HIPAA Journal

JUNE 9, 2023

The Supreme Court unanimously ruled that it could not support “such a boundless interpretation” of the Identity Theft Penalty Enhancement Act of 2004. Under the letter of the law, small-scale fraud and large-scale fraud carry the same sentence for aggravated identity theft.

Fraud 107

Fraud Medicaid Medicaid Doctors 107

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. While health plans may use other numbers internally, the NPI is mandatory for HIPAA transactions.

Fraud 97

Fraud HIPAA Medicare Medicare 97

Verisys

FEBRUARY 1, 2022

CMS.gov’s Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 ( HIPAA ) mandated the adoption of a standard, unique health identifier for each healthcare provider. 23, 2004, established the NPI as this standard. The NPI fulfills this provision. Why Are NPI Numbers Necessary?

Fraud 52

Fraud Medicare Medicare HIPAA 52

Verisys

DECEMBER 29, 2024

The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the development of a standard, unique health identifier for healthcare providers, which the NPI satisfies. Why Are NPI Numbers Necessary? Who Needs an NPI? What Are the Two Types of NPI Providers?

HIPAA 52

HIPAA Fraud Health Insurance Medicare 52

AIHC

NOVEMBER 29, 2023

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 and is becoming increasingly prevalent as the environment shifts to value-based payment models.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 and is becoming increasingly prevalent as the environment shifts to value-based payment models.

Medicare 52

Medicare Medicare Medicaid Medicaid 52