HIPAA Journal

AUGUST 10, 2023

Four more entities have confirmed they were affected by the mass hacks of the MOVEit Transfer file transfer solution and had protected health information stolen. It is currently unclear exactly how many Medicaid recipients were affected. The incident occurred at a third-party claims processor, TMG Health.

Medicaid 52

Medicaid Medicaid Health Insurance HIPAA 52

Kaiser Permanente

JANUARY 1, 2022

Medicaid and the Children’s Health Insurance Program (CHIP) have served as critical supports to children, pregnant women, parents, seniors, and individuals with disabilities – covering 80 million individuals during the COVID-19 pandemic. Since February 2020, Medicaid enrollment has grown sharply to cover an additional 9.9

Medicaid 92

Medicaid Medicaid Medicare Medicare 92

HIPAA Journal

MARCH 16, 2023

Florida Medical Clinic, NorthStar Emergency Medical Services, Denver Public Schools, Wichita Urology Group, and The Bone & Joint Clinic have recently reported hacking incidents and the exposure and potential theft of protected health information. 95% of the compromised files only included an individual’s name.

Electronic Medical Records 67

Electronic Medical Records Health Insurance Ransomware HIPAA 67

Healthcare Law Blog

JANUARY 20, 2023

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] Please refer to our prior blog for more information on CalAIM.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

APRIL 29, 2024

A Portland, ME-based accounting and consulting firm has recently reported a data breach to the Maine Attorney General that involved the personal information of 1,107,354 individuals. A vendor was engaged to conduct a review of the affected files, and that process was completed on April 2, 2024.

Health Insurance 94

Health Insurance Health Analytics HIPAA Medicaid 94

Bill of Health

JANUARY 23, 2024

Medicaid pays for more than 40% of births in the U.S., Examining efforts at the federal and state level, I highlight three options, leveraging Medicaid as a policy lever. In the past, when individuals were Medicaid-eligible due to pregnancy, federal law required states to provide coverage for at least 60 days postpartum.

Medicaid 111

Medicaid Medicaid Patient Satisfaction Health Insurance 111

Health Care Law Brief

FEBRUARY 2, 2024

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

FEBRUARY 26, 2023

Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job. Proposed fixes include improved health insurance literacy – which could help could help 3.8

Medicaid 99

Medicaid Medicaid FDA Health Insurance 99

HIPAA Journal

AUGUST 14, 2023

The information security firm Kon Briefing has been tracking the incidents and reports that at least 670 organizations fell victim to the attacks and more than 41 million records are now confirmed as having been compromised. Maximus handles the department’s communications with Medicaid recipients.

Medicaid 73

Medicaid Medicaid HIPAA Health Insurance 73

HIPAA Journal

AUGUST 14, 2023

The Colorado Department of Health Care Policy and Financing (HCPF), which oversees the state’s Medicaid program and the Child Health Plan Plus (CHP+) program, has recently confirmed that the protected health information of 4,091,794 individuals was compromised. HCPF said its own systems were not affected.

Medicaid 71

Medicaid Medicaid HIPAA Health Insurance 71

MRO Compliance

NOVEMBER 13, 2023

Morrell brings with her more than 25 years of government affairs experience covering both state and federal rulemaking tied to Medicare, Medicaid, commercial insurance and health IT. Morrell spent over a decade at Health Net, Inc. For more information, visit www.mrocorp.com. . – November 13 , 2023 – MRO Corp.,

Governance 129

Governance Health Insurance Medicaid Medicaid 129

HIT Consultant

MARCH 8, 2022

The steep incline in unemployment and fears that millions of people would lose their health coverage drove the declaration of the national public health emergency (PHE) on January 31, 2020. Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. .

Public Health 98

Public Health Medicaid Medicaid Health Insurance 98

Kaiser Health News

APRIL 16, 2024

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

ACA 131

ACA Health Insurance Governance Medical Billing 131

Bill of Health

DECEMBER 6, 2023

By Hannah Rahim Many mental health provider directories for private and public insurance plans contain inaccurate or outdated provider information , which creates a misleading illusion of accessible care. These ghost networks result in many patients being unable to access essential mental health care.

Governance 144

Governance Medicaid Medicaid Medicare 144

HIPAA Journal

JULY 4, 2023

Murfreesboro Medical Clinic & SurgiCenter (MMC) in Tennessee has recently confirmed that the protected health information of more than half a million patients was compromised in what it describes as “a series of attacks on our network and IT systems,” which were discovered on or around April 24, 2023.

Medicaid 70

Medicaid Medicaid Health Insurance Licensing 70

C&M Health Law

JANUARY 18, 2023

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

Medicaid 52

Medicaid Medicaid Health Outcomes Federal Policy 52

HIPAA Journal

JUNE 16, 2023

EpiSource Confirms Breach of its AWS Environment The Gardena, CA-based medical coding vendor, EpiSource, has confirmed that the protected health information of patients of its healthcare clients has been exposed and potentially compromised in a February 2023 cyberattack on its Amazon Web Services (AWS) environment.

Medicaid 79

Medicaid Medicaid HIPAA Health Insurance 79

MedTrainer

SEPTEMBER 20, 2023

Below are a variety of resource links to refer to for more information as you equip yourself with the knowledge needed to pass a survey. This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). CMS wants the industry and public to be fully informed.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

HIT Consultant

JULY 17, 2023

Cessation of PHE telehealth, prescribing, and mental health access exceptions could impact the Medicaid population the most. Twenty-one percent of Medicaid enrollees have mild, moderate, or severe SUD, compared to 16% of commercially insured individuals. And as of the latest data, 7.3% And as of the latest data, 7.3%

Public Health 98

Public Health Medicaid Medicaid Electronic Medical Records 98

Healthcare It News

JUNE 3, 2022

Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents.

