursing Homes Nurses Hospitals Fraud 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? hospitals generate $11.7B

Nurses 40

Nurses Nursing Homes Medicaid Medicaid 40