Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.

Licensing 52

Licensing Fraud Compliance Nurses 52

Provider Trust

JULY 8, 2022

A holistic approach to exclusion monitoring and license verifications must include monitoring of disciplinary databases such as the National Practitioner Data Bank (NPDB). Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S. Who Can Search the NPDB?

Licensing 52

Licensing Malpractice Fraud Compliance 52

Healthcare IT News - Telehealth

JANUARY 26, 2022

Healthcare IT News interviewed Griffin to take a closer look at what he will be presenting at the HIMSS22 conference. The evergreen concern about virtual care is that of fraud, waste and abuse and how to balance it with the demonstrated value of extended medical services to patients who are either geographically or economically underserved.

Fraud 148

Fraud Telemedicine COVID-19 Licensing 148

Healthcare Law Blog

MARCH 24, 2022

The Requestor’s enrollment specialist, under the guidance of a licensed clinical supervisor, determines the type of services and frequency of recovery coaching using an evidence-based, automated algorithm. Therefore, the OIG determined that the risk is low an entity would become a Customer to “generate business or reward referrals.”.

Fraud 96

Fraud Licensing 96

Provider Trust

SEPTEMBER 12, 2022

In 2006, New York’s Office of the Medicaid Inspector General (OMIG) was established as an independent office within New York State’s Department of Health to combat fraud and abuse in New York State’s Medicaid program. As far as the numbers go, you might wonder how complete the OMIG List of Restricted and Excluded Providers is.

Medicaid 52

Medicaid Medicaid Fraud Licensing 52

Healthcare IT News - Telehealth

JUNE 8, 2022

While it is important to carefully consider the most effective methods of providing care and the intended purpose behind various reimbursement, privacy, and fraud and abuse regulations, it is also clear that healthcare delivery has always and continues to evolve, and the regulatory framework needs to do the same. Federal rules.

US Department of Health and Human Services 181

US Department of Health and Human Services Compliance Overpayments Overpayment 181

HIPAA Journal

APRIL 15, 2022

A subset of individuals also had their Social Security numbers and/or driver’s license numbers exposed. SuperCare Health said unauthorized individuals had access to its network between July 23, 2021, to July 27, 2021, but did not disclose the nature of the cyberattack.

Electronic Medical Records 116

Electronic Medical Records HIPAA Health Insurance Fraud 116

MedTrainer

APRIL 22, 2024

While adherence to these guidelines is voluntary, organizations implementing effective compliance programs are better equipped to identify and address potential compliance risks, mitigate fraud and abuse, and uphold the integrity of healthcare programs and services. Ensure compliance with licensing agreements and software usage terms.

Compliance 52

Compliance HIPAA Licensing Fraud 52

Provider Trust

AUGUST 9, 2023

Grimm, the OIG continues its tireless efforts to uncover instances of fraud, waste, and abuse within HHS programs. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders. Led by acting Inspector General Christi A. What is the HHS-OIG Semiannual Report to Congress?

Nursing Homes 52

Nursing Homes COVID-19 Fraud Medicaid 52

Verisys

JUNE 8, 2023

However, this may present compliance challenges for organizations without established and scalable systems in place for screening, verifications, and continuous monitoring. Without technology automation, on average, it takes two to four months to complete the credentialing and enrollment for a newly hired licensed medical professional.

Compliance 52

Compliance Fraud Licensing Medicare 52

Healthcare Law Blog

JULY 5, 2022

The conference presenters grappled in real-time with the transitory nature of the healthcare landscape today, including the significant role that technology has played in driving shifts in care delivery. Antitrust and Labor Relations. Health Equity. Mental/Behavioral Health.

Fraud 52

Fraud Governance Ransomware Licensing 52

HIPAA Journal

OCTOBER 10, 2022

According to the breach notice, a presentation was emailed to the DHS Children’s Long-Term Support Council in April 2021 that contained protected health information. Steps were also taken to recover all distributed copies of the presentation.

Medicaid 57

Medicaid Medicaid Governance Fraud 57

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. Variety of Risks Present in Telehealth Arrangements. Provider Licenses.

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Healthcare Compliance Blog

APRIL 6, 2022

The defendant presented the facility staff with falsified documentation indicating that she had performed neurological evaluations throughout the evening. The nurse was sentenced to six months under house arrest and may not seek reinstatement of her license or work in a care facility/home during her five-year supervision period.

Nurses 59

Nurses Nursing Homes Fraud Licensing 59

Verisys

JANUARY 6, 2022

The OIG through the Social Security Act has the power to bar individuals and entities from receiving federal payments as the result of intentional fraud or abuse. The individual or entity may also request permission to present an oral argument and/or documentary evidence and written argument. Permissive Exclusions.

US Department of Health and Human Services 52

US Department of Health and Human Services Fraud Medicaid Medicaid 52

NY Health Law

JUNE 25, 2019

The Court of Appeals began its decision with a clear and broad statement that the practice of medicine by corporations controlled by non-physicians is prohibited: “Only licensed physicians may practice medicine in New York. Larger sums were transferred to Sher. v Mallela , 372 F3d 500, 503 (2d Cir.

Fraud 52

Fraud Licensing Governance Health Insurance 52

HIPAA Journal

NOVEMBER 17, 2022

Salud Family Health said affected employees and patients have been offered free credit monitoring and identity fraud protection services, and security policies and procedures are being reviewed and will be updated to protect against future cyberattacks. At present, it is unclear how many individuals have been affected.

Ransomware 82

Ransomware Health Insurance Hospitals Fraud 82

Hall Render

NOVEMBER 15, 2023

The medical history and physical examination must be completed and documented by a physician (as defined in section 1861(r) of the Act), an oral and maxillofacial surgeon, or other qualified licensed individual in accordance with State law and hospital policy. 42 CFR 482.22 (emphasis added).

