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Michigan Registered Nurse Pleads Guilty in COVID-19 Vaccination Record Card Fraud

Med-Net Compliance

A registered nurse from a veteran’s hospital in Detroit pleaded guilty to charges related to COVID-19 vaccination record cards fraud. Issue: Legitimate vaccination cards are being stolen from healthcare facilities and then used in a fraudulent manner. Participating in the fraud can result in the person(s) being prosecuted.

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Significant Upcoding Risks Emerge with Medicare Advantage

YouCompli

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

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Oklahoma Hospital Pays over $1.1 Million to Settle False Claims Act Allegations

Healthcare Compliance Blog

An acute care hospital in Oklahoma has paid over $1.1 million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. Throughout the investigation, the hospital cooperated with the above entities. The hospital agreed to pay the United States $1,151,770.50 to resolve the claims.

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Health Provider News

Hall Render

NATIONAL 5 numbers on the rise of Stark law violations 3 takeaways on the new federal data privacy proposal after its first public showcase 80% of Change Healthcare restored after cyberattack Authentication failure blamed for Change Healthcare ransomware attack Biden administration issues new rule to protect privacy of those seeking reproductive health (..)

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Improving Patient Care With a “Prevent, Detect, Report” Strategy  

YouCompli

Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic.

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Sanctions and penalties for hiring excluded individuals in healthcare 

YouCompli

Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.

Fraud 52
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Importance of Regulatory Compliance in Healthcare

Compliancy Group

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.