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 105

Fraud Medicaid Medicaid Doctors 105

C&M Health Law

APRIL 21, 2022

Department of Justice (DOJ) to resolve allegations that it had made donations in order to improperly inflate the funding four of its hospitals received from the federal Medicaid program. Florida Medicaid is administered by the state but jointly funded by both the state and federal governments.

Medicaid 52

Medicaid Medicaid Governance Fraud 52

The Health Law Firm

FEBRUARY 21, 2014

Board Certified by The Florida Bar in Health Law A licensed speech therapist faces up to five years in prison for allegedly defrauding Medicaid during the summer of 2013. Indest III, J.D., Click here to read the press release from the AG.

Medicaid 40

Medicaid Medicaid Fraud Licensing 40

The Health Law Firm

JULY 6, 2015

FACTS: Via three Final Audit Reports dated July 10, 2013, AHCA advised the Chrysalis Center that it had overbilled the Medicaid program by $284,535.83 Indest III, J.D., for community mental health services.

Medicaid 40

Medicaid Medicaid Overpayments Overpayment 40

The Health Law Firm

JULY 8, 2013

Board Certified by The Florida Bar in Health Law The owner of a Lake County, Florida, medical center was arrested by the Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) on June 27, 2013, for allegedly committing $300,000 in Medicaid fraud. Indest III, J.D., To read the press release from the AG, click here.

Fraud 40

Fraud Medicaid Medicaid 40

The Health Law Firm

SEPTEMBER 20, 2013

Board Certified by The Florida Bar in Health Law A Broward County, Florida, home health care company is accused of overbilling the Medicaid program for patient services by almost $500,000, according to the Sun Sentinel. Click here to read the Sun Sentinel article from September 18, 2013. By George F. Indest III, J.D.,

Medicaid 40

Medicaid Medicaid Fraud 40

The Health Law Firm

APRIL 30, 2013

As the investigation into a Central Florida mental health counselor continues, new details are emerging on the extent of the $3 million Medicaid fraud scheme. On March 27, 2013, I blogged about a registered mental health counselor arrested on charges of racketeering, Medicaid fraud and identity theft.

Fraud 40

Fraud Medicaid Medicaid 40

The Health Law Firm

APRIL 22, 2013

Edna Lorraine Watkins, the owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has been sentenced to six years in prison for defrauding Medicaid, according to the Florida Office of the Attorney General (AG). Watkins was sentenced on April 2, 2013. We blogged about this case in February 2013, when Ms.

Medicaid 40

Medicaid Medicaid Fraud 40

HIPAA Journal

MARCH 15, 2023

FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida. FHKC contracted with Jelly Bean Communications Design on October 13, 2013, to provide web design, programming, and hosting services.

Health Insurance 80

Health Insurance HIPAA Fraud Due Diligence 80

The Health Law Firm

SEPTEMBER 3, 2013

million to settle claims it overbilled Medicare and Medicaid for cancer clinical trial services that were not permitted by the Medicare and Medicaid rules. This announcement from the Department of Justice (DOJ) was released on August 28, 2013. Indest III, J.D.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

The Health Law Firm

SEPTEMBER 24, 2013

Leider with The Health Law Firm will be giving a presentation on Thursday, September 26, 2013, to the members of the Medical Office Resources of Florida (MOROF) and attending health care providers. This presentation is called, “Medicare and Medicaid Audits: Ready or Not, Here They Come.” Brown and Lance O.

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

HIT Consultant

NOVEMBER 8, 2021

States can also decide how they want to determine Medicaid eligibility. While popular back in 2013, custom solutions have proven in most cases to be too costly and time-consuming to be sustainable. Consider how you want the SBM to work with Medicaid. These are just a few of the many decisions a state will need to make.

