MedTrainer

JANUARY 12, 2024

Healthcare facilities, from hospitals and clinics to insurance providers, are deeply affected by the regulations set forth by the Health Insurance Portability and Accountability Act (HIPAA). How does HIPAA compliance affect healthcare facilities? What is Healthcare Compliance?

HIPAA 52

HIPAA Compliance Health Insurance Hospitals 52

HIPAA Journal

FEBRUARY 8, 2024

Department of Health & Human Services Office of Inspector General (HHS-OIG) has published a Roadmap for New Physicians on avoiding Medicare and Medicaid fraud and abuse. The post Advice for New Physicians on Avoiding Medicare and Medicaid Fraud and Abuse appeared first on HIPAA Journal.

Fraud 40

Fraud Medicaid Medicaid Medicare 40

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. Five state Medicaid programs, two Medicare Administrative Contractors, and two private health insurers were tricked into changing the bank account details for payments. Medicare, Medicaid, and private health insurers suffered losses of more than $4.7

Medicaid 75

Medicaid Medicaid Medicare Medicare 75

HIPAA Journal

APRIL 29, 2024

Berry, Dunn, McNeil & Parker, LLC (BerryDunn) provides health data analytics services to healthcare providers, health insurers, and government regulatory and healthcare policy agencies and its clients provide BerryDunn with personal and health data to allow the firm to perform its contracted services.

Health Insurance 91

Health Insurance Health Analytics HIPAA Medicaid 91

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S.

Ransomware 59

Ransomware Governance Compliance HIPAA 59

HealthIT Answers

DECEMBER 21, 2022

By Art Gross - A security risk assessment must be conducted to maintain HIPAA compliance per the Security Rule. It is a requirement for government plans such as Medicare, Obamacare, and Medicaid. A security risk assessment is also referred to as an SRA. The post End of Year SRA appeared first on Health IT Answers.

HIPAA 52

HIPAA Medicaid Medicaid Compliance 52

HealthIT Answers

OCTOBER 20, 2022

By Art Gross - The HIPAA Security Rule mandates that covered entities must conduct a security risk assessment or SRA. This includes health care plans for individuals, government plans (Medicare, Medicaid, Obamacare), and employer-sponsored plans. The post Security Risk Assessment appeared first on Health IT Answers.

HIPAA 52

HIPAA Medicaid Medicaid Medicare 52

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S.

Ransomware 52

Ransomware Governance Compliance HIPAA 52

HIPAA Journal

MARCH 15, 2023

The United States Department of Justice has agreed to settle alleged False Claims Act violations with Jelly Bean Communications Design LLC and manager Jeremy Spinks related to the failure to protect HIPAA-covered data. FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida.

Health Insurance 72

Health Insurance HIPAA Due Diligence Fraud 72

HIPAA Journal

JUNE 9, 2023

Prior to the Supreme Court ruling, there was no distinction between an identity thief stealing an individual’s identity and running up huge debts, a lawyer rounding up bills and only charging full hours, a waitress overcharging customers, and a doctor overbilling Medicaid. The Supreme Court decision related to the latter.

Fraud 95

Fraud Medicaid Medicaid Doctors 95

American Medical Compliance

MARCH 15, 2024

Furthermore, it prohibits knowingly submitting false or false claims to Medicare, Medicaid, or other federally funded healthcare programs. HIPAA regulations govern the use, disclosure, and safeguarding of protected health information (PHI) by covered entities and their business associates.

Compliance 105

Compliance Fraud HIPAA Health Insurance 105

Verisys

FEBRUARY 14, 2024

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is healthcare data governance? What is GRC in Healthcare?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

HIPAA Journal

NOVEMBER 4, 2022

Warner suggests the only way to improve healthcare cybersecurity rapidly is through a collaborative effort involving the public and private sectors, with the federal government providing overall leadership. Modernize HIPAA. Develop a Healthcare-Specific Cybersecurity Framework.

