HIPAA Journal

MARCH 15, 2023

FHKC is a state-created entity that offers health and dental insurance to children in Florida between the ages of 5 and 18. FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida.

Health Insurance 100

Health Insurance HIPAA Fraud Due Diligence 100

Healthcare IT Today

JUNE 3, 2024

Nobody really knows or cares what health care costs, because they aren’t paying. He further asserts that on average, only 53% of your health insurance premiums get returned to you as benefits. However, the ACA states “…an insurance company must assign 80% of their premiums to activities that develop the healthcare sector.”

Health Insurance 75

Health Insurance ACA Doctors Fraud 75

HIPAA Journal

APRIL 11, 2025

million people that some of their personal and health information has been exposed or stolen in a recent hacking incident. Health insurance information such as plan names, plan types, insurance companies, and member/group ID numbers.

Ransomware 84

Ransomware Fraud HIPAA Licensing 84

AIHC

APRIL 22, 2025

37293733) is the federal governments primary tool for combating fraud against public programs. Healthcare fraud accounts for a significant portion of FCA activity. Under this statute, employees are protected from reprisal for reporting gross mismanagement, fraud, abuse of authority, or dangers to public health and safety.

Compliance 89

Compliance HIPAA Compliance Officers Fraud 89

HIPAA Journal

MARCH 30, 2022

For example: Had the health insurance industry been allowed to continue operating as it did prior to HIPAA, tens of millions of Americans would be excluded from health plan benefits. Had the momentum to improve health care not been given a kickstart by HIPAA, subsequent health care initiatives may never have happened.

HIPAA 137

HIPAA Fraud Health Insurance Health Care Reform 137

HIPAA Journal

SEPTEMBER 8, 2022

The Michigan law firm, Warner Norcross and Judd LLP, has issued notification letters to 255,160 individuals advising them about an October 2021 security breach in which files containing their personal and protected health information were potentially accessed and exfiltrated from its systems.

Fraud 96

Fraud Health Insurance Ransomware HIPAA 96

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.

Department of Veterans Affairs 82

Department of Veterans Affairs Licensing Ransomware Fraud 82

HIPAA Journal

JULY 9, 2024

The Houston, TX-based medical device company, LivaNova, is facing multiple class action lawsuits over an October 2023 cyberattack that exposed the protected health information of 180,000 patients. At least two lawsuits have now been filed by patients whose information was exposed in the incident.

Fraud 122

Fraud Health Insurance HIPAA Compliance 122

Bill of Health

OCTOBER 30, 2023

In another legal case, a “moon” emoji was found to be possible evidence of securities fraud. This code of ethics prohibits ads from using misleading statements or omitting necessary material information. In health care, complexity is everywhere. Health insurance is confusing.

Doctors 290

Doctors Hospitals Fraud Health Insurance 290

Compliancy Group

NOVEMBER 6, 2024

With workforce compliance software and other digital tools, organizations can centralize and streamline their compliance activities, making it easier for employees to stay informed and actively maintain the highest healthcare standards. Non-compliance damages your financial stability and could lead to fewer contracts, patients, or customers.

Compliance 52

Compliance Compliance Officers Fraud Health Insurance 52

HIPAA Journal

APRIL 25, 2024

Several class action lawsuits have been filed against City of Hope National Medical Center, a National Cancer Institute (NCI)-designated cancer treatment and research center, over a recently disclosed data breach that exposed the protected health information of more than 827,000 individuals.

Fraud 120

Fraud Health Insurance HIPAA Licensing 120

HIPAA Journal

APRIL 28, 2025

At the time, it was unclear to what extent patient data had been compromised in the incident, but it has now been confirmed that the electronic protected health information of 934,326 patients was stolen. The post Ransomware Attack on Frederick Health Medical Group Affects 934,000 Patients appeared first on The HIPAA Journal.

