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 72

HIPAA Health Insurance Fraud Governance 72

Compliancy Group

MARCH 19, 2024

Hospitals and private practices aren’t the only enterprises with compliance obligations within this sector. Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. No other industry in the U.S.

Regulatory Compliance 52

Regulatory Compliance Compliance US Department of Health and Human Services ACA 52

HIPAA Journal

OCTOBER 6, 2022

The information potentially accessed and stolen included names, addresses, birth dates, Social Security numbers, Medicare claim numbers, patient account numbers, health insurance information, medical record numbers, dates of service, provider names, claims information, and medical and clinical treatment information.

HIPAA 89

HIPAA Fraud Hospitals Health Insurance 89

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. The payments were intended for hospitals for providing covered medical services. The arrests were related to a series of scams that spoofed hospital email accounts. million, and $6.4

Medicaid 75

Medicaid Medicaid Medicare Medicare 75

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

MARCH 24, 2022

Chelan Douglas Health District said it is unaware of any cases of identity fraud or other misuse of patient data. East Tennessee Children’s Hospital Investigating Security Breach. Notification letters started to be sent to affected individuals on March 15, 2022.

Ransomware 122

Ransomware Fraud Hospitals HIPAA 122

HIPAA Journal

JULY 20, 2022

Louis-based hospital system reported a breach of its email system to the HHS’ Office for Civil Rights on May 5, 2020, that affected 287,876 individuals. BJC HealthCare has agreed to settle a class action lawsuit to resolve claims it failed to adequately protect patient data from phishing attacks. The nonprofit St.

Fraud 107

Fraud Licensing HIPAA Health Insurance 107

MedTrainer

MARCH 8, 2024

Specific topic areas include: HIPAA: The Health Insurance Portability and Accountability Act is a federal law that governs the privacy and security of patient health information. MedTrainer Learning supports training for hospitals, clinics, urgent care, home health, long-term care, physician offices, and more.

Compliance 52

Compliance Fraud Governance HIPAA 52

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 102

HIPAA Compliance Fraud Health Insurance 102

HIPAA Journal

JULY 4, 2023

As a precaution against identity theft and fraud, affected individuals have been offered 24 months of complimentary credit monitoring services. Affected individuals had one or more of the following exposed: name, address, driver’s license number, health insurance information, medical information, date of birth, and Social Security number.

Medicaid 72

Medicaid Medicaid Health Insurance Licensing 72

HIPAA Journal

JULY 27, 2023

Norton Healthcare, a Kentucky-based operator of more than 140 clinics and hospitals in Kentucky and Southern Indiana, is facing a class action lawsuit over a May 2023 cyberattack and data breach.

Ransomware 52

Ransomware Fraud Licensing Health Insurance 52

Kaiser Health News

NOVEMBER 11, 2021

She won’t answer the phone unless her caller ID displays a number she recognizes, but this call showed the number of the hospital where her doctor works. She contacted the 1-800-MEDICARE helpline to get a new Medicare number and called the AARP Fraud Watch Network Helpline and the Federal Trade Commission.

Medicare 143

Medicare Medicare Doctors Fraud 143

HIPAA Journal

JANUARY 16, 2023

Rehoboth McKinley Christian Health Care Services operates a 60-bed acute care hospital and outpatient clinics and provides home health care services in New Mexico and Arizona. Rehoboth McKinley Christian Health Care Services had argued that there was no actionable duty to protect the plaintiffs’ data, but U.S.

Fraud 95

Fraud Health Insurance HIPAA Hospitals 95

MedTrainer

JANUARY 30, 2024

In these cases, the Centers for Medicare and Medicaid Services (CMS) require compliance programs from the following facilities: Hospitals: General acute care and specialty hospitals. Additionally, compliance programs address a wide range of potential issues, including fraud, waste, and abuse.

Governance 52

Governance Compliance Nursing Homes Medicaid 52

MedTrainer

JUNE 29, 2023

By promoting equity and fairness in healthcare delivery, regulations prevent discrimination, ensure equal access to care, and reduce health disparities. This federal law ensures individuals receive emergency medical care regardless of their ability to pay or insurance status. Here are the ones you need to know above all others: 1.

Fraud 52

Fraud HIPAA Compliance Governance 52

HIPAA Journal

JANUARY 25, 2023

Under the terms of the settlement, Logan Health has agreed to create a fund of $4.3 Logan Health, formerly Kalispell Regional Medical Center, is a 622-bed health system based in Kalispell, MT, which operates six hospitals and more than 68 provider clinics in the state. A lawsuit – Tafelski, et al.

Medical Billing 81

Medical Billing Fraud HIPAA Health Insurance 81

YouCompli

MAY 11, 2022

They perform procedures and surgeries, admit patients to hospitals, and document in the medical record. . In March of 2022, a New Jersey rheumatologist was convicted by a federal jury for defrauding Medicare and other health insurance programs. The doctor will be sentenced in July for multiple counts of healthcare fraud.

