Hall Render

SEPTEMBER 12, 2022

Healthsouth of Sarasota Limited Partnership, et al , the Eleventh Circuit held that for a plaintiff to qualify as engaging in “protected activity,” the plaintiff must demonstrate that they had both a subjectively reasonable belief of fraud and an objectively reasonable belief of fraud. Your primary Hall Render contact.

Fraud 40

Fraud Governance Compliance 40

HIPAA Journal

APRIL 25, 2024

The exposed and stolen data included contact information, Social Security numbers, driver’s license numbers, financial information, health insurance information, medical records, medical histories, diagnoses/conditions, and health insurance information. During that time, files containing patient data were exfiltrated from its network.

Fraud 69

Fraud Health Insurance Licensing HIPAA 69

Natalia Mazina

JUNE 28, 2022

The scammer then contacted Cardinal and placed a large order for Invokana (the cost of around $90,000). If you see an order that you haven’t placed, then fraud is likely. Someone called the pharmacy and represented to be a California Board of Pharmacy inspector who was investigating an anonymous complaint against the pharmacy.

Fraud 52

Fraud Hospitals 52

HIPAA Journal

APRIL 13, 2023

Insight Global LLC has agreed to settle a class action lawsuit that was filed in response to an April 2021 data breach that exposed the contact tracing data of more than 76,000 Pennsylvania residents. Insight Global was appointed the administrator of Pennsylvania’s contact tracing program during the pandemic.

Fraud 104

Fraud COVID-19 HIPAA 104

HIPAA Journal

APRIL 23, 2024

The HHS Office of Inspector General (HHS-OIG) has issued a warning to the public about a fraud scheme that targets Medicare enrollees and involves them setting up monthly payments for medically unnecessary remote patient monitoring (RPN).

Medicare 52

Medicare Medicare Fraud HIPAA 52

Healthcare IT News - Telehealth

MAY 13, 2022

The owners of a national telehealth company pleaded guilty this week to charges of conspiracy to violate the federal Anti-Kickback Statute and to commit healthcare fraud. Law enforcement agencies have ramped up the pressure on telehealth fraud, particularly amid the COVID-19 pandemic. According to a statement released by the U.S.

Doctors 145

Doctors Fraud COVID-19 Medicare 145

HIPAA Journal

AUGUST 30, 2022

The lawsuit alleges the sensitive information of the plaintiff and class members is now in the hands of cybercriminals, including their names, contact information, Social Security numbers, bank account information, and health information and they now face an imminent and future risk of identity theft and fraud.

Nursing Homes 126

Nursing Homes Fraud Ransomware HIPAA 126

Hall Render

FEBRUARY 25, 2022

The OIG noted that although the arrangement would not fit squarely under any AKS safe harbor or Civil Monetary Penalties Law exception, there was a low risk of fraud and abuse based on the following safeguards: The Agreement would cover care-related expenses incurred by all qualified families regardless of payor and would not apply only to cost?

Fraud 40

Fraud Hospitals Medicare Medicare 40

Compliancy Group

MARCH 12, 2024

When unauthorized parties gain access to this information, identity theft, fraud, and diminished care often result. Prevent fraud: All parties must comply with laws that prevent fraud and misconduct, such as ordering necessary tests or treatments or billing for services not provided.

Compliance Framework 52

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

Verisys

MARCH 1, 2024

As the healthcare industry is increasingly targeted for data theft and fraud, information security has emerged as a top priority for healthcare institutions. Continuously monitoring keeps you in compliance and prevents fraud and abuse within your organization. Healthcare data has never been more susceptible to fraud and abuse.

Governance 52

Governance Compliance Fraud HIPAA 52

MedTrainer

JANUARY 10, 2024

The OIG is making major investments to systematically detect and prosecute fraud. In this guidance it’s clear the OIG expects healthcare organizations and suppliers to understand their role and responsibilities to fight fraud, waste, and abuse. We all should be a LOT more prepared!

Compliance 94

Compliance Fraud HIPAA Compliance Officers 94

HIPAA Journal

MARCH 7, 2023

The cyberattack was detected on December 8, 2022, by which time the hackers had access to a huge amount of sensitive patient data, including full names, contact information, Social Security numbers, diagnoses, treatment information, medications, lab test results, radiology reports, and health insurance information.

