MedTrainer

JANUARY 31, 2024

federal government enacted the Federal False Claims Act (FCA) in 1863 during the American Civil War. It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. The need to combat fraud, waste, and abuse is what brought about the modern compliance program.

Compliance 52

Compliance Fraud Governance ACA 52

Innovaare Compliance

MARCH 24, 2024

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.

Fraud 52

Fraud Health Insurance Compliance Medicaid 52

MedTrainer

MARCH 8, 2024

It educates employees on the laws, regulations, and policies governing their work and ensures they understand their responsibilities and obligations as healthcare professionals. Successful training is when team members understand and comply with various laws, regulations, and policies that govern the healthcare industry.

Compliance 52

Compliance Fraud Governance HIPAA 52

Verisys

FEBRUARY 12, 2024

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is GRC in Healthcare?

Compliance 52

Compliance Governance Health Insurance HIPAA 52

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

American Medical Compliance

JANUARY 9, 2024

Provider Compliance and Responsibilities Additionally, the federal government’s False Claims Act (FCA) of 1986 explicitly targeted fraud and abuse in the healthcare industry in an effort to eliminate it. HCFAC received $248,459,000 from HHS and the Attorney General in 2007 to combat healthcare fraud and abuse.

Fraud 52

Fraud Compliance HIPAA Health Insurance 52

HIPAA Journal

JANUARY 1, 2023

Most state that HIPAA is an acronym of the Health Insurance Portability and Accountability Act of 1996 and that it led to the development of standards for the privacy of Protected Health Information. However, at the time, the healthcare insurance industry was governed by a hotchpotch of federal and state legislation.

HIPAA 77

HIPAA Health Insurance Fraud Governance 77

Verisys

FEBRUARY 14, 2024

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is healthcare data governance? What is GRC in Healthcare?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

HIPAA Journal

SEPTEMBER 8, 2022

Notification letters were sent to affected individuals in August and information was provided on the steps that individuals can take to reduce the risk of identity theft and fraud, but it would appear that credit monitoring and identity theft protection services are not being offered. Gateway Diagnostic Imaging and Radiology Ltd.

Fraud 103

Fraud Health Insurance Ransomware HIPAA 103

HIPAA Journal

FEBRUARY 23, 2022

HIPAA is an acronym for the Health Insurance Portability and Accountability Act. When the Health Insurance Portability and Accountability Act was passed by Congress in 1996, the establishment of federal standards for safeguarding PHI was not one of the primary objectives. What is HIPAA? What is HIPAA Title II?

HIPAA 94

HIPAA Fraud Health Insurance Medicaid 94

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

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

MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. What is Healthcare Compliance?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. Violations of the False Claims Act can result in significant financial penalties, including fines and exclusion from government healthcare programs.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

HIPAA Journal

SEPTEMBER 8, 2022

Notification letters were sent to affected individuals in August and information was provided on the steps that individuals can take to reduce the risk of identity theft and fraud, but it would appear that credit monitoring and identity theft protection services are not being offered.

Fraud 72

Fraud Health Insurance Ransomware HIPAA 72

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

Kaiser Health News

JANUARY 19, 2022

” The changes are part of a 400-page proposed rule governing the federal health insurance marketplace and a few states that use the federal platform for their own exchanges. The new broker provision aims to deter fraudulent sign-ups by clarifying that applicants must attest that the income projections listed are correct.

ACA 72

ACA Health Insurance Licensing Governance 72

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. Five state Medicaid programs, two Medicare Administrative Contractors, and two private health insurers were tricked into changing the bank account details for payments. million, and $6.4

Medicaid 81

Medicaid Medicaid Medicare Medicare 81

HIPAA Journal

AUGUST 2, 2023

Notification letters will be sent to the affected individuals in the coming weeks and credit monitoring, fraud consultation, and identity theft restoration services will be offered. A third-party data review company was provided with the files on December 22, 2022, and provided the results of the analysis to SHS on May 16, 2023.

Licensing 75

Licensing Electronic Medical Records Ransomware Health Insurance 75

Verisys

JANUARY 8, 2024

This includes adherence to standards set by the Health Insurance Portability and Accountability Act (HIPAA) , the Centers for Medicare & Medicaid Services (CMS), and other regulatory bodies. The audit evaluates if the healthcare organization follows billing and coding standards to prevent fraud and abuse.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

MedTrainer

JUNE 29, 2023

Healthcare is an industry governed by countless regulations. While it can sometimes feel like there’s dozens and dozens of different healthcare standards, the biggest governing policies really boil down to four major regulations. Why are Healthcare Regulations Important? Healthcare regulations are crucial for several reasons.

Fraud 52

Fraud HIPAA Compliance Governance 52

Healthcare IT Today

DECEMBER 21, 2023

Predominantly, the risk of fraud, theft, or abuse of customer or company information increases, which can cause regulatory violations resulting in significant fines and penalties. If healthcare providers fail to comply, the consequences can be costly.