Compliance Officers 52

Compliance Officers Fraud Compliance Medicare 52

HIPAA Journal

NOVEMBER 17, 2022

Salud Family Health said affected employees and patients have been offered free credit monitoring and identity fraud protection services, and security policies and procedures are being reviewed and will be updated to protect against future cyberattacks. New York-Presbyterian Hospital Discovers Breach Affecting up to 12,000 Patients.

Ransomware 79

Ransomware Health Insurance Hospitals Fraud 79

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. Office of Inspector General (OIG) Compliance Program Guidance Office of Inspector General (OIG) compliance program guidance is for individual providers like hospitals or nursing homes.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52

Hall Render

APRIL 19, 2024

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

HIPAA Journal

JULY 14, 2022

The breach was detected on April 20, 2022, with the forensic investigation confirming an unauthorized third-party had accessed the IT networks of Baptist Medical Center or Resolute Health Hospital between March 31 and April 24, 2022, and removed files containing sensitive patient data. The lawsuit seeks damages in excess of $1 million.

Fraud 68

Fraud HIPAA Health Insurance Hospitals 68

Health Populi

APRIL 24, 2018

consumers rank hospitals as the top-trusted segment in the U.S., Otherwise, the news is negative across the remaining four segments: consumer health is the second most-trusted segment, by 56% of Americans, but dropped by 7 percentage points from 2017. Hospitals ranked top in trust among U.S.

Health Insurance 74

Health Insurance Fraud Hospitals Doctors 74

MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Compliance efforts shifted toward protecting patient information.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Compliancy Group

SEPTEMBER 27, 2023

Close Mount Desert Island Hospital (MDIH) Breach Incident In another concerning incident related to vulnerabilities in Progress Software’s MOVEit Transfer software, Mount Desert Island Hospital (MDIH) in Bar Harbor, Maine, reported a breach affecting 32,661 individuals. Please Wait. Something is wrong with your submission.

HIPAA 52

HIPAA Compliance Health Insurance Fraud 52

Compliancy Group

JANUARY 3, 2024

This mistake resulted in millions of dollars in lost revenue for hospitals. Because many denied claims can be recovered, providers need to follow up within the window of appeal or before the deadline outlined in the insurance payer contract. Many medical bills are unpaid because providers do not promptly follow up on claim denials.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting “reasonable and customary charges” requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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. Why Is Compliance Training and Education Important?

Compliance 52

Compliance Informed Consent Fraud HIPAA 52

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting "reasonable and customary charges" requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Verisys

FEBRUARY 23, 2022

HCOs are expected to not only understand healthcare legal issues, but also to work with the hospital or healthcare facility to create practices and procedures that protect the entity, the practitioners, and the patients. The False Claims Act prevents fraud and abuse by making it illegal to file false medical claims. HCO Qualifications.

Compliance Officers 52

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

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

HIPAA Journal

OCTOBER 14, 2022

Large health systems store millions of patient records and even relatively small healthcare providers may store the records of hundreds of thousands of patients. Stolen data can be used to develop convincing spear phishing, smishing, and vishing campaigns, where the attacker impersonates a hospital or health insurer.

Ransomware 107

Ransomware HIPAA Health Insurance Hospitals 107

Healthcare IT Today

DECEMBER 15, 2023

The following is a guest article by Natalie Tkachenko, Healthcare Software Solutions Consultant at NIX To obtain test results today, there’s no need to visit the hospital. They also handle large volumes of data effortlessly within their hospitals. Simply open a mobile app and download the report to your smartphone.

Electronic Medical Records 102

Electronic Medical Records Doctors HIPAA Hospitals 102

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

Florida Health Care Law Firm

JANUARY 20, 2022

Essentially, the AHCA regulates and coordinates the Medicaid system and the healthcare providers that offer medical services through that program to Floridians, so there is sharing of healthcare data and resources across the state through the Florida Center for Health Information and Policy Analysis. What Are Florida AHCA Regulations?

Nursing Homes 52

Nursing Homes Medicaid Medicaid Fraud 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 98

Records Management Regulatory Compliance Compliance HIPAA 98

Health Care Law Brief

JUNE 24, 2022

Providers must inquire about the specific telephonic technology employed in their respective practice, as many phones in offices and hospitals appear to be “landline” phones yet employ VoIP technology, especially if the phones were manufactured within the last five years.

HIPAA 52

HIPAA Fraud Compliance COVID-19 52

HIPAA Journal

APRIL 1, 2022

Catholic Health said the compromised information included patient names, provider names, dates of birth, dates of service, health insurance information, and/or medical record numbers.

Fraud 127

Fraud HIPAA Licensing Health Insurance 127