Health Insurance 98

Health Insurance Medicaid Medicaid Governance 98

The Health Law Firm

AUGUST 19, 2013

million to settle civil allegations under the False Claims Act, according to the Department of Justice (DOJ) on August 16, 2013. The nonprofit organization is accused of fraudulently billing Medicaid and other government programs for health services provided by some of its Texas clinics between 2003 and 2009, according to the DOJ.

Medicaid 40

Medicaid Medicaid Fraud Governance 40

Healthcare IT News - Telehealth

OCTOBER 19, 2020

In the suit, the EHR giant argues that it has used the CarePort trademark since 2013 and that in 2018 the telemedicine company changed its name from ER at Home to CarePortMD. Earlier this summer, CarePort launched a tool to help hospitals comply with the Centers for Medicare and Medicaid Services' interoperability final rules.

Telemedicine 124

Telemedicine Medicaid Medicaid Hospitals 124

CMS.gov

OCTOBER 2, 2018

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Between 2013 and 2016, Federal spending on Medicaid grew by over $100 billion.

Medicaid 40

Medicaid Medicaid Fraud Health Outcomes 40

Health Law Advisor

FEBRUARY 2, 2023

On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. The final rule codifies long-awaited regulations first proposed by CMS in 2018.

Medicare 98

Medicare Medicare Overpayment Overpayments 98

HIT Consultant

AUGUST 17, 2023

They also serve a majority of Medicaid and non-insured patients, which makes it harder to keep the doors open on maternity wards, whose cost of upkeep can be substantial. Incentivizing Medicaid capture. Hospitals in under-resourced areas have less to offer new doctors in terms of equipment, support, and quality of life.

Medicaid 98

Medicaid Medicaid Telemedicine Doctors 98

Healthcare IT Today

FEBRUARY 27, 2024

HealthBeacon was founded in 2013 in Dublin, Ireland. The product is patent protected, FDA cleared, and FSA, HSA, Medicare, and Medicaid eligible. Postal Service’s approved mail-back program. HealthBeacon also provides a digital risk management platform for prescribing restricted medication to oncology patients.

FDA 114

FDA Licensing Medicaid Medicaid 114

Healthcare IT News - Telehealth

JULY 18, 2022

"Since 2013, we had provided e-consults as one of the original AAMC Project CORE institutions," she added. "In 2019, UVA Health created a multi-stakeholder strategic plan for telemedicine.

COVID-19 161

COVID-19 Telemedicine Electronic Medical Records Hospitals 161

CMS.gov

JUNE 25, 2019

The Medicaid program has grown from $456 billion in 2013 to an estimated $576 billion in 2016, largely fueled by a mostly federally financed expansion of the program to more than 15 million new working age adults.

Medicaid 46

Medicaid Medicaid 46

HIPAA Journal

MAY 30, 2023

MCNA), which also does business as MCNA Dental – a provider of dental benefits and services for state Medicaid and Children’s Health Insurance Programs – has recently reported a major data breach to the Maine Attorney General that has affected 8,923,662 individuals. Managed Care of North America, Inc. Nascentia Health, Inc.

Health Insurance 104

Health Insurance Medicaid Medicaid Ransomware 104

Med-Net Compliance

SEPTEMBER 9, 2022

to resolve allegations that they submitted false claims to Medicare and Medicaid. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent. A West Virginia ophthalmologist and his practice have paid $907,074.64

Medicare 59

Medicare Medicare Medicaid Medicaid 59

The Health Law Firm

AUGUST 16, 2013

According to the Daytona Beach News-Journal, the surgeon allegedly made an initial incision into a patient’s right leg when it was suppose to be made in the left leg on July 3, 2013.

Hospitals 40

Hospitals Medicaid Medicaid Medicare 40

HIPAA Journal

FEBRUARY 23, 2022

The preamble could give the impression that the Administrative Simplification provisions of HIPAA Title II will improve accessibility to and affordability of the Medicare and Medicaid programs, or that the development of a health information system would streamline the provision of healthcare between providers.

