Compliancy Group

FEBRUARY 12, 2024

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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Fraud Medicare Medicare US Department of Health and Human Services 52

HIPAA Journal

JANUARY 12, 2024

The HIPAA Omnibus Rule mandated modifications to the Privacy, Security, and Enforcement Rules in order to adopt measures passed in the HITECH Act, finalized the Breach Notification Rule, and added standards to account for the passage of the GINA Act. The adoption of a four-tired civil monetary penalty structure for violations of HIPAA.

HIPAA 78

HIPAA Compliance Health Insurance Medicaid 78

HIPAA Journal

DECEMBER 31, 2022

To best answer the question what is a HIPAA violation, it is necessary to explain what HIPAA is, who it applies to, and what constitutes a violation; for although most people believe they know what a HIPAA compliance violation is, evidence suggests otherwise. What is HIPAA and Who Does It Apply To?

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HIPAA Due Diligence Compliance Fraud 132

HIPAA Journal

DECEMBER 15, 2022

HMS is a subcontractor of ASRC Federal Data Solutions, LLC (ASRC Federal), which is a business associate of the HHS’ Centers for Medicare and Medicaid Services (CMS). The CMS says up to 254,000 Medicare beneficiaries have potentially been affected and had some of their PII and PHI exposed.

Ransomware 102

Ransomware Medicare Medicare HIPAA 102

HIPAA Journal

MARCH 6, 2023

The Department of Justice has announced one of its first prosecutions under the Medicare Access and CHIP Reauthorization Act of 2015 in a case involving the theft and sale of Medicare Beneficiary Identifiers. MACRA also made it illegal to buy, sell, or distribute Medicare Beneficiary Identifiers without proper authority.

Medicare 89

Medicare Medicare Fraud Medicaid 89

Medisys Compliance

APRIL 24, 2024

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that safeguards the privacy of individuals’ health information, including mental health and substance abuse treatment records. Understanding and complying with HIPAA regulations is crucial for your practice. What is HIPAA?

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HIPAA Compliance Medical Billing Outsourcing Medical Billing 59

Total Medical ComplianceHIPAA

JANUARY 11, 2024

HIPAA stands as a beacon of privacy and security standards within the industry. These screenings search through various databases containing records of individuals or organizations barred from participating in Medicaid, Medicare, or other federal/state healthcare programs due to fraud, abuse, or other offenses.

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HIPAA Regulatory Compliance Malpractice Compliance 52

HIPAA Journal

JUNE 8, 2023

The Iowa Department of Health and Human Services has announced there have been three separate breaches of the protected health information of Iowa Medicaid recipients in the past two months – two hacking incidents and an impermissible disclosure, all three of which involved third-party contractors.

Medicaid 80

Medicaid Medicaid Ransomware Health Insurance 80

HIPAA Journal

JANUARY 30, 2023

The National HIPAA Summit is the leading forum on healthcare EDI, privacy, breach notification, confidentiality, data security, and HIPAA compliance, and the deadline for registration for the Virtual 40th National HIPAA Summit is fast approaching.

US Department of Health and Human Services 81

US Department of Health and Human Services HIPAA Compliance Medicaid 81

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?

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HIPAA Compliance Health Insurance Hospitals 52

HIPAA Journal

JUNE 26, 2023

HIPAA enforcement discretion occurs when the Secretary for Health and Human Services (HHS) announces the Department will exercise discretion in the enforcement of HIPAA Rules. Typically, Notices of Enforcement Discretion last between 72 hours and 60 days, are state or region-specific and apply to specific provisions of the HIPAA Rules.

HIPAA 68

HIPAA COVID-19 COVID-19 Vaccine Public Health 68

Compliancy Group

FEBRUARY 9, 2023

Navigating the complexities of HIPAA compliance takes work, especially for healthcare providers and their vendors. Because of the vague nature of the law and the fact that HIPAA compliance is an all-or-nothing endeavor, too many organizations depend on hope more than knowledge. Learn More × Get HIPAA Compliant! Please Wait.

