HIPAA Journal

DECEMBER 15, 2022

Mulvey, 30, of Grand Island, NY, worked as a registered nurse at Roswell Park between February 2018 and June 2018. On June 27, 2018, Mulvey was observed accessing a medication dispensing machine in a room to which she was not assigned and left carrying a backpack.

Nurses 102

Nurses HIPAA Fraud Licensing 102

Med-Net Compliance

JUNE 15, 2022

California Attorney General Rob Bonta announced a settlement against a Southern California doctor for submitting false claims to Medicare and Medi-Cal between the years of 2011 and 2018 for drugs, procedures, services, and tests that were never administered to patients. As part of the settlement, the doctor will pay a total of more than $9.48

Fraud 59

Fraud Doctors Elder Abuse Medicare 59

AIHC

FEBRUARY 24, 2025

Part 2: When Criminal Behavior Infiltrates Your Audit Program Written by Carl J Byron , CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret) We Recommend Reading Part 1 Fraud Indicators and Red Flags When Audit Managers Knowingly Skew Audit Results as this article is Part 2, the rest of the story.

Fraud 52

Fraud Compliance Governance Compliance Officers 52

Health Populi

OCTOBER 31, 2018

based healthcare IT leaders for the survey in October 2018. Health Populi’s Hot Points: Unisys published their 2018 Security Index , finding growing global insecurity concerns among consumers about the internet, identity theft and bankcard fraud — ahead of terrorism, natural disaster and epidemic threats.

Fraud 89

Fraud Doctors Hospitals 89

The Health Law Firm

JANUARY 9, 2019

Board Certified by The Florida Bar in Health Law On December 21, 2018, the US Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) cases in 2018. billion involved health care fraud. Health Care Fraud. Indest III, J.D.,

Fraud 40

Fraud Governance Hospitals 40

HIPAA Journal

MARCH 13, 2023

While data misuse has not been detected, as a precaution against identity theft and fraud, affected individuals have been offered complimentary credit monitoring and identity theft protection services for 24 months. Notification letters are now being mailed to all affected individuals.

Ransomware 120

Ransomware Fraud HIPAA 120

AIHC

JUNE 14, 2024

Financial exploitation refers to 2 types of financial crimes committed against older adults: Financial abuse (committed by someone you know) Financial fraud (committed by a stranger) Both result in serious financial, physical, and emotional harm to older adults. Call the Elder Fraud Hotline at 1-833-372-8311 (Monday-Friday, 10:00 a.m.-6:00

Fraud 52

Fraud Elder Abuse Governance Compliance 52

HIPAA Journal

JULY 25, 2023

Vanderbilt University Medical Center (VUMC) in Nashville, TN, has confirmed that the medical records of transgender patients have been provided to Tennessee Attorney General, Jonathan Skrmetti, in connection with an investigation of medical billing fraud.

Fraud 95

Fraud HIPAA Medical Billing Doctors 95

Provider Trust

JANUARY 26, 2022

It’s no secret–when fraud enters healthcare, things get risky. But how exactly does the HHS-OIG (Office of Inspector General), the main body responsible for conducting investigations into suspected fraudulent activity, address healthcare fraud and assess future risk of these bad actors?

Fraud 52

Fraud US Department of Health and Human Services Medicaid Medicaid 52

Florida Health Care Law Firm

DECEMBER 7, 2021

Telemedicine pharmacy arrangements continue to be of significant interest to fraud enforcement. A 2018 case in which four individuals and seven companies were indicted ended in a month-long jury trial of one of the individuals, a Florida pharmacy owner. Sentencing in the case is set for May of 2022. THE SCHEME. THE “TELL”.

Fraud 40

Fraud Telemedicine Governance Compliance 40

The Health Law Firm

OCTOBER 31, 2019

Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. The vast fraud scheme totaled $2.1 billion worth of false Medicare and Medicaid claims between July 2018 and January 2019.

Fraud 40

Fraud Medicare Medicare Doctors 40

The Health Law Firm

SEPTEMBER 25, 2018

Board Certified by The Florida Bar in Health Law On August 22, 2018, a doctor received a sentence of one year and a day in prison from a New York federal court for his part in a $30 million scheme to defraud Medicare and the state Medicaid program. Indest III, J.D., Lies and Cover-ups.