Fraud 124

Fraud Health Insurance HIPAA Doctors 124

Compliancy Group

MARCH 22, 2024

Medicare Compliance Training Another CMS requirement for healthcare entities is to offer fraud, waste, and abuse (FWA) training to all providers and staff. For example, a risk assessment can shed light on conditions that make fraud, waste, and abuse most likely to occur.

Medicare 52

Medicare Medicare Compliance Compliance Officers 52

HIPAA Journal

APRIL 20, 2022

The notification letters state that credit monitoring, fraud consultation, and identity theft restoration services are being offered through Kroll for 12 months at no cost. A Google search for the company returns a result that is a 2-page site that has a placeholder for the contact us page that includes dummy text.

US Department of Health and Human Services 139

US Department of Health and Human Services Fraud HIPAA 139

McGuire Wood

SEPTEMBER 8, 2023

In its continued effort to curb fraud and abuse in the hospice industry, on Aug. If you anticipate being affected by CMS’ latest announcement and/or would like additional guidance on CMS’ latest hospice oversight policies and best practices, please contact the authors.

Medicare 52

Medicare Medicare Fraud Medicaid 52

HIPAA Journal

NOVEMBER 23, 2022

The delay in issuing notifications to affected individuals was due to the time-intensive process of investigating the breach, reviewing the affected files, and confirming contact information for affected individuals.

Ransomware 123

Ransomware Fraud Licensing HIPAA 123

HIPAA Journal

MARCH 21, 2023

During that time they exfiltrated files that contained sensitive patient data, including names, contact information, Social Security number, Medicare/Medicaid IDs, health information, and health insurance information.

Fraud 118

Fraud Health Insurance Medicaid Medicaid 118

Provider Trust

APRIL 18, 2024

Impact Compliance represents a shift in the organization’s market approach, establishing a compliance spectrum that measures healthcare organizations’ exclusion monitoring and license and credential verification processes against gold-standard practices to demonstrate their tangible impact on eradicating fraud, waste, and abuse.

Compliance 52

Compliance Licensing Fraud Medicaid 52

Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. and cybersecurity threats.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Compliancy Group

MARCH 21, 2024

OIG compliance training is crucial to ensure that providers and other employees understand and implement the laws designed to prevent fraud, breaches of patient privacy, and other behaviors that undermine the federal programs that patients depend on.

Compliance 52

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

HIPAA Journal

JUNE 15, 2023

While the investigation into the data breach is ongoing, the initial findings indicate that sensitive personal and financial information was impacted, including names, contact information, and health billing records. At this stage, it is unclear how many individuals have been affected.

Ransomware 108

Ransomware Health Insurance Fraud HIPAA 108

HIPAA Journal

FEBRUARY 22, 2022

Databreaches.net spotted the leaked data on the Marketo data leak site in June 2021 and contacted Sea Mar. The breach came to light in June 2021 when files stolen in the attack were posted on the Marketo dark web leak site.

Fraud 126

Fraud HIPAA 126

Verisys

NOVEMBER 8, 2023

Tracking actions to a standardized identifier provides transparency that can identify and impede fraud. NPI Helps Prevent Healthcare Fraud Tracking actions to a standardized identifier provides transparency that can identify and impede fraud.

Fraud 97

Fraud HIPAA Medicare Medicare 97

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

The Health Law Firm

MARCH 5, 2012

The Medicaid Fraud Control Unit is a division of the Florida Office of the Attorney General charged with investigating and prosecuting health care providers suspected of defrauding the state's Medicaid program. Immediately contact an attorney knowledgeable in Medicaid fraud and abuse prior to responding to the government's requests.

Fraud 40

Fraud Medicaid Medicaid Governance 40

HIPAA Journal

FEBRUARY 8, 2024

Azura Vascular Care said individuals who had sensitive information exposed such as Social Security numbers have been offered complimentary identity protection, credit monitoring, and fraud resolution services.