HIPAA 52

HIPAA Compliance Regulations Compliance Medicaid 52

HIPAA Journal

DECEMBER 31, 2022

One of the questions we are sometimes asked is how to report a HIPAA violation anonymously. Consequently, it is not possible to report a HIPAA violation anonymously via the OCR Complaints Portal. HHS´ Office for Civil Rights is not the only “enforcer” of HIPAA. How Else to Report a HIPAA Violation Anonymously.

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HIPAA Medicaid Medicaid Medicare 93

HIPAA Journal

SEPTEMBER 11, 2023

Care Health Plan, has settled multiple violations of the HIPAA Privacy and Security Rules with the HHS’ Office for Civil Rights (OCR) and will pay a $1,300,000 penalty and adopt a robust corrective action plan. OCR determined that there had been several failures to fully comply with the requirements of the HIPAA Privacy and Security Rules.

HIPAA 71

HIPAA Compliance Medicaid Medicaid 71

HIPAA Journal

OCTOBER 21, 2022

There are – and always have been – gaps in HIPAA and, after more than a quarter of a century, some have yet to be addressed. Most of the gaps in HIPAA are attributable to omissions from the original Act, provisions of HIPAA and HITECH that have never been enacted, and the increasing use of technology in healthcare.

HIPAA 95

HIPAA Compliance Medicare Medicare 95

HIPAA Journal

MAY 29, 2023

It has been 27 years since President Clinton signed the Health Insurance Portability and Accountability Act (HIPAA) into law, but compliance is still proving a challenge for many HIPAA-regulated entities. The average HIPAA penalty has fallen from $2.6 reduction in total penalties compared to 2018, falling from $28.7

HIPAA 93

HIPAA Compliance Due Diligence COVID-19 93

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). . OCR HIPAA Privacy Rule Guidance. The Old Laws. The Guidances.

HIPAA 184

HIPAA Medicare Medicare Medicaid 184

Innovaare Compliance

DECEMBER 11, 2023

Before the Medicare Advantage Open Enrollment Period (MA OEP) [1] begins on January 1, 2024, Medicare Advantage Organizations (MAOs) still have time to review if they are completely ready for a new contract year. The Annual Election Period (AEP) has ended. ethnic, cultural, racial, or religious minorities. the disabled.

Medicare 52

Medicare Medicare Compliance Medicaid 52

Compliancy Group

MARCH 8, 2023

are missing out on most of these opportunities because their names are on the HHS OIG (Health and Human Services, Office of Inspector General) Medicare Exclusion List. How do people end up on the Medicaid Exclusion List, what are the consequences of being on the list, and can you ever get off the list?

Medicare 52

Medicare Medicare Fraud HIPAA 52

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

Healthcare It News

JUNE 13, 2023

Uber Health launched its HIPAA-enabled API and dashboard in 2018 to offer logistics services to population health management programs. KFF's online Medicaid Waiver Tracker has information on which state Medicaid programs are granted 1115 waivers.

Medicaid 196

Medicaid Medicaid HIPAA Hospitals 196

HIPAA Journal

AUGUST 10, 2023

Missouri Department of Social Services The Missouri Department of Social Services (DSS) has confirmed that the data of Medicaid recipients was compromised in the recent mass MOVEit hacks by the Clop threat group. It is currently unclear exactly how many Medicaid recipients were affected.

Medicaid 52

Medicaid Medicaid Health Insurance HIPAA 52

HIPAA Journal

APRIL 29, 2024

The information exposed or stolen in the incident included names, addresses, dates of birth, Social Security numbers, health insurance policy numbers, Medicare or Medicaid numbers, state or governmental ID numbers, passport numbers, and medical information. Million Record MSP Data Breach appeared first on HIPAA Journal.

Health Insurance 91

Health Insurance Health Analytics HIPAA Medicaid 91

AIHC

FEBRUARY 7, 2024

This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns. Medicaid policies on this issue vary from state to state. Address HIPAA and Privacy Concerns Technology considerations The telehealth platform you use should meet HIPAA requirements.

