American Medical Compliance

OCTOBER 25, 2024

These regulations secure sensitive health information and uphold the financial integrity of healthcare organizations. Audits serve as a critical defense against fraud and inefficiency while fostering trust in your practice. A powerful way to ensure this is through regular compliance audits.

Compliance 105

Compliance Fraud Compliance Framework HIPAA 105

HIPAA Journal

JANUARY 20, 2023

It has been almost 27 years since the Health Insurance Portability and Accountability Act (HIPAA) was signed into law, more than 2 decades since the Privacy Rule was enacted, and this February will be the 20 th anniversary of the HIPAA Security Rule.

HIPAA 121

HIPAA Fraud Compliance Health Insurance 121

HIPAA Journal

JANUARY 1, 2023

Many articles discussing what does HIPAA stand for fail to give a complete answer. 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.

HIPAA 100

HIPAA Health Insurance Fraud Governance 100

HIPAA Journal

MARCH 15, 2023

The United States Department of Justice has agreed to settle alleged False Claims Act violations with Jelly Bean Communications Design LLC and manager Jeremy Spinks related to the failure to protect HIPAA-covered data. FHKC is a state-created entity that offers health and dental insurance to children in Florida between the ages of 5 and 18.

Health Insurance 100

Health Insurance HIPAA Fraud Due Diligence 100

HIPAA Journal

DECEMBER 31, 2022

To best answer the question what is a HIPAA violation, it is necessary to explain what HIPAA is, who it applies to, and what constitutes a violation; for although most people believe they know what a HIPAA compliance violation is, evidence suggests otherwise. What is HIPAA and Who Does It Apply To?

HIPAA 133

HIPAA Due Diligence Compliance Fraud 133

HIPAA Journal

APRIL 16, 2025

The hackers encrypted files and stole data such as names, addresses, telephone numbers, email addresses, dates of birth, demographic information, Social Security numbers, drivers license numbers, medical record numbers, health information, payment information, and health insurance information. Bean of Siri & Glimstad LLP.

Ransomware 69

Ransomware Fraud Licensing HIPAA 69

HIPAA Journal

JANUARY 27, 2023

This is the third article in the ‘Benefits of HIPAA’ series, this time around exploring how the Health Insurance Portability and Accountability Act (HIPAA) and its subsequent amendments have benefited patients. A World of Change for Patients It has now been 27 years since HIPAA was signed into law by President Clinton.

HIPAA 106

HIPAA Health Insurance Fraud Electronic Medical Records 106

HIPAA Journal

DECEMBER 31, 2022

The Health Insurance Portability and Accountability Act (HIPAA) is a landmark piece of legislation, but why is HIPAA compliance important? What changes did HIPAA introduce and what are the benefits to the healthcare industry and patients? Why is HIPAA Important for Healthcare Organizations?

HIPAA 110

HIPAA Compliance Fraud Health Insurance 110

HIPAA Journal

APRIL 11, 2025

Health insurance information such as plan names, plan types, insurance companies, and member/group ID numbers. The affected individuals should be vigilant against identity theft and other fraud by monitoring their accounts and Explanation of Benefits statements carefully.

Ransomware 83

Ransomware Fraud HIPAA Licensing 83

HIPAA Journal

SEPTEMBER 12, 2023

Schneck Medical Center has agreed to pay a penalty of $250,000 to resolve alleged violations of the Health Insurance Portability and Accountability Act (HIPAA) and state laws and will implement additional safeguards to prevent further data breaches.

HIPAA 102

HIPAA Ransomware Health Insurance Fraud 102

HIPAA Journal

MARCH 28, 2023

A New York law firm that suffered a LockBit ransomware attack has agreed to pay a financial penalty of $200,000 to the New York Attorney General to resolve alleged violations of New York General Business Law and the Privacy and Security Rules of the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA 110

HIPAA Ransomware Malpractice Health Insurance 110

HIPAA Journal

NOVEMBER 16, 2022

The review of the compromised email accounts confirmed they contain information such as names, addresses, dates of birth, driver’s license numbers, state identification card numbers, financial account numbers, usernames and passwords, payment card information, medical histories, and health insurance information.

HIPAA 112

HIPAA Licensing Health Insurance Fraud 112

HIPAA Journal

OCTOBER 21, 2022

There are – and always have been – gaps in HIPAA and, after more than a quarter of a century, some have yet to be addressed. Most of the gaps in HIPAA are attributable to omissions from the original Act, provisions of HIPAA and HITECH that have never been enacted, and the increasing use of technology in healthcare.

