Healthcare IT Today

JANUARY 19, 2021

The Federal Trade Commission (FTC) announced a consumer fraud settlement against a company that displayed a ‘HIPAA Compliant’ seal on its website.

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Healthcare IT News - Telehealth

JANUARY 27, 2021

Department of Justice announced Monday that four people and one company have recently pleaded guilty in a telemedicine pharmacy healthcare-fraud conspiracy that allegedly lasted for years. "Telemarketing fraud is a major threat to the integrity of government and commercial insurance programs," said Derrick L. ON THE RECORD.

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Total Medical Compliance Resources

MAY 11, 2023

trillion is spent on healthcare in the United States, of which an estimated $60 billion is attributable to fraud and abuse. In order to combat this, HIPAA established the Healthcare Fraud and Abuse Control Program (HCFAC). Criminal Health Care Fraud Statute – 18 U.S.C. Every year a minimum of $4.3

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American Medical Compliance

MARCH 13, 2023

The United States Department of Justice charged 36 defendants for healthcare fraud that amounted to over $1 Billion. Healthcare organizations must take all possible steps to prevent instances of fraud. Employees should receive training that educates them on how to identify, report, and combat fraud, waste, and abuse in the workplace.

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Verisys

MARCH 23, 2023

3 Healthcare Fraud and Abuse Laws Providers Should Know About In 2021, the Department of Justice reported recovering over $5.5 billion from settlements due to fraud and false claims. As a healthcare provider, being familiar with healthcare fraud and abuse laws is important. government or a government contractor.

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Med-Net Compliance

JULY 11, 2022

The report says that in FY 2021 the DOJ opened 831 new criminal healthcare fraud investigations. Federal prosecutors filed criminal charges in 462 cases involving 741 defendants, and a total of 312 defendants were convicted of healthcare fraud related crimes during the year. 2,947 investigations were pending at the end of FY 2021.

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American Medical Compliance

MAY 22, 2023

million to settle allegations that it paid kickbacks to healthcare providers committing fraud violations. US Efforts to Crack Down on Fraud Violations Kickbacks are illegal under the False Claims Act because they can lead to overuse or misuse of medical products, harming patients and increasing healthcare costs. DePuy Synthes, Inc.

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AIHC

SEPTEMBER 21, 2023

Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS This article addresses the Information Blocking Final Rule regarding enforcement, associated Civil Monetary Penalties (CMPs) and entities subject to these penalties. Information blocking is defined in § 171.103.

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Hall Render

NOVEMBER 21, 2023

The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. This category of individuals is sometimes called a “fraud alert employee.” Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C.

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Med-Net Compliance

JUNE 22, 2022

A registered nurse from a veteran’s hospital in Detroit pleaded guilty to charges related to COVID-19 vaccination record cards fraud. Employees and applicants of healthcare facilities must provide truthful information regarding their vaccination status and understand the penalties for engaging in fraud.

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Med-Net Compliance

NOVEMBER 2, 2022

Massachusetts Attorney General Maura Healey announced that her office’s Medicaid Fraud Division recovered more than $71 million during the most recent federal fiscal year, which ended on September 30. The AG’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state’s Medicaid program, MassHealth.

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Med Law Blog

JULY 21, 2022

The US Office of Inspector General (OIG) released another in a series of Special Fraud Alerts on July 20, 2022, this one directed to potentially fraudulent telehealth, telemedicine, and telemarketing service fraud schemes, collectively referred to as “Telemedicine Companies”.

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Med-Net Compliance

OCTOBER 27, 2022

The psychologist was convicted of four counts of healthcare fraud. The FBI and HHS-OIG investigated the case, which was brought as part of the Chicago Strike Force, supervised by the Criminal Division’s Fraud Section and the US Attorney’s Office for the Northern District of Illinois.

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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. The breach was detected on October 22, 2021.

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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.

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Compliancy Group

AUGUST 31, 2022

Department of Justice’s (DOJ) Civil Cyber Fraud Initiative (CCFI). Details of DOJ Cyber Fraud Initiative Settlements. Even after staff raised concerns about the privacy of protected medical information, CHS did not take adequate steps to store the data exclusively on the EMR system.

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Healthcare Compliance Blog

JANUARY 25, 2022

A Missouri woman who had previously pled guilty to Medicare and Medicaid fraud was sentenced in Federal Court to three years imprisonment and ordered to pay $7,620,779 in restitution. Discussion Points: Review your policy and procedure for preventing and reporting false claims, kickbacks, or other fraud, waste, and abuse violations.