HIPAA 59

HIPAA Medicaid Medicaid Telemedicine 59

MedTrainer

SEPTEMBER 20, 2023

This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you want to obtain or retain CMS certification in order to be reimbursed by services provided to patients with a Medicare/Medicaid health plan, you must comply with HIPAA rules and regulations.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

Med-Net Compliance

JULY 25, 2022

The Office for Civil Rights (OCR) at the US Department of Health and Human Services (HHS) announced the resolution of eleven investigations in its Health Insurance Portability and Accountability Act (HIPAA) Right of Access Initiative, bringing the total number of these enforcement actions to thirty-eight since the initiative began.

HIPAA 59

HIPAA US Department of Health and Human Services Nursing Homes Nurses 59

AIHC

FEBRUARY 7, 2024

This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns. Medicaid policies on this issue vary from state to state. Address HIPAA and Privacy Concerns Technology considerations The telehealth platform you use should meet HIPAA requirements.

HIPAA 52

HIPAA Medicaid Medicaid Telemedicine 52

Healthcare It News

OCTOBER 4, 2022

The Electronic Healthcare Network Accreditation Commission and The CARIN Alliance have partnered to bring both the CARIN Code of Conduct and EHNAC’s criteria review process to health plans, health systems, EHR vendors and others for reporting to the Centers for Medicare & Medicaid Services on their data practices and privacy protections.

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COVID-19 Vaccine Medicaid Medicaid COVID-19 281

Compliancy Group

SEPTEMBER 11, 2023

As guardians of privacy and security in the realm of protected health information (PHI), OCR enforces the HIPAA: Privacy Rule Security Rule Breach Notification Rule These set forth the mandatory obligations of HIPAA-regulated entities. Schedule a Demo See the software that makes getting compliant a breeze! Please Wait.

HIPAA 52

HIPAA Compliance Medicaid Medicaid 52

HIPAA Journal

AUGUST 14, 2023

Several other HIPAA-regulated entities have confirmed that they have been affected. The Colorado Department of Health Care Policy and Financing , which oversees the state’s Medicaid program and the Child Health Plan Plus (CHP+) program, was also affected. Maximus handles the department’s communications with Medicaid recipients.

Medicaid 76

Medicaid Medicaid HIPAA Health Insurance 76

Verisys

NOVEMBER 8, 2023

CMS.gov The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the creation of a standard, unique health identifier for healthcare providers, which the NPI satisfies. Providers also need an NPI to enroll in Medicare. Why Are NPI Numbers Necessary?

Fraud 97

Fraud HIPAA Medicare Medicare 97

Wyatt Law Blog

FEBRUARY 22, 2024

On February 8, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum entitled Texting of Patient Information and Orders for Hospitals and CAHs (the 2024 Memo), which provides updated guidance to State Survey Agency Directors.

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Medicaid Medicaid Medicare Medicare 98

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. Maximus handles the department’s communications with Medicaid recipients.

Medicaid 73

Medicaid Medicaid HIPAA Health Insurance 73

Healthcare IT News - Telehealth

MARCH 18, 2020

The HHS Office for Civil Rights announced on Tuesday that during the coronavirus pandemic it will use discretion when enforcing HIPAA-compliance for telehealth communications tools. " Wherever possible, providers should use telehealth tools from vendors that are HIPAA compliant and will enter into business-associate agreements, said OCR.

COVID-19 189

COVID-19 HIPAA Nursing Homes Medicare 189

Medisys Compliance

FEBRUARY 27, 2024

Key regulations include the Health Insurance Portability and Accountability Act (HIPAA), the Stark Law, the Anti-Kickback Statute, and regulations set forth by the Centers for Medicare & Medicaid Services (CMS) and private payers. Radiology practices must stay updated on these regulations to ensure compliance.

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Compliance Medical Billing Outsourcing Medicare Medicare 59

HIPAA Journal

JULY 28, 2023

The HHS’ Centers for Medicare and Medicaid Services (CMS) is being urged not to implement the proposed standards for prior authorization attachments, as detailed in its December 2022 Notice of Proposed Rulemaking (NPR).

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HIPAA Health Insurance Medicaid Medicaid 83

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. appeared first on HIPAA Journal. The post What is OIG in Healthcare?

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Fraud HIPAA Compliance Medicare 84