HIPAA 114

HIPAA Governance FDA Medicaid 114

AIHC

APRIL 10, 2024

HITECH is a critical aspect of the Health Insurance Portability & Accountability Act (HIPAA). Since 2009, HITECH has given “teeth” to HIPAA law. What’s the difference between HIPAA and HITECH? HIPAA guarantees patients access to their paper medical records. Understanding HIPAA is crucial.

Compliance 99

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

HIPAA Journal

JANUARY 11, 2024

One of the first tasks undertaken by the newly created OIG in healthcare was to establish the OIG HHS Exclusions List as required by the Medicare-Medicaid Anti-Fraud and Abuse Amendments 1977. An example of this is the investigation into OCR’s governance of cybersecurity threats. appeared first on HIPAA Journal.

Fraud 84

Fraud HIPAA Compliance Medicare 84

Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. Violations of the False Claims Act can result in significant financial penalties, including fines and exclusion from government healthcare programs.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

Medisys Compliance

FEBRUARY 27, 2024

Understanding Regulatory Framework Radiology billing is governed by a multitude of regulations at the federal, state, and local levels. Radiology practices must stay updated on these regulations to ensure compliance. Our expert team ensures accuracy and adherence to regulations, optimizing revenue for radiology practices.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

MedTrainer

OCTOBER 4, 2023

Federal healthcare compliance requirements encompass a set of regulations and laws established by various government agencies to ensure certain standards for the healthcare industry at the national level. CMS plays a crucial role in overseeing federal healthcare programs, including Medicare and Medicaid. Office for Civil Rights (OCR).

Compliance 52

Compliance Fraud HIPAA Governance 52

MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. What is Healthcare Compliance?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

MedTrainer

NOVEMBER 14, 2023

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Exclusion from Government Programs: Entities found non-compliant may be barred from participating in government healthcare programs like Medicare and Medicaid. What Is Healthcare Compliance?

Compliance 52

Compliance HIPAA Governance Medicare 52

Healthcare IT News - Telehealth

JANUARY 23, 2023

We spoke with the HIMSS government relations team for their thoughts on those priorities and more in 2023 and beyond. HIMSS has also aggressively supported the Connect for Health Act , and a bill that's expected to be reintroduced this year, said Amanda Krzepicki, government relations manager at HIMSS.

Medicare 156

Medicare Medicare Governance Medicaid 156

Total Medical ComplianceHIPAA

NOVEMBER 13, 2023

HIPAA: Who can be fined under the Information Blocking Rule and what are the Office of Inspector General’s (OIG) priorities? Only certain entities are currently subject to an OIG information blocking penalty.

HIPAA 52

HIPAA Medicaid Medicaid Medicare 52

AIHC

NOVEMBER 6, 2023

The focus of this article is to “connect the dots” between Health Insurance Portability & Accountability Act (HIPAA) and HITECH regarding privacy and security of electronically protected health information (ePHI). HITECH puts a “bite” into specific elements of the HIPAA rule, such as higher penalty amounts for non-compliance.

HIPAA 59

HIPAA Compliance Governance Health Insurance 59

HIPAA Journal

MARCH 6, 2023

Cedar Park, TX-based Dental Health Management Solutions (DHMS), a provider of dental services to the government/military and private patients has recently announced – via its legal counsel – that the protected health information of certain patients was exposed in a 2021 hacking incident.

Electronic Medical Records 74

Electronic Medical Records HIPAA Licensing Nurses 74

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. Involves ensuring adherence to laws and regulations specific to the healthcare industry.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

MedTrainer

APRIL 11, 2024

They are responsible for developing policies that govern the employment relationship between the organization and its employees. They develop and implement compliance programs that include policies, practices, and procedures to ensure all departmental operations align with federal and state laws.