Ransomware 124

Ransomware Electronic Medical Records Fraud Licensing 124

Compliancy Group

APRIL 18, 2025

It ensures patient data protection, especially in an age where electronic health records (EHRs) are central to care. Patients deserve to know their sensitive information is safe from unauthorized access and misuse. It applies not only to providers and insurers, but also to third-party vendors and business associates.

Regulatory Compliance 52

Regulatory Compliance Compliance Fraud HIPAA 52

HIPAA Journal

OCTOBER 17, 2022

Phoenix, AZ-based Valle del Sol Community Health has notified 70,268 patients that some of their protected health information has been exposed. Valle de Sol said the investigation indicated unauthorized individuals had access to files containing sensitive patient data and that patient information may have been acquired.

Health Insurance 136

Health Insurance Licensing Fraud HIPAA 136

Medisys Compliance

MARCH 31, 2025

Understanding Medicare for Physicians Medicare, the federal health insurance program for individuals aged 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease, is divided into several parts. Modifiers play a crucial role in providing additional information about the services rendered.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 59

HIPAA Journal

OCTOBER 7, 2022

Questions are often sent to HIPAA Journal about the Health Insurance Portability and Accountability Act, one of which is how HIPAA has improved healthcare. In this article, I explain some of the main ways that healthcare has been improved by HIPAA for healthcare providers, health plans, and patients.

HIPAA 109

HIPAA Fraud Health Insurance Compliance 109

HIPAA Journal

MARCH 11, 2022

District Court for the District of Montana Great Falls Division by law firm Heenan & Cook on behalf of plaintiff Allison Smeltz and all similarly affected individuals over the alleged failure of the health system to protect the plaintiff’s and class members’ sensitive personal information.

HIPAA 135

HIPAA Health Insurance Medical Billing Fraud 135

HIPAA Journal

AUGUST 5, 2022

Rivera, MD, doing business as Arlington Skin in Virginia, has started notifying 17,468 patients that their protected health information may have been accessed by unauthorized individuals in a security breach at business associate, Virtual Private Network Solutions (VPN Solutions). Dr. Michelle A.

Electronic Medical Records 119

Electronic Medical Records Health Insurance Fraud HIPAA 119

HIPAA Journal

SEPTEMBER 30, 2022

. – was filed in the Arizona Superior Court against Magellan Health Inc. and Magellan RX Management, LLC on behalf of patients whose protected health information was exposed in a May 2019 phishing attack. Approximately 273,000 individuals were affected and had their protected health information exposed.

Fraud 120

Fraud HIPAA Health Insurance 120

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. Anyone in this industry should know the healthcare compliance laws and regulations that guide how they do their jobs and provide quality care.

Compliance 52

Compliance HIPAA Electronic Medical Records Fraud 52

HIPAA Journal

MARCH 11, 2025

The ransomware attack was detected and blocked on August 5, 2021; however, the forensic investigation confirmed that hackers gained access to its network on August 3, 2021, and stole sensitive data including names, dates of birth, Social Security numbers, and health plan ID numbers. RIPTA announced the data breach on December 23, 2021.The

Ransomware 55

Ransomware Fraud HIPAA Health Insurance 55

HIPAA Journal

SEPTEMBER 29, 2022

Humana has recently announced that the protected health information of 22,767 individuals has potentially been compromised in a security incident and data breach at one of its business associates – Choice Health – which Human used to sell Medicare products on its behalf.

Health Insurance 130

Health Insurance Medicare Medicare Fraud 130

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.

HIPAA 131

HIPAA Ransomware Fraud Health Insurance 131

HIPAA Journal

MARCH 25, 2022

Ultimate Care said no reports have been received that indicate there has been any misuse of patient information; however, as a precaution against identity theft and fraud, individuals whose Social Security numbers were impacted have been offered complimentary one-year memberships with a credit monitoring service.