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. But state Medicaid exclusion sources are varied and present significant challenges to manual screening processes.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare Law Blog

MAY 31, 2022

These advancements, present challenges and raise novel questions as to how the current healthcare and life sciences legal regime would apply to the metaverse. How healthcare providers are licensed in the metaverse is also an open question. Data Privacy and Security. Licensure and its enforcement can also occur at the state level.

FDA 90

FDA HIPAA Medicare Medicare 90

C&M Health Law

JUNE 15, 2021

bribery, fraud, misuse). Health Insurance Portability and Accountability Act (HIPAA) can present several areas of exposure. It is possible that businesses, both individually and across entire industrial sectors, may face considerable penalties and possibly even lose their “social license” to use data through a severe loss in trust.

Due Diligence 40

Due Diligence Licensing Informed Consent HIPAA 40

Health Law Advisor

MARCH 1, 2023

On February 14, 2023, the Utah Senate passed a bill that would repeal the State’s “Online Prescribing, Dispensing, and Facilitation Licensing Act” (“Online Prescribing Act”). 2] Statements of Charges may be found on the Washington State Department of Health website, filed under the individual provider’s name and/or license number.

Telemedicine 52

Telemedicine COVID-19 Fraud Licensing 52

AIHC

SEPTEMBER 5, 2023

The lack of multistate licensure presents a barrier to telehealth because providers must obtain and uphold licensure (and the associated medical education and financial obligations) in multiple states. This compact does not apply to nurse practitioners (NPs) because they are licensed under state boards of nursing and not medicine.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

Med-Net Compliance

NOVEMBER 1, 2022

South Carolina Attorney General Alan Wilson announced that his office’s Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old woman for allegedly practicing medicine as a registered nurse without a license at seven nursing and assisted living facilities in Anderson, Greenville, and Pickens counties. Update as necessary.

Nursing Homes 59

Nursing Homes Licensing Nurses Fraud 59

Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

Hall Render

JULY 28, 2023

million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.

US Department of Health and Human Services 40

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

Provider Trust

MAY 18, 2022

OIG may exclude the provider if certain circumstances regarding the ownership are present. This action was in addition to the 2018 settlement and sought these additional actions alleging that the clinics named in the complaint suffered significant gaps in licensing and supervision of therapists during the relevant time period.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

Bill of Health

SEPTEMBER 29, 2022

manufacturing information submitted to the FDA in a New Drug Application or Biologics License Application). Failure to comply with these disclosure rules is sanctionable and can result in a finding of fraud, inequitable conduct, or violation of the duty of disclosure, rendering a patent unenforceable. MPEP § 2016.

FDA 130

FDA Governance Fraud Licensing 130

Verisys

APRIL 27, 2023

If an application is missing key pieces, such as a scan through a primary source or a copy of their license, table the application. Start with quality data As a first step, pre-screening all applicants ensures that only viable applicants are presented to the credentials committee for review. With over 5.5

Malpractice 52

Malpractice Licensing Fraud Medicaid 52

Hall Render

DECEMBER 1, 2023

fraud scheme Nursing home must face vaccine-related wrongful firing claim, but not $2M retaliation accusations Transgender woman sues employer, Harvard Pilgrim for discrimination MICHIGAN 48-unit senior housing development could go up next to Vicksburg Halls in Marysville Can ads help a Michigan nursing home fix a staffing crisis?

Nursing Homes 40

Nursing Homes Nurses Ransomware COVID-19 40

New Jersey Healthcare Blog

JULY 22, 2022

771(a), the Department of Law and Public Safety, Division of Consumer Affairs, State Board of Pharmacy proposed new rules setting forth the requirements to allow a pharmacy to have licensed pharmacists and registered pharmacy technicians perform limited pharmaceutical functions at a location other than on the premises of a pharmacy.

COVID-19 Vaccine 40

COVID-19 Vaccine Licensing COVID-19 Public Health 40

Hall Render

MARCH 3, 2023

million for youth mental health care KENTUCKY Pike County nursing home officials release statement following loss of Medicare agreement Three Humana executives drop $11.2M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Verisys

JULY 13, 2023

Furthermore, speaker programs present serious optical and reputational risks since the speakers represent the pharmaceutical company. Typically, a pharmaceutical customer master group will verify a healthcare provider’s license and exclusion status. If approved, the pharmaceutical rep can provide samples to that healthcare provider.

Compliance 52

Compliance Due Diligence Pharmaceutical Industry Fraud 52

Healthcare Law Blog

MARCH 8, 2023

First, the Biologics License Application approval letter from the U.S. The rationale for providing medical flights as opposed to other forms of travel is due to the high-risk of infection that is present with all patients with the Condition.

FDA 52

FDA Doctors Medicaid Medicaid 52

Hall Render

FEBRUARY 18, 2022

License wait times reach crisis levels for healthcare workers. Florida physician convicted of $110M fraud. Lack of ICU doctors presents challenges for healthcare in Idaho. billing fraud. 3 Texas medical labs charged in $300M fraud scheme. Hospitals plead with Congress to tackle workforce shortages.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

APRIL 1, 2022

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. Fraud plagues California’s hospice industry, audit finds. over MassHealth fraud. NEW JERSEY.

COVID-19 40

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

Hall Render

MARCH 25, 2022

2 sentenced for $48M medical reimbursement account fraud scheme. lawmaker presents plan to improve women’s healthcare. Massachusetts Doctor Faces Health Care Fraud Charges. New York physician gets 4 years in prison for COVID-19 loan fraud. Nurses are frustrated by months-long delays to get licensed in some states.

COVID-19 40

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