Fraud 40

Fraud Doctors Medicaid Medicaid 40

HIPAA Journal

MARCH 31, 2023

In 2018, the U.S. The proposed class definitions would allow claims to be submitted by all affected CareFirst customers, even though many of those customers took no steps to mitigate their exposure to identity theft or medical fraud and therefore suffered no Article III injury.

Fraud 105

Fraud HIPAA 105

The Health Law Firm

OCTOBER 3, 2019

Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. The vast fraud scheme totaled $2.1 billion worth of false Medicare and Medicaid claims between July 2018 and January 2019.

Fraud 40

Fraud Doctors Medicare Medicare 40

HIPAA Journal

JUNE 15, 2023

A relatively small data breach was reported to OCR on February 28, 2018, by Yakima Valley Memorial Hospital (formerly Virginia Mason Memorial), a 222-bed non-profit community hospital in Washington state. So far this year, penalties totaling $1,901,500 have been imposed by OCR to resolve violations of the HIPAA Rules.

HIPAA 98

HIPAA Hospitals Electronic Medical Records Fraud 98

Compliancy Group

AUGUST 23, 2023

September of 2020 marked the month when Cronin, burdened by guilt, reluctantly admitted to a single count of conspiring to orchestrate health care fraud and another count of brazenly committing such deceitful acts. Prosecutors Evan Panich and Chris Looney from the Health Care Fraud Unit, alongside Special Assistant U.S.

Fraud 52

Fraud Medicaid Medicaid Governance 52

The Health Law Firm

MAY 10, 2018

Board Certified by The Florida Bar in Health Law On April 26, 2018, the owner of several Florida pharmacies was sentenced to 15 years in prison and ordered to give up $54.5 Health Care Billing Fraud. By George F. Indest III, J.D., million in restitution. Nicholas A. Borgesano Jr., Borgesano Jr., Click here to read more.

Fraud 40

Fraud 40

The Health Law Firm

JANUARY 4, 2019

Board Certified by The Florida Bar in Health Law On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. By George F. Indest III, J.D., US District Judge Robert N.

Fraud 40

Fraud Medicare Medicare 40

Health Populi

JULY 17, 2018

This and other important questions will be brainstormed on the webcast hosted by Accenture on Wednesday 18 July 2018 as we discuss the five trends that paint the firm’s Digital Health Tech Vision 2018. Finally, the Internet of Thinking rounds out Accenture’s five themes in the 2018 Digital Health Tech Vision.

Fraud 48

Fraud Health Outcomes Hospitals 48

HIPAA Journal

MAY 18, 2023

HIPAA enforcement by state attorneys general was stepped up in 2017 with 5 settlements and again in 2018 when 12 cases resulted in financial penalties for violations of the HIPAA Rules. million Hacked by Chinese APT group Failure to implement and maintain reasonable security practices 2020 Multistate (43 states) Anthem Inc $39.5 million 78.8

HIPAA 102

HIPAA Compliance Ransomware Hospitals 102

HIPAA Journal

FEBRUARY 27, 2023

These data breaches include non-malicious snooping on the medical records of colleagues, friends, family members, and high-profile patients, and insider wrongdoing incidents where patient data is stolen for identity theft and fraud or to take to a new employer.

Fraud 113

Fraud HIPAA Hospitals 113

HIPAA Journal

JANUARY 23, 2024

Theranos and Homes denied the allegations and threatened to sue Carreyrou; however, in 2018, Homes stepped down from her position as CEO, and following an FBI investigation the company was shut down. HHS-OIG Issues Notice of Exclusion HHS-OIG Inspector General Christi A.

Fraud 89

Fraud FDA Medicaid Medicaid 89

Healthicity

APRIL 12, 2022

The OIG issued a report in 2018 which revealed an error rate of 31% in billing and coding for telehealth services.

Fraud 97

Fraud Telemedicine 97

HIPAA Journal

MAY 5, 2022

BEC/EAC scams involving cryptocurrencies started to be received by IC3 in 2018 when losses of less than $5 million. The FBI says fraudulent transfers were made to banks in 140 countries, with Thailand topping the list followed by Hong Kong, China, Mexico, and Singapore.

Fraud 139

Fraud HIPAA 139

HIPAA Journal

MARCH 20, 2025

2023, OCR reported a 239% increase in hacking-related data breaches between January 1, 2018, and September 30, 2023, and a 278% increase in ransomware attacks over the same period. PA Business Associate 2,675,934 Hacking/IT Incident 45 2018 AccuDoc Solutions, Inc. In 2019, hacking accounted for 49% of all reported breaches.