Public Health 267

Public Health Health Insurance Professionals ACA Medicaid 267

HIPAA Journal

OCTOBER 7, 2022

Anthem has confirmed that the protected health information of certain plan members has been compromised in a data breach at its vendor, Choice Health. Choice Health was provided with the data of plan members to perform its contracted duties. CareOregon Reports August 2022 Mailing Error.

HIPAA 97

HIPAA Health Insurance Medicaid Medicaid 97

HIPAA Journal

MARCH 15, 2023

Independent Living Systems, LLC (ILS), a Miami, FL-based provider of third-party administrative services to managed care organizations, has recently informed the Maine Attorney General that it suffered a data breach that has affected up to 4,226,508 individuals – the largest healthcare data breach to be reported so far this year.

HIPAA 109

HIPAA Health Insurance Medicaid Medicaid 109

HIPAA Journal

FEBRUARY 15, 2022

South Shore Hospital engaged a team of third-party computer forensics experts to investigate the security breach and determine whether patient information was accessed or stolen. The investigation confirmed names, Social Security numbers, and plan selection information had been exposed.

Hospitals 116

Hospitals Health Insurance HIPAA Medicaid 116

Bill of Health

OCTOBER 27, 2023

By Adithi Iyer In my last piece , I discussed the hypothetical successor of 23andme — a tissue-based direct-to-consumer testing service I’ve called yourtissueandyou — and the promise and perils that it might bring in consumer health information and privacy. Consumer protections for this type of information are, in a word, complicated.

HIPAA 157

HIPAA FDA Informed Consent Health Insurance 157

HIPAA Journal

OCTOBER 17, 2022

Phoenix, AZ-based Valle del Sol Community Health has notified 70,268 patients that some of their protected health information has been exposed. Valle de Sol said the investigation indicated unauthorized individuals had access to files containing sensitive patient data and that patient information may have been acquired.

Health Insurance 113

Health Insurance Licensing Fraud HIPAA 113

Bill of Health

MARCH 27, 2024

These high costs highlight the need for comprehensive insurance coverage because many of those experiencing symptoms of conditions like PTSD also frequently lack the resources to pay for such treatments. The easiest way to qualify for this program is for patients to have insurance that covers Spravato. for depression).

FDA 201

FDA Medicare Medicare Health Insurance 201

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 107

Health Insurance Licensing Ransomware Fraud 107

HIPAA Journal

MARCH 14, 2022

Capital Region Medical Center (CRMC) in Jefferson City, MO has recently confirmed patient information was accessed by unauthorized individuals in a December 2021 cyberattack that took its network and phone systems offline for several days. It was initially unclear if patient information had been compromised but that has now been confirmed.

Electronic Medical Records 126

Electronic Medical Records Health Insurance HIPAA Licensing 126

Bill of Health

OCTOBER 26, 2022

In the post- Dobbs fight to safeguard reproductive healthcare, a new spotlight has been placed on two existing federal laws: the Health Insurance Portability and Accountability Act (HIPAA) and the Emergency Medical Treatment and Active Labor Act (EMTALA). . By Katie Gu. The Old Laws. OCR HIPAA Privacy Rule Guidance.

HIPAA 184

HIPAA Medicare Medicare Medicaid 184

HIPAA Journal

SEPTEMBER 9, 2022

Birmingham, AL-based Henderson & Walton Women’s Center (HWWC) has recently notified 34,306 patients that some of their protected health information may have been compromised as a result of a hacker gaining access to the email account of one of its employees. The information exposed varied from patient to patient.

Licensing 99

Licensing Health Insurance Fraud HIPAA 99

Jane Sarashon

FEBRUARY 27, 2024

NABIP, whose members represent professionals in the health insurance benefits industry, drafted and adopted a new American Healthcare Consumer Bill of Rights launched at the meeting. Health Populi’s Hot Points: Is there an American Civil Right for health care?

ACA 117

ACA Prescription Drug Pricing Health Insurance Hospitals 117

American Medical Compliance

JANUARY 9, 2024

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. Educating patients on how to reduce their overall risk helps protect their health information.

Fraud 52

Fraud Medicare Medicare Compliance 52

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. for more information. Critical for protecting sensitive patient health information.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

HIPAA Journal

FEBRUARY 23, 2022

HIPAA is an acronym for the Health Insurance Portability and Accountability Act. When the Health Insurance Portability and Accountability Act was passed by Congress in 1996, the establishment of federal standards for safeguarding PHI was not one of the primary objectives. What is HIPAA? What is HIPAA Title II?

HIPAA 88

HIPAA Fraud Health Insurance Medicaid 88

HIPAA Journal

JANUARY 23, 2024

governors to invite them to apply for Section 1115 waivers to expand access to care under the Medicaid program to women who are prohibited from receiving abortion care in the states where they live and may be denied care under the Medicaid program. The HHS has written to U.S.

HIPAA 84

HIPAA Medicaid Medicaid Health Insurance 84

HIPAA Journal

MARCH 21, 2023

During that time they exfiltrated files that contained sensitive patient data, including names, contact information, Social Security number, Medicare/Medicaid IDs, health information, and health insurance information.

Fraud 101

Fraud Health Insurance Medicaid Medicaid 101

HIPAA Journal

APRIL 25, 2023

NationsBenefits learned of the attack on February 7, 2023, and was informed by Fortra that the attack occurred on or around January 30, 2023. The review of the account confirmed it contained protected health information, although the press release issued did not state what types of information had been exposed.

Health Insurance 83

Health Insurance Public Health Ransomware Fraud 83