Ransomware 93

Ransomware Electronic Medical Records Licensing Health Insurance 93

Healthcare Law Today

FEBRUARY 3, 2023

Be sure to stop by Booth 1302 in the Expo Hall to meet and reconnect with your Foley contacts. To learn more and register for the event, visit the ATA2023 conference website. Use code ATA23FOLEY50 for a 50% discount. The Business of Telehealth: The Biggest Telehealth Legal Issues You Need to Understand On Saturday, March 4 th at 2:00 p.m.

Telemedicine 83

Telemedicine Fraud Compliance Officers Compliance 83

YouCompli

JANUARY 18, 2023

Featured speakers : Eric Gold , Chief, Massachusetts Attorney General’s Office Healthcare Division; Jennifer Goldstein , Managing Attorney, Medicaid Fraud Division, Massachusetts Attorney General’s Office; and Steven Sharobem , Assistant US Attorney, District of Massachusetts. Priorities for Massachusetts’s Medicaid Fraud Division.

Fraud 52

Fraud COVID-19 Compliance Medicaid 52

Hall Render

FEBRUARY 8, 2023

Department of Justice (“DOJ”) charged over two dozen individuals with wire fraud and conspiracy to commit wire fraud in connection with leading the alleged fraudulent scheme – each defendant faces up to 20 years in prison. Fraudulent Scheme On January 25, 2023, the U.S.

Nurses 40

Nurses Licensing Fraud Governance 40

HIPAA Journal

FEBRUARY 2, 2024

The stolen data included names, contact information, medical information, health insurance information, Social Security numbers, and bank account details. The hacker threatened to publish the stolen data and Blackbaud negotiated a 24 Bitcoin ($235,000) payment for the data to be deleted.

Fraud 89

Fraud HIPAA Health Insurance Compliance 89

HIPAA Journal

JUNE 23, 2023

Intellihartx, a revenue cycle management company, said protected health information was compromised in the January 30, 2023 cyberattack, including names, contact information, insurance information, diagnoses, medications, dates of birth, and Social Security numbers. Intellihartx was one of 130 GoAnywhere users to be affected.

HIPAA 103

HIPAA Ransomware Fraud Health Insurance 103

HIPAA Journal

NOVEMBER 7, 2022

The stolen data included names, contact information, dates of birth, and Social Security numbers. The forensic investigation confirmed that the attackers had exfiltrated files containing patient data. OakBend Medical Center said entire medical records do not appear to have been stolen.

HIPAA 122

HIPAA Fraud 122

Healthcare Law Blog

NOVEMBER 9, 2023

Thereafter, OIG said it planned to update existing industry-specific compliance program guidance (ICPG), which would include tailoring each to address fraud and abuse risk areas specific to a particular industry and describing the compliance measures that industry could take to reduce these risks [2].

Compliance 52

Compliance Compliance Officers Fraud Medicare 52

Hall Render

APRIL 4, 2024

Although the OIG issued a favorable decision, entities seeking to establish similar programs to that of the Proposed Arrangement should consult with qualified fraud and abuse counsel. Special thanks to Antoine Neumann, Summer Associate, for their assistance in the preparation of this article.

Payment Systems 40

Payment Systems Medicare Medicare Fraud 40

HIPAA Journal

DECEMBER 8, 2022

According to databreaches.net, which contacted the Hive group, Empress EMS paid the ransom. Those files were stolen on July 13, 2022. The Hive ransomware group published some of the stolen data on their data leak site, but the data was promptly removed. Notification letters were sent to affected individuals on September 9, 2022.

Ransomware 118

Ransomware HIPAA Fraud 118

Healthcare Compliance Blog

FEBRUARY 3, 2022

Bassett stated, “Vaccination fraud is a serious crime. To report vaccine-related fraud in New York contact the New York State Department of Health by calling 833-VAX-SCAM (833-829-7226) or emailing STOPVAXFRAUD@health.ny.gov.

COVID-19 Vaccine 59

COVID-19 Vaccine COVID-19 Nursing Homes Nurses 59

Healthcare Law Blog

DECEMBER 12, 2022

Now, almost three years later, governmental entities have focused their attention on telehealth services and the potential for fraud and abuse. Although the PHE and its telehealth flexibilities currently remain in effect, the DOJ has started to investigate allegations of fraud and violations of the Controlled Substances Act.

COVID-19 52

COVID-19 Fraud Telemedicine Public Health 52