Compliancy Group

MAY 15, 2024

OIG compliance and compliance training intends to help hospitals protect patient health and safety, prevent fraud and abuse, ensure legal and regulatory compliance, and safeguard patient privacy, making it an invaluable tool for success. Automated Reminders and Schedules: Ensure timely internal audits and staff training sessions.

Compliance 52

Compliance Hospitals Fraud Regulatory Compliance 52

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 88

HIPAA Fraud Health Insurance Medicaid 88

MedTrainer

SEPTEMBER 20, 2023

Below are a variety of resource links to refer to for more information as you equip yourself with the knowledge needed to pass a survey. This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). CMS wants the industry and public to be fully informed.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

Verisys

NOVEMBER 8, 2023

Providers, employers, health plans, and payers use these numbers for billing purposes. CMS.gov The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the creation of a standard, unique health identifier for healthcare providers, which the NPI satisfies.

Fraud 97

Fraud HIPAA Medicare Medicare 97

HIPAA Journal

JULY 4, 2023

Murfreesboro Medical Clinic & SurgiCenter (MMC) in Tennessee has recently confirmed that the protected health information of more than half a million patients was compromised in what it describes as “a series of attacks on our network and IT systems,” which were discovered on or around April 24, 2023.

Medicaid 72

Medicaid Medicaid Health Insurance Licensing 72

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 113

Health Insurance Licensing Fraud HIPAA 113

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. With Medicaid, the challenges are equally formidable.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

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 98

Fraud Health Insurance Medicaid Medicaid 98

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

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 104

Health Insurance Licensing Ransomware Fraud 104

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 96

Licensing Health Insurance Fraud HIPAA 96

HIPAA Journal

APRIL 25, 2023

NationsBenefits learned of the attack on February 7, 2023, and was informed by Fortra that the attack occurred on or around January 30, 2023. The review of the account confirmed it contained protected health information, although the press release issued did not state what types of information had been exposed.

Health Insurance 81

Health Insurance Public Health Ransomware Fraud 81

HIPAA Journal

AUGUST 31, 2023

The investigation determined that the encrypted files included personal and protected health information related to certain individuals. It is also providing credit monitoring, fraud consultation, and identity theft restoration services for a year.

Medicare 52

Medicare Medicare HIPAA Medicaid 52

HIPAA Journal

NOVEMBER 15, 2022

A New York-based physician-owned provider of administrative services to anesthesiology firms is facing several class action lawsuits over a cyberattack and data breach that has affected at least 24 entities and involved the exposure and potential theft of the protected health information of more than 450,000 patients.

HIPAA 81

HIPAA Fraud Licensing Health Insurance 81

Compliancy Group

MARCH 19, 2024

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number). healthcare.

Regulatory Compliance 52

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

MedTrainer

JANUARY 30, 2024

Compliance is Mandatory for Federal Programs One constant is that organizations and facilities that participate in federal healthcare programs, such as Medicare and Medicaid, must have a compliance program. Laboratories: Clinical laboratories that perform tests covered by Medicare or Medicaid.

Governance 52

Governance Compliance Nursing Homes Medicaid 52

HIPAA Journal

MAY 25, 2022

Social Action Community Health System (SAC Health) has recently notified 149,940 patients that documents containing their protected health information were stolen in a break-in at an off-site storage location where patient records were stored. Notification letters were sent to those individuals on May 3, 2022.

Ransomware 124

Ransomware Fraud HIPAA Licensing 124

Medisys Compliance

JANUARY 30, 2023

HIPAA: The Health Insurance Portability and Accountability Act( HIPAA) is a federal law that establishes the national standards for protecting the privacy and security of individuals’ personal health information ( PHI). Let us discuss the top compliance issues in the medical billing industry, shall we?

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

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

MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. Compliance efforts expanded to encompass EHR security.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Kaiser Health News

NOVEMBER 11, 2021

Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or include their doctors. To use the new option, beneficiaries should contact their state’s health insurance assistance program at www.shiphelp.org/.

Medicare 144

Medicare Medicare Doctors Fraud 144

Compliancy Group

MARCH 8, 2023

How do people end up on the Medicaid Exclusion List, what are the consequences of being on the list, and can you ever get off the list? The Medicare Exclusion Database can trace its roots to 1996, when HIPAA (Health Insurance Portability and Accountability Act) was signed into law.

Medicare 52

Medicare Medicare Fraud HIPAA 52

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

Compliancy Group

SEPTEMBER 27, 2023

The widespread exploitation of this vulnerability has been well-documented, with organizations worldwide falling victim to threat actors who have gained unauthorized access to databases housing sensitive information. Although the vulnerability has since been addressed, the repercussions continue to unfold as breach notifications flood.

HIPAA 52

HIPAA Compliance Health Insurance Fraud 52

Verisys

FEBRUARY 23, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act safeguard patient privacy by restricting the sharing of healthcare information and requiring healthcare organizations to keep patient records safe. .

Compliance Officers 52

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

MedTrainer

JANUARY 26, 2024

Here are some common non-compliance activities: Failure to Maintain HIPAA Compliance: The Health Insurance Portability and Accountability Act (HIPAA) sets strict guidelines for safeguarding patient health information. This ensures that staff members are well-informed and equipped to avoid compliance pitfalls.

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

Florida Health Care Law Firm

JANUARY 20, 2022

The Agency for Health Care Administration (AHCA) in Florida was created by Chapter 20 of the Florida Statutes and serves as the primary health policy and planning institution for all of Florida. Florida’s Medicaid program is worth $25.2 Health plan enrollment, rates, contracts, and related information.

Nursing Homes 52

Nursing Homes Medicaid Medicaid Fraud 52

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

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

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. In the healthcare landscape, it’s crucial to have strict regulations and guidelines in place to ensure quality care, patient safety, and ethical conduct within the medical field.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52

AIHC

SEPTEMBER 5, 2023

Medicare covers many telebehavioral and telemental health services including audio-only services. Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

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. Healthcare data can be used to impersonate patients to obtain expensive medical services, Medicare and Medicaid benefits, healthcare devices, and prescription medications.

Ransomware 108

Ransomware HIPAA Health Insurance Hospitals 108

MedTrainer

OCTOBER 23, 2023

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.

Compliance 52

Compliance Compliance Officers Fraud Governance 52

Medisys Compliance

NOVEMBER 6, 2023

This checklist outlines the key steps to achieve and maintain compliance: Patient Information Accuracy Verify that the patient’s name, date of birth, address, insurance information, and other demographic data are accurate and complete. Accurate patient information is the foundation of proper billing.

Compliance 59

Compliance Medical Billing Outsourcing Medical Billing ACA 59

Verisys

FEBRUARY 14, 2024

This holistic approach to governance ensures that decisions are informed by a comprehensive understanding of the hospital’s overall performance and its implications for patient care. It is crucial for ensuring patient safety, safeguarding privacy, and enhancing the quality of care through informed decision-making.

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Compliancy Group

DECEMBER 8, 2023

With the digitalization of patient records and the use of electronic health systems, protecting sensitive information has become a significant challenge. Compliance with regulations, such as HIPAA (Health Insurance Portability and Accountability Act) , is critical in safeguarding patient privacy.

Compliance 52

Compliance Medicare Medicare Fraud 52

MedTrainer

OCTOBER 16, 2023

Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a pivotal regulation that focuses on the protection of patient health information, enforced by the U.S. Department of Health and Human Services (HHS). The statute protects patients and federal healthcare programs from fraud and abuse.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Medicaid 52