HIPAA 106

HIPAA Compliance Medicare Medicare 106

HIPAA Journal

APRIL 27, 2025

HIPAA violation cases are compliance investigations that result from a data breach being notified to the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) or a privacy complaint being submitted to OCR via the complaints portal. There are many different types of HIPAA violation cases.

HIPAA 85

HIPAA Ransomware Hospitals Compliance 85

HIPAA Journal

DECEMBER 23, 2022

It has been another bad year for healthcare data breaches, with some of the biggest HIPAA breaches of 2022 resulting in the impermissible disclosure of well over a million records. The Biggest HIPAA Breaches of 2022. The 12 biggest HIPAA breaches of 2022 affected almost 22.66 million patients and health plan members.

HIPAA 105

HIPAA Ransomware Health Insurance Compliance 105

Compliancy Group

APRIL 18, 2025

For compliance professionals, understanding how these different rules interact, including HIPAA, the Stark Law, the Anti-Kickback Statute, FWA, OIG guidance, and OSHA regulations, is key to creating a safe healthcare environment of the highest quality. With annual U.S. healthcare expenditures exceeding $4.5

Regulatory Compliance 52

Regulatory Compliance Compliance Fraud HIPAA 52

Bill of Health

OCTOBER 30, 2023

In another legal case, a “moon” emoji was found to be possible evidence of securities fraud. In health care, complexity is everywhere. Health insurance is confusing. Notes about our health can be difficult to understand. This year a “thumbs-up” emoji was found to be part of a legally binding contract.

Doctors 290

Doctors Hospitals Fraud Health Insurance 290

Compliancy Group

MAY 27, 2022

Almost as surely as summer follows spring, lawsuits follow breaches of protected health information. Here’s a roundup of recent HIPAA breach lawsuits and settlements. Lawsuits Increasing Following HIPAA Breaches – Facts and Figures. Let’s Simplify Compliance HIPAA and cybersecurity go hand-in-hand.

HIPAA 98

HIPAA Ransomware Hospitals Compliance 98

HIPAA Journal

MAY 18, 2023

The Department of Health and Human Services’ Office for Civil Rights is the main enforcer of HIPAA compliance; however, state Attorneys General also play a role in enforcing compliance with the Rules of the Health Insurance Portability and Accountability Act (HIPAA). Community Health Systems/CHSPSC, Anthem Inc.,

HIPAA 103

HIPAA Compliance Ransomware Hospitals 103

HIPAA Journal

AUGUST 29, 2023

The HHS’ Office for Civil Rights released guidance in 2022 on HIPAA and website tracking technologies and confirmed disclosures of protected health information to third parties via website tracking technologies is a HIPAA violation unless authorization has been received from patients or if there is a valid business associate agreement in place.

HIPAA 97

HIPAA Fraud Health Insurance Compliance 97

HIPAA Journal

OCTOBER 21, 2022

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. He is due to be sentenced on Feb.

Fraud 60

Fraud HIPAA FDA Health Insurance 60

HIPAA Journal

JULY 9, 2024

The data compromised in the incident included names, addresses, phone numbers, Social Security numbers, birth dates, diagnoses, treatment information, prescriptions, physician names, medical record numbers, device serial numbers, and health insurance information.

Fraud 121

Fraud Health Insurance HIPAA Compliance 121

Compliancy Group

NOVEMBER 1, 2024

When you work in healthcare, you must comply with the most rigorous regulations that safeguard patient health and privacy, protect workers, and prevent fraud, waste, and abuse of federal funds. Healthcare compliance under HIPAA includes adhering to the Security Rule, which covers the handling, maintenance, and sharing of PHI.

Compliance 52

Compliance HIPAA Electronic Medical Records Fraud 52

HIPAA Journal

MARCH 11, 2025

The file review confirmed that the types of data compromised in the cyberattack included names, addresses, dates of birth, Social Security numbers, drivers license numbers, medical information, and health insurance information. It is currently unclear which hacking group is behind the attack, and if patient data was compromised.