Records Management 102

Records Management Regulatory Compliance Compliance HIPAA 102

MedTrainer

OCTOBER 23, 2023

Who Governs Healthcare Compliance? These are just few examples: Occupational Health and Safety Administration (OSHA) : Supports the overall health and safety of workers by reducing the risk of injury, illness, death, suffering, and financial hardship. Learn more about how MedTrainer can streamline your compliance.

Compliance 52

Compliance Compliance Officers Fraud Governance 52

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 86

Ransomware Electronic Medical Records Licensing Health Insurance 86

MedTrainer

APRIL 8, 2024

As a healthcare professional, it is vital to maintain compliance with the 629 legal and regulatory requirements that govern the delivery of quality care. Legal And Regulatory Requirements In Healthcare More than 620 legal and regulatory requirements govern how the healthcare industry ensures patient safety, privacy, and quality of care.

Compliance 52

Compliance Governance ACA HIPAA 52

HIPAA Journal

JULY 27, 2023

The stolen information included names, addresses, email addresses, dates of birth, Social Security numbers, government identification ID numbers, driver’s license numbers, payment/financial institution information, health insurance providers, medical treatment information, medical diagnoses, medications, medical images, and lab test results.

Ransomware 52

Ransomware Fraud Licensing Health Insurance 52

Verisys

FEBRUARY 23, 2022

As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. Facilities increasingly rely on healthcare compliance officers (HCOs) to bridge the gap between government regulation and daily operations.

Compliance Officers 52

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

HIPAA Journal

FEBRUARY 21, 2022

EHRs usually contain all the information required for multiple types of fraud, including names, addresses, dates of birth, Social Security numbers, other government and state ID numbers, health data, and health insurance information. Cyberattacks on EHRs can be extremely profitable for cyber threat actors.

Ransomware 129

Ransomware Fraud HIPAA Health Insurance 129

MedTrainer

JANUARY 31, 2024

Healthcare compliance is following and meeting the laws, regulations, and ethical standards that govern the healthcare industry. Ensure Patient Privacy: Compliance programs – with the Health Insurance Portability and Accountability Act (HIPAA) at the top – help safeguard patient privacy and data security.

Compliance 52

Compliance Compliance Officers Governance Fraud 52

MedTrainer

AUGUST 31, 2023

Healthcare compliance refers to the process of adhering to the laws, regulations, and ethical standards that govern the healthcare industry. It also helps prevent fraud, abuse, and errors, ensuring the delivery of high-quality care and ethical decision-making. What Is Healthcare Compliance? What Are the Consequences of Non-Compliance?

Compliance 52

Compliance Compliance Officers HIPAA Fraud 52

HIPAA Journal

JUNE 8, 2023

Those files contained names, government-issued identification numbers such as Social Security numbers and passport numbers, financial account information, health insurance information, and/or tax-related information. The post Alvaria Confirms November 2022 Hive Ransomware Attack appeared first on HIPAA Journal.

Ransomware 52

Ransomware Fraud HIPAA Health Insurance 52

Compliancy Group

AUGUST 2, 2023

Healthcare GRC (Governance, Risk, and Compliance) is a crucial framework that helps healthcare providers navigate these complexities effectively. Governance: Establishing Accountability Effective governance forms the foundation of any robust healthcare GRC software.

Compliance 52

Compliance Regulatory Compliance Governance Fraud 52

MedTrainer

JANUARY 26, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Denied Claims: Failure to comply with coding and billing regulations can lead to denied claims, delayed reimbursement, or even accusations of fraud. What is Healthcare Compliance?

Compliance 52

Compliance Fraud Regulatory Compliance Health Insurance 52

Compliancy Group

JANUARY 23, 2024

Various laws, regulations, and industry standards govern this sector. Protecting patients’ rights, ensuring privacy and data security, preventing fraud and abuse, and promoting fair billing practices. This includes federal statutes such as HIPAA (Health Insurance Portability and Accountability Act).

Compliance 52

Compliance Regulatory Compliance Governance Fraud 52

MedTrainer

JANUARY 26, 2024

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

JULY 6, 2023

With various regulations like HIPAA (Health Insurance Portability and Accountability Act), OSHA (Occupational Safety and Health Administration), and FWA (Fraud, Waste, and Abuse) in place, it is crucial for healthcare providers to adhere to these guidelines to ensure patient safety, privacy, and ethical practices.

Compliance 52

Compliance HIPAA Fraud Health Insurance 52

Compliancy Group

AUGUST 31, 2023

Healthcare compliance laws play a vital role in safeguarding patients’ rights, preventing fraud and abuse, and maintaining the integrity of healthcare systems. Let’s delve into the importance of healthcare compliance laws and regulations, their impact on providers and organizations, and the guidelines governing their implementation.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52