HIPAA 109

HIPAA Ransomware Compliance Hospitals 109

Healthcare IT Today

DECEMBER 28, 2023

The Challenges of Identity in Healthcare Startling statistics from Verizon Enterprise’s 2018 Data Breach Investigations Report reveal that in 2016, medical records were compromised at a rate nine times greater than financial records. VCs stand as a real-world solution by ensuring the integrity of patient information.

Fraud 120

Fraud Hospitals 120

HIT Consultant

APRIL 12, 2024

Sharing private medical information with third parties like Google and Facebook without consent is a violation of federal law, specifically Section 5 of the FTC Act and the Opioid Addiction Recovery Fraud Prevention Act of 2018. The potential consequences for patients are life-altering.

Fraud 74

Fraud 74

Healthcare IT Today

FEBRUARY 21, 2025

In fact, in a 2018 paper published in Nature , researchers demonstrated that 99.8% As a result, there is no protection or recourse if de-identified data is re-identified by a third party that is not a HIPAA-defined Covered Entity and then used for nefarious purposes such as identity theft or healthcare fraud.

HIPAA 56

HIPAA Patient Advocacy Fraud Health Insurance 56

Healthcare Compliance Blog

MAY 11, 2022

The South Carolina Attorney General announced that his office’s Medicaid Fraud Control Unit (SCMFCU) had arrested a 57-year-old woman on two counts of Exploitation of a Vulnerable Adult and two counts of Breach of Trust with Fraudulent Intent, value of $10,000 or more.

Fraud 59

Fraud Nursing Homes Medicaid Medicaid 59

Health Populi

APRIL 24, 2018

I covered the launch of the 2018 Edelman Trust Barometer across all industries here in Health Populi in January 2018 , when this year’s annual report was presented at the World Economic Forum in Davos as it is each year. The resulting monetary loss was calculated to be at least $160 mm of fraud in 2017 alone. In the U.S.,

Health Insurance 74

Health Insurance Fraud Hospitals Doctors 74

Healthcare IT Today

AUGUST 14, 2024

It ensures timely patient access to care, automatic claim processing, network management, compliance, fraud detection, physician recruitment and more. A study ( “What Physicians are Saying About Directories” American Medical Association, 2018. However, much of this provider data has a short shelf life.

Fraud 75

Fraud Hospitals Medicaid Medicaid 75

Pharmacy Law Blog

MARCH 13, 2018

fraud suit – judge.” Copyright © 2018 The Health Law Firm. “Florida compounding pharmacy must face U.S. December 4, 2017). The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. All rights reserved.

Fraud 52

Fraud Governance Licensing FDA 52

HIT Consultant

NOVEMBER 24, 2022

– Delivery model : Whether to ship OTC products to a hearing clinic where the consumer can receive professional diagnosis, fitting and support, or ship directly to the consumer’s home thereby providing convenience but no professional support (and increased fraud risk), or offer both options? – Fraud. Potential pitfalls.

FDA 98

FDA Public Health Fraud Medicare 98

HIPAA Journal

APRIL 5, 2024

In 2018, the Supreme Court declined a review of the case, which was referred back to the District Court, then followed several years of back-and-forth litigation. law, mitigation expenses incurred to abate the risk of future fraud do not qualify as actual damages, therefore the plaintiffs would only be able to recover nominal damages.

Fraud 84

Fraud HIPAA Health Insurance Compliance 84

Provider Trust

OCTOBER 29, 2021

My favorite memory at ProviderTrust was the holiday celebration in 2018. Being smarter means having the right people seeing patients, limiting fraud and waste, and giving the resources to teams that want to make healthcare better. I know first hand how much we can improve processes and I was excited to share that with others.

Fraud 97

Fraud Nurses Compliance 97

AIHC

APRIL 5, 2022

Due to the huge volume of claims payers receive to process, deny and pay, they have implemented various methods to track providers to detect potential waste, fraud and/or abuse. They are also a large contributing factor for potential fraud and abuse when documentation does not support the diagnoses reported. They can, sometimes!

Fraud 52

Fraud Medicare Medicare Compliance 52

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Fri, 11/16/2018 - 18:46. Fraud, waste, & abuse. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program. Seema Verma.

Medicare 20

Medicare Medicare Overpayment Overpayments 20