Compliance Officers 52

Compliance Officers Compliance Medicaid Medicaid 52

Hall Render

AUGUST 8, 2022

The web server contained ePHI, including patients’ names, Medicaid numbers, health care provider names, dates of service, dates of birth, addresses and treatment information. Further, data governance is key to proactively managing ePHI. This breach occurred when a hacker gained access to a web server by uploading malware.

HIPAA 73

HIPAA Governance Medicaid Medicaid 73

Health Care Law Brief

JUNE 5, 2023

In 2013, Jelly Bean contracted with the Florida Health Kids Corporation (“ FHKC ”)—a state-created entity that offers health and dental insurance for Florida children—to create, host, and maintain HealthyKids.org, where, in part, parents and others could apply for state Medicaid insurance coverage for eligible children.

Fraud 52

Fraud Due Diligence Medicaid Medicaid 52

MedTrainer

JUNE 28, 2023

The primary goal of a Certified Fraud Examiner in healthcare is to safeguard the integrity of healthcare systems and protect patients, insurance providers, and government programs from financial losses due to fraudulent activities. Typically, that means looking at the five main Federal laws governing healthcare fraud : False Claims Act (FCA).

Fraud 52

Fraud Compliance Governance Compliance Officers 52

AIHC

NOVEMBER 6, 2023

The focus of this article is to “connect the dots” between Health Insurance Portability & Accountability Act (HIPAA) and HITECH regarding privacy and security of electronically protected health information (ePHI). HITECH puts a “bite” into specific elements of the HIPAA rule, such as higher penalty amounts for non-compliance.

HIPAA 52

HIPAA Compliance Governance Health Insurance 52

MedTrainer

SEPTEMBER 8, 2023

Advocate Health Care HIPAA Breach (2016) In August 2016, Advocate Health Care Network —one of the largest healthcare systems in Illinois—agreed to settle potential violations of Privacy and Security Rules for $5.55 This settlement was the largest HIPAA settlement at that time. Loss of reimbursements. License revocation or suspension.

Compliance 52

Compliance HIPAA Medicaid Medicaid 52

AIHC

APRIL 10, 2024

HITECH is a critical aspect of the Health Insurance Portability & Accountability Act (HIPAA). Since 2009, HITECH has given “teeth” to HIPAA law. What’s the difference between HIPAA and HITECH? HIPAA guarantees patients access to their paper medical records. Understanding HIPAA is crucial.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

MedTrainer

JANUARY 26, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Significant fines also can be levied by the Office of Inspector General (OIG) for overbilling Medicare and Medicaid. What is Healthcare Compliance?

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

HIPAA Journal

DECEMBER 8, 2022

However, they need support from the federal government as the field continues to face targets from sophisticated cyber adversaries and nation-states.”. Greater support is required from the federal government for victims of cyberattacks. Modernize HIPAA to better address healthcare cybersecurity.

HIPAA 104

HIPAA FDA Governance Hospitals 104

HIPAA Journal

SEPTEMBER 29, 2022

The Government Accountability Office (GAO) recently conducted a review of Medicare telehealth services provided during the COVID-19 pandemic, when a waiver was in place that greatly expanded access to telehealth and virtual visits. Between April and December 2019, 5 million Medicare telehealth visits were conducted.

Medicare 70

Medicare Medicare COVID-19 HIPAA 70

MedTrainer

FEBRUARY 1, 2024

Ensure Legal and Regulatory Compliance: This helps healthcare facilities stay in compliance with federal, state, and accreditation regulations, including laws like the Health Insurance Portability and Accountability Act (HIPAA). Risk Management: Identify and mitigate legal, financial, and reputational risks.

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 52

MedTrainer

NOVEMBER 2, 2023

Health Insurance Portability and Accountability Act (HIPAA) HIPAA ensures the privacy of patient health information. Having intimate knowledge of HIPAA laws, rules, and consequences for non-compliance aid healthcare compliance officers in keeping their staff and organization compliant.

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52