Remove services
article thumbnail

Preventing Genetic Testing Fraud: 5 Actions for Health Plans

Healthcare IT Today

The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient. In 2021, a U.S.

Fraud 62
article thumbnail

Pharma Sales Rep Pleads Guilty to Healthcare Fraud and Criminal HIPAA Violations

HIPAA Journal

A pharmaceutical sales rep has pleaded guilty to conspiring to commit healthcare fraud and wrongfully disclosing and obtaining patients’ protected health information in an elaborate healthcare fraud scheme involving criminal HIPAA violations. Alario pleaded guilty to his role in the healthcare fraud scheme earlier this month.

Fraud 62
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

How Will New FDA Hearing Aid Regulations Impact Health Plans?

HIT Consultant

First, let’s examine the new regulatory framework the FDA established. – Aftercare service : Whether to offer virtual support and/or an optional care package purchased by members at a clinic? – Fraud. – What new opportunities will arise? – What potential pitfalls should they be aware of?

FDA 98
article thumbnail

Navigating the Maze of Who Regulates Healthcare Compliance

MedTrainer

Here are some of the key organizations involved in regulating healthcare compliance: Centers for Medicare & Medicaid Services (CMS): CMS is a federal agency within the U.S. Department of Health and Human Services responsible for administering and regulating healthcare programs such as Medicare and Medicaid.

article thumbnail

Digital Health in the Metaverse: Three Legal Considerations

Healthcare Law Blog

Developers and other players in the metaverse offering health-related products and services will face an ever-growing patchwork of state and federal privacy and data security laws. In response to the growth of the metaverse and digital health generally, the FDA has been working to expand its guidance in the area.

FDA 90
article thumbnail

Weekly Roundup – May 6, 2023

Healthcare IT Today

Read more… Preventing Genetic Testing Fraud: 5 Actions for Health Plans. Medicare payments for genetic testing quadrupled from 2016 to 2019, which has unfortunately led to a rise in a rise in fraud, waste, and abuse. Business process management service provider Sagility acquired Devlin Consulting. at Valencell.

Fraud 93
article thumbnail

Healthcare Supplier Compliance Checklist

MedTrainer

Healthcare organizations rely on third-party vendors for myriad products and services – from biohazard disposal and cleaning to credentialing and durable medical equipment. For example, a healthcare IT vendor should include items related to HIPAA, while a checklist for a food vendor should focus on FDA or USDA regulations.