Department of Veterans Affairs 82

Department of Veterans Affairs Licensing Ransomware Fraud 82

HIPAA Journal

APRIL 28, 2025

According to its March 28, 2025, substitute breach notice, the ransomware group stole data such as patient names, addresses, dates of birth, Social Security numbers, drivers license numbers, medical record numbers, health insurance information, and/or clinical information related to patients care.

Ransomware 123

Ransomware Electronic Medical Records Fraud Licensing 123

HIPAA Journal

MARCH 11, 2022

Hackers gained access to a single file server housing files that contained patients’ protected health information such as names, contact information, insurance claim information, date(s) of service, medical bill account number, and health insurance informa­tion.

HIPAA 135

HIPAA Health Insurance Medical Billing Fraud 135

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.

Fraud 119

Fraud Health Insurance HIPAA Licensing 119

HIPAA Journal

SEPTEMBER 7, 2022

Before file encryption, the attackers potentially accessed or acquired documents from its systems that contained names, addresses, dates of birth, Social Security numbers, health insurance information, and medical treatment information. Lamoille Health Partners Inc. The lawsuit – Marshall v. – was filed in the U.S.

HIPAA 130

HIPAA Ransomware Fraud Health Insurance 130

HIPAA Journal

SEPTEMBER 7, 2023

The information accessed in the attack included names, addresses, dates of birth, Social Security numbers, financial account information, medical record numbers, health insurance plan member IDs, and claims data. The post CentroMed Facing 2 Class Action Lawsuits Over 350,000-Record Data Breach appeared first on HIPAA Journal.

HIPAA 106

HIPAA Health Insurance Fraud 106

American Medical Compliance

MARCH 15, 2024

Among the various areas of compliance, Fraud, Waste, and Abuse (FWA) compliance stands out as a critical pillar. The Department of Justice recently revealed charges against 78 individuals involved in healthcare fraud schemes.

Compliance 105

Compliance Fraud HIPAA Health Insurance 105

Compliancy Group

NOVEMBER 6, 2024

Importance of Workforce Compliance Compliance with workforce requirements in healthcare involves ensuring the organization and its members comprehend and adhere to laws governing patient safety and privacy, maintaining secure working conditions, and preventing fraud, waste, and abuse.

Compliance 52

Compliance Compliance Officers Fraud Health Insurance 52

HIPAA Journal

MARCH 11, 2025

An investigation was launched, and it was confirmed that RIPTAs previous health insurance provider, UnitedHealthcare of New England, had provided RIPTA with files containing the data of non-RIPTA employees, and that data was compromised in the attack.

Ransomware 54

Ransomware Fraud HIPAA Health Insurance 54

HIPAA Journal

SEPTEMBER 30, 2022

The plaintiffs alleged the security failures were in violation of the Health Insurance Portability and Accountability Act, although the lawsuit was filed over the violation of state laws. The plaintiffs also took issue with how Magellan Health handled the data breach and the delay in issuing notifications.

Fraud 119

Fraud HIPAA Health Insurance 119

Healthcare IT Today

FEBRUARY 21, 2025

While HIPAA revolutionized patient data protection in 1996, today’s interconnected digital landscape has rendered these safeguards obsolete. Additionally, since the Privacy Rule holds that de-identified data is not considered PHI, the relatedprivacy protections under HIPAA are lost once a data set is de-identified.

HIPAA 56

HIPAA Patient Advocacy Fraud Health Insurance 56

HIPAA Journal

OCTOBER 26, 2022

According to RIPTA, those individuals were insured by UnitedHealthcare, RIPTA’s previous health insurance provider. Morelli alleges she has been a victim of fraud and has had unauthorized charges on her credit cards and withdrawals from her bank account.

HIPAA 128

HIPAA Fraud Health Insurance 128

HIPAA Journal

AUGUST 5, 2022

The cyberattack was discovered by VPN Solutions on or around October 31, 2021, and the forensic investigation confirmed that the information potentially compromised in the attack included names, addresses, dates of birth, diagnostic and treatment information, health insurance information, and Social Security numbers.

Electronic Medical Records 117

Electronic Medical Records Health Insurance Fraud HIPAA 117

HIPAA Journal

OCTOBER 6, 2022

Mon Health announced the security breach on February 28, 2022, and confirmed that the hackers had access to the personal and protected health information of 492,861 individuals , including information about patients, employees, providers, and contractors. The lawsuit, which names Monongalia Health Systems Inc.

HIPAA 119

HIPAA Fraud Hospitals Health Insurance 119