Health Insurance 120

Health Insurance Licensing Ransomware Fraud 120

HIPAA Journal

JUNE 15, 2022

The South Carolina-based health insurance company, Choice Health, now part of Alight Solutions, has recently announced that the protected health information of some of its members has been obtained by an unauthorized individual. This post will be updated when further information becomes available.

Ransomware 144

Ransomware Health Insurance Fraud HIPAA 144

HIPAA Journal

JULY 4, 2024

Gaia Software Gaia Software, a provider of electronic medical record and billing management software services to Americare Renal Center, has mailed notification letters to patients whose protected health information was compromised in a February 2024 cyberattack. Those individuals will be notified when the investigation is completed.

Electronic Medical Records 120

Electronic Medical Records Health Insurance Ransomware Fraud 120

HIPAA Journal

JULY 4, 2024

SkinCure Oncology has notified 13,434 patients about an email attack that occurred in June 2023, and the Wisconsin Department of Health Services has announced a breach of the personal information of 19,150 Medicaid recipients. Further information can be contained by calling SkinCure Oncology’s helpline – (866) 528-8844.

Medicaid 120

Medicaid Medicaid Fraud Licensing 120

Healthcare IT Today

NOVEMBER 22, 2024

In addition to the challenges that all organizations face like multiple devices, applications, and operating systems being used for day-to-day operations, they also store massive amounts of sensitive protected health information (PHI). Here’s a checklist of eight things your organization can do to protect against ransomware.

Ransomware 67

Ransomware Hospitals COVID-19 Compliance 67

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. However, they encounter numerous challenges in achieving this goal.

Compliance 105

Compliance Fraud HIPAA Health Insurance 105

HIPAA Journal

MARCH 30, 2023

A lawsuit has been filed against the digital marketing agency, Rise Interactive Media & Analytics, over a cyberattack in which the protected health information of approximately 54,500 patients of Edgepark Medical Supplies was compromised.

Health Insurance 107

Health Insurance Fraud HIPAA 107

AIHC

SEPTEMBER 25, 2024

Government agencies expect your organization to stay informed. Stay Informed Through Training & Education Engage by receiving news through ListServ offered by organizations such as AIHC, CMS, OIG, etc. These are free ways to stay informed of lessons learned. You may unsubscribe at any time. Enroll in Low-Cost Short Courses.

Fraud 52

Fraud Compliance Compliance Officers Licensing 52

HIPAA Journal

FEBRUARY 22, 2023

The database included names, addresses, dates of birth, Social Security numbers, health insurance information, medical record numbers, and patient account numbers. Sorrentino-Poggi was notified on February 8, 2023, that some of her information was stolen by the hackers.

Ransomware 117

Ransomware Fraud Health Insurance HIPAA 117

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 103

HIPAA Fraud Health Insurance Medicaid 103

HIPAA Journal

APRIL 17, 2025

The physical therapist used his KU Health credentials to access patient records, which included nude clinical before and after photographs, body measurements, and sensitive personally identifiable information. The first unauthorized access occurred in February 2021 and continued until February 2023.

Fraud 49

Fraud HIPAA Hospitals Health Insurance 49

HIPAA Journal

MARCH 7, 2023

Four Californian medical groups have been named in a class action lawsuit that alleges a failure to implement reasonable and appropriate cybersecurity measures, resulting in a cyberattack and data breach involving the personal and protected health information of 3,300,638 current and former patients.

Fraud 122

Fraud Health Insurance Doctors HIPAA 122

HIPAA Journal

SEPTEMBER 9, 2022

Birmingham, AL-based Henderson & Walton Women’s Center (HWWC) has recently notified 34,306 patients that some of their protected health information may have been compromised as a result of a hacker gaining access to the email account of one of its employees. The information exposed varied from patient to patient.

Licensing 119

Licensing Health Insurance Fraud HIPAA 119

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. Ritson would then be paid a commission on those prescriptions.

Fraud 60

Fraud HIPAA FDA Health Insurance 60