HIPAA 97

HIPAA Fraud Health Insurance Medicaid 97

Healthcare Compliance Blog

JANUARY 14, 2022

Custom shoe inserts for diabetic patients can be covered by Medicare and Medicaid. The United States alleges that between 2013 and 2018 the shoe company sold diabetic shoe inserts that were represented to be custom made for an individual’s foot but were actually made using generic foot models.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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

The Health Law Firm

MARCH 6, 2014

Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) continues to stop fraudulent repayment claims before they happen. The agency performed a similar enrollment moratorium in July 2013. Indest III, J.D., Click here to read the press release from CMS.

Fraud 40

Fraud Medicaid Medicaid Medicare 40

The Health Law Firm

AUGUST 30, 2013

Board Certified by The Florida Bar in Health Law On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) released the 2014 Inpatient Prospective Payment System (IPPS) Final Rule (the 2014 IPPS Final Rule). By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D.,

Hospitals 40

Hospitals Payment Systems Medicaid Medicaid 40

Health Law Attorney

APRIL 22, 2021

President Obama issued a Sequestration Order in March 2013. In response, the Centers for Medicare & Medicaid Services (“ CMS ”) issued guidance that Medicare fee-for-service (“ FFS ”) claims with dates of service after April 1, 2013 would incur a 2% reduction in Medicare payment.

Medicare 40

Medicare Medicare COVID-19 Medicaid 40

The Health Law Firm

AUGUST 21, 2013

Board Certified by The Florida Bar in Health Law On August 19, 2013, Shands Healthcare agreed to pay $26 million to settle a lawsuit that stemmed from a whistleblower/qui tam claim. Indest III, J.D.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

The Health Law Firm

SEPTEMBER 23, 2013

million, according to the Department of Justice (DOJ) on September 13, 2013. The providers were accused of defrauding Medicare, Medicaid and TRICARE by performing unnecessary and improperly supervised procedures from 2007 until 2011. Indest III, J.D.,

Fraud 40

Fraud Medicaid Medicaid Medicare 40

The Health Law Firm

MARCH 4, 2013

A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability. Leider, J.D., The Health Law Firm.

Medicare 40

Medicare Medicare Fraud Medicaid 40

HIT Consultant

APRIL 20, 2022

Hospitals report the data to the Centers for Medicare & Medicaid Services (CMS), which uses that data to create the Overall Hospital Quality Star rating for each hospital. Analysts looked at the health care costs of individuals enrolled in commercial insurance, Medicare, and Medicaid in the United States.

Medicare 98

Medicare Medicare Telemedicine Medicaid 98

American Medical Compliance

JANUARY 9, 2024

Through Medicare, Medicaid, and the Children’s Health Insurance Program, the federal government and state governments offer health care coverage to nearly 100 million individuals. This type of theft is just one example of healthcare fraud. trillion in 2015.

Fraud 52

Fraud Medicare Medicare Compliance 52

Med-Net Compliance

OCTOBER 19, 2022

The settlement resolves allegations that between 2013 and 2020, the company paid remuneration to its home health medical directors in Oklahoma and Texas for the purpose of inducing referrals of Medicare and TRICARE home health patients. The corporate officers were previously the CEO and COO of the company.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Medicaid 59

MedTrainer

NOVEMBER 27, 2023

The Department of Community Health (DCH) serves as the lead agency for Medicaid and PeachCare for Kids® , and also oversees the State Health Benefit Plan , Healthcare Facility Regulation Division and State Office of Rural Health. The Medical Assistance Plans Division oversees Georgia’s Medicaid and PeachCare for Kids® programs.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Healthcare IT Today

AUGUST 7, 2022

Cybersecurity company Surfshark found the number of government requests for user data increased 4x from 2013 to 2020 among Apple, Google, Facebook, and Microsoft. While 7 out of 10,000 may not seem like a lot, a large hospital with up to 20 connected devices per patient room could have several devices at risk.

Governance 75

Governance Telemedicine Medicaid Medicaid 75