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American Medical Compliance

FEBRUARY 15, 2023

The Dental Healthcare Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Trust is core to the provider-patient relationship.

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HIPAA Journal

MARCH 16, 2022

This is the first settlement to be reached under the DOJ Civil Cyber Fraud Initiative, which was launched in 2021. Some staff members expressed concern about the insecure storage of private medical information, but CHS took no action to address the issue and failed to ensure medical records were only stored in the EMR system.

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Med-Net Compliance

JUNE 13, 2022

Three independent clinical laboratories, their owner and holding company, an additional independent clinical laboratory and its owner, two laboratory marketing companies, and a Massachusetts physician have been charged in connection with Medicaid fraud, money laundering, and kickbacks involving urine drug tests?that

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Med-Net Compliance

JULY 20, 2022

He was convicted of one count of healthcare fraud and one count of making a false claim. Healthcare providers, suppliers, or other individuals or entities subject to Civil Monetary Penalties can use the OIG’s Provider Self-Disclosure Protocol to voluntarily disclose self-discovered evidence of potential fraud.

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Healthcare Compliance Blog

JANUARY 10, 2022

A South Carolina man has been arrested for financial transaction card fraud and exploitation of a vulnerable adult who was a resident of a nursing home. Due to his past criminal record, he also faces enhancement to the financial transaction card fraud charge. Encourage residents not to give credit cards or banking information to staff.

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Healthcare Compliance Blog

APRIL 29, 2022

in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. In March 2020 she pleaded guilty to one count of healthcare fraud, one count of wire fraud, and one count of theft of government funds. The money judgment represents the proceeds that she obtained as part of her scheme.

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HIT Consultant

DECEMBER 10, 2021

What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. For more information, download the full report here. Report Background.

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Florida Health Care Law Firm

APRIL 18, 2022

Fraud in these cases is generally easy to prove. Simply verifying inventory, orders and dispensing records yields incredible data that when combined with comparative data from peer pharmacies can be used by law enforcement to establish that fraud has been committed. So what information did the DOJ have at its disposal in this case?

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Health Law Advisor

MARCH 31, 2022

Department of Justice (DOJ) intend to leverage its enforcement authority under the False Claims Act to advance DOJ’s recently announced Civil Cyber-Fraud Initiative? For more information, read our recent article: “DOJ’s Civil Cyber-Fraud Initiative: What Contractors Need to Know About Novel Use of False Claims Act”.

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Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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Med-Net Compliance

JULY 7, 2022

A federal district judge in Miami sentenced the last of five defendants for his role in a healthcare fraud scheme operated out of a physical therapy clinic. According to evidence introduced in court, the billing fraud conspiracy resulted in more than $8 million in false claims being submitted to BCBS.

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Healthcare Compliance Blog

FEBRUARY 22, 2022

Two women, one from Colorado and the other from Houston, have been sentenced in federal court for their roles a multi-million dollar Medicare Fraud Scheme. Each woman pled guilty to one count of conspiracy to commit healthcare fraud. The post Two Women Sentenced for Conspiracy to Commit Healthcare Fraud appeared first on.

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American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Fraud schemes range from solo ventures to widespread activities of an institution or group.

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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.

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Med-Net Compliance

AUGUST 25, 2022

A Texas physician and his employee were charged for their roles in a healthcare fraud scheme involving the submission of more than $3.5 The physician allegedly paid kickbacks to various adult day care companies to gain Medicare beneficiary information under the guise of providing medical services. million in claims to Medicare.

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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. The breach was detected on October 22, 2021.

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Med-Net Compliance

JUNE 15, 2022

informational technology consultant. Division of Medi-Cal Fraud and Elder Abuse (DMFEA) and the US Attorney’s Office for the Eastern District of California intervened in the? The investigation culminated in the doctor pleading guilty to one count of federal healthcare fraud, and on May 2, 2022, he was sentenced to a?prison

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Florida Health Care Law Firm

DECEMBER 7, 2021

Telemedicine pharmacy arrangements continue to be of significant interest to fraud enforcement. The federal jury trial in the billion-dollar telehealth pharmacy fraud scheme resulted in conviction on 22 counts of mail fraud, conspiracy to commit health care fraud and introduction of misbranded drugs into interstate commerce.

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Natalia Mazina

JUNE 28, 2022

The callers requested and obtained each pharmacy’s DEA number and account purchasing information for their principal distributor. scammers may pose as a manufacturer, informing the pharmacy that certain products must be replaced and a credit will be issued through the original wholesaler. I thought that this was a stand-alone incident.

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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.

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