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

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

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

MedTrainer

JANUARY 12, 2024

The protection of patient data, adherence to privacy regulations like the Health Insurance Portability and Accountability Act (HIPAA) in the United States, and the prevention of cyber threats have become paramount concerns. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care.

Compliance 52

Compliance HIPAA Telemedicine ACA 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

HIPAA Journal

MAY 25, 2022

SAC Health said it is unaware of any actual or attempted misuse of patient data as a result of the break-in; however, as a precaution against identity theft and fraud, affected individuals have been offered complimentary credit monitoring services. Notification letters were sent to those individuals on May 3, 2022.

Ransomware 124

Ransomware Fraud HIPAA Licensing 124

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. Significant fines also can be levied by the Office of Inspector General (OIG) for overbilling Medicare and Medicaid.

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

Compliancy Group

SEPTEMBER 27, 2023

While no reports of identity theft or fraud have emerged thus far related to this incident, affected individuals are urged to remain vigilant. HIPAA compliance can help protect against breaches, as HIPAA compliant organizations are generally more secure. Prevent HIPAA Breaches Don’t fall victim to breaches. Please Wait.

HIPAA 52

HIPAA Compliance Health Insurance Fraud 52

MedTrainer

FEBRUARY 12, 2024

Non-compliance can lead to significant fines, legal battles, and the loss of license or accreditation. For example, healthcare fraud or intentional non-compliance with regulations can lead to criminal charges. These actions can include fines, sanctions, or even revocation of licenses or certifications.

Compliance 52

Compliance Licensing Governance Fraud 52

AIHC

SEPTEMBER 5, 2023

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. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

Health Care Law Brief

JUNE 2, 2022

For example, New York continues to maintain a professional licensing waiver that enables certain providers, licensed out of state, to render care within the state, for the duration of the declared state of emergency. Provider Licenses. Does the state apply different standards, for example, to Medicaid encounters?

Public Health 52

Public Health Compliance COVID-19 Licensing 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. The statute protects patients and federal healthcare programs from fraud and abuse. For instance, HIPAA violations can cost up to $1.5

Compliance 52

Compliance US Department of Health and Human Services HIPAA Medicaid 52

HIPAA Journal

OCTOBER 10, 2022

The presentation contained the following types of information: first and last names, date of birth, gender, county location, Wisconsin Medicaid member ID number, and social security number of affected members of Wisconsin Medicaid.

Medicaid 55

Medicaid Medicaid Governance Fraud 55

Verisys

FEBRUARY 14, 2024

This includes clinical risks, financial risks, cybersecurity threats, and compliance risks with laws and regulations such as HIPAA (Health Insurance Portability and Accountability Act) in the United States. For instance, within the realm of healthcare compliance, HIPAA compliance plays a pivotal role.

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

HIPAA Journal

APRIL 25, 2023

No evidence of misuse of plan member data has been uncovered; however, as a precaution against identity theft and fraud, individuals whose Social Security numbers were exposed have been offered complimentary credit monitoring services.

Health Insurance 81

Health Insurance Public Health Ransomware Fraud 81

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

HIPAA Journal

OCTOBER 14, 2022

Data compiled by HIPAA Journal from breach reports submitted to the HHS’ Office for Civil Rights (OCR) show the number of data breaches reported by HIPAA-regulated entities continues to increase every year. Editor-in-Chief, HIPAA Journal. Medical records are highly prized, but why are medical records so valuable to criminals?

Ransomware 108

Ransomware HIPAA Health Insurance Hospitals 108

YouCompli

DECEMBER 19, 2023

Exclusions (page 26) : OIG recommends that any entity participating in the federal Medicaid program should check the state Medicaid program exclusion list for each applicable state. Regarding exclusions, an individual or entity or an employee with an invalid license can have a significant negative impact on a small entity.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

Healthcare Law Blog

MAY 31, 2022

However, traditional healthcare players, subject to the Health Insurance Portability and Accountability Act (“HIPAA”), may also find themselves innovating in this space (and grappling with how to stand up a HIPAA compliance program in the metaverse). How healthcare providers are licensed in the metaverse is also an open question.

FDA 90

FDA HIPAA Medicare Medicare 90

YouCompli

NOVEMBER 29, 2023

Exclusions (page 26) : OIG recommends that any entity participating in Medicaid should check the state Medicaid program exclusion list for each applicable state. Regarding exclusions, an individual or entity or an employee with an invalid license can have a significant negative impact on a small entity.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

HIPAA Journal

JULY 24, 2023

The team’s roles are to investigate and audit the Department’s operations to prevent fraud, waste, and abuse within the Department, and also to audit and investigate potential crimes against the Department. In addition to HHS OIG enforcement actions, Medicare Fraud Control Units (MFCUs) operate in every state and territory.

Fraud 52

Fraud Medicare Medicare Medicaid 52

Verisys

NOVEMBER 13, 2022

Compliance procedures and training programs define and monitor numerous areas for adherence to laws and regulations including patient care, physician license verification, billing, reimbursement, HIPAA privacy, and security. Felony convictions for other healthcare-related fraud, theft, or other financial misconduct.

Fraud 52

Fraud Compliance Medicaid Medicaid 52

Verisys

FEBRUARY 1, 2022

CMS.gov’s Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 ( HIPAA ) mandated the adoption of a standard, unique health identifier for each healthcare provider. The NPI fulfills this provision. Why Are NPI Numbers Necessary? Providers also need an NPI prior to enrolling in Medicare.

Fraud 52

Fraud Medicare Medicare HIPAA 52

Hall Render

JUNE 30, 2023

for physician referral scheme In Los Angeles, hospital CEO pay could be capped Kaiser Permanente ratings affirmed amid healthy financial profile Nurses vote ‘no confidence’ in California hospital administration, board Nursing facility, management company settle physician kickback allegations for $3.8M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

NOVEMBER 4, 2022

HHS releases video on documenting recognized HIPAA security practices. Governor Hutchinson Announces Expansion To Rural Health Services With ARHOME Medicaid Program. California physician charged with $53M mail fraud and money laundering scheme. Hospitals in Mississippi risk closure, and state officials debate Medicaid expansion.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nurses Nursing Homes 40

MedTrainer

AUGUST 2, 2023

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. Primary source verification is done by contacting educational institutions, licensing boards, and other relevant authorities.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Hall Render

JULY 22, 2022

cancer, cardio lab fraud. Eric Holder’s wife accused of major HIPAA ‘breach’ by her former women’s health practice. Delaware Adds Centene Plan to Medicaid Managed Care Offerings. Key advocates reflect on Hawaii postpartum Medicaid coverage extension. HHS orders additional 2.5

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

DECEMBER 22, 2023

fraud scheme UConn Health is in financial trouble. fraud scheme UConn Health is in financial trouble. health care spending hits $4.5 health care spending hits $4.5 health care spending hits $4.5

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

AUGUST 4, 2023

Will Nemours’ Medicaid move leave 10,000 special-needs kids behind? to settle Medicare fraud claims Maine in top 10 for health care, No. 1 CMS final rule boosts Medicare hospice payments by 3.1% To Address SDOH Needs U.S. sues UnitedHealth over ‘thousands’ of denied claims What’s a fair price for a prescription drug?

COVID-19 40

COVID-19 Hospitals Nursing Homes Nurses 40

Hall Render

SEPTEMBER 23, 2022

Senators Seek HHS Update to HIPAA, FBI Warns About Legacy Devices. Aspen U surrenders nursing program license. Aspen University in Phoenix surrenders nursing program license, failing to meet NCLEX first-time pass rate. A federal judge schedules a hearing on Florida’s Medicaid transgender rule. Akorn to pay $7.9

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

FEBRUARY 18, 2022

License wait times reach crisis levels for healthcare workers. Senators look to address privacy, new technology in renewed push to modernize HIPAA. Colorado mental health professionals incensed after Medicaid forum that was intended to clear the air. Florida physician convicted of $110M fraud. billing fraud.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

APRIL 15, 2022

HHS Seeks Input on Critical HIPAA Enforcement Considerations. Huntsville Doctor Charged with Health Care Fraud Conspiracy. Florida’s BayCare Health System and Hospital Affiliates Agree to Pay $20 Million to Settle False Claims Act Allegations Relating to Impermissible Medicaid Donations. to settle fraud, kickback charges.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

JANUARY 19, 2024

Francis emergency room KENTUCKY Apollo’s 220-hospital ‘stranglehold’ harms patients and workers, report alleges Humana cuts ‘small’ number of jobs in multiple locations LMU School of Nursing will open Lexington site at CHI Saint Joseph Health Mercy Health announces acquisition of orthopedic center in Paducah, Ky.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

OCTOBER 27, 2023

Million Health Care Fraud Conspiracy in Idaho Orthopedic activity in the 5 most underserved states St. Million Health Care Fraud Conspiracy in Idaho Orthopedic activity in the 5 most underserved states St. Here’s why Grady Health System recognized as health care I.T. Here’s why Grady Health System recognized as health care I.T.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Hall Render

APRIL 1, 2022

OCR Announces Four HIPAA Enforcement Actions. Arizona extends temporary licenses for healthcare workers. Governor Ducey Signs Bill Extending Temporary Health Care Professional Licenses. Ducey signs bill extending temporary health care worker licenses in Arizona. over MassHealth fraud. for VA EHR project.

COVID-19 40

COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

APRIL 14, 2023

But hospitals say they can’t afford to pay California hospital nurses to receive raises of up to 30% California pharmacist pleads guilty to multi-year Medicare fraud scheme Carmichael-based Eskaton pays $5.5

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses COVID-19 40

Hall Render

FEBRUARY 24, 2023

Dunleavy adds $9M to budget to address food stamp, Medicaid backlog New study provides snapshot of increase in maternal deaths in Alaska Mental Health Trust Grants $1.6M Dunleavy adds $9M to budget to address food stamp, Medicaid backlog New study provides snapshot of increase in maternal deaths in Alaska Mental Health Trust Grants $1.6M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40