Fierce Healthcare

SEPTEMBER 27, 2021

Pain doctor convicted in $100M fraud scheme involving unnecessary spinal injections. Mon, 09/27/2021 - 12:54.

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Fraud Doctors 119

Fierce Healthcare

SEPTEMBER 21, 2021

OIG: Most states not doing enough to monitor Medicaid telehealth fraud for behavioral health services. Tue, 09/21/2021 - 16:26.

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Fraud Medicaid Medicaid 126

HIPAA Journal

MARCH 24, 2022

The Federal Bureau of Investigation (FBI) Internet Crime Complaint Center (IC3) has released its 2021 Internet Crime Report , which reveals there were at least 649 ransomware attacks on critical infrastructure organizations from June 2021 to December 2021. billion in 2021 – a 28% increase from 2020. Source IC3.

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Ransomware Public Health Fraud HIPAA 130

Fierce Healthcare

AUGUST 5, 2021

Ascension Michigan to pay nearly $3 million in latest settlement to resolve fraud claims. Thu, 08/05/2021 - 13:30. agliadkovskaya.

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Fraud 111

HIPAA Journal

MARCH 24, 2022

Chelan Douglas Health District in East Wenatchee, WA, has announced it was the victim of a cyberattack in July 2021 in which the personal and protected health information of patients was exfiltrated from its systems. Chelan Douglas Health District said it is unaware of any cases of identity fraud or other misuse of patient data.

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Ransomware Fraud Hospitals HIPAA 132

HIPAA Journal

OCTOBER 26, 2022

The American Civil Liberties Union of Rhode Island (ACLU of RI) is taking legal action against the Rhode Island Public Transit Authority (RIPTA) and UnitedHealthcare New England (UHC) over an August 2021 data breach that affected more than 22,000 individuals.

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HIPAA Fraud Health Insurance 116

Bill of Health

SEPTEMBER 2, 2022

With a June 2022 report from AARP and the FINRA Foundation, a winter 2022 piece by Anna Tims in The Guardian , and a fall 2021 column by John Gapper in the Financial Times making exactly this argument, this is an idea that’s gaining traction. Social views about fraud and scams would, no doubt, be difficult to change quickly.

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Healthcare It News

MAY 20, 2022

Digital health startup investments reached a new high in 2021, closing the year with more than $30 billion in venture capital funding. VCs couldn’t get enough, plowing vast sums into unproven companies like Noom, which provided weight-loss advice and received $540 million in a mega-funding round in 2021.

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Fraud 351

Med-Net Compliance

JULY 11, 2022

The report says that in FY 2021 the DOJ opened 831 new criminal healthcare fraud investigations. Federal prosecutors filed criminal charges in 462 cases involving 741 defendants, and a total of 312 defendants were convicted of healthcare fraud related crimes during the year. You can view the report here: [link].

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Fraud Compliance Medicaid Medicaid 59

Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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Fraud Medicaid Medicaid Nursing Homes 59

Compliancy Group

JANUARY 25, 2022

With at least six weeks before final numbers are in, the Department of Health and Human Services HIPAA Breach Reporting Tool website is reporting 713 major healthcare data breaches in 2021, an increase of more than 7.5 By the Numbers: Major Healthcare Data Breaches Increase in 2021. million records in 2021.

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HIPAA Ransomware Governance Fraud 98

HIPAA Journal

MARCH 16, 2022

This is the first settlement to be reached under the DOJ Civil Cyber Fraud Initiative, which was launched in 2021. The post DOJ Settles Civil Cyber Fraud Initiative Case with CHS and Imposes a $930,000 Penalty appeared first on HIPAA Journal.

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Fraud Electronic Medical Records Governance HIPAA 109

HIT Consultant

DECEMBER 10, 2021

What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. Report Background. Telehealth Spend.

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Fraud COVID-19 Nurses Licensing 98

Healthcare IT Today

MAY 5, 2023

The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient. In 2021, a U.S.

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Fraud Medicare Medicare Overpayment 72

Healthcare IT News - Telehealth

MAY 13, 2022

The owners of a national telehealth company pleaded guilty this week to charges of conspiracy to violate the federal Anti-Kickback Statute and to commit healthcare fraud. Law enforcement agencies have ramped up the pressure on telehealth fraud, particularly amid the COVID-19 pandemic. According to a statement released by the U.S.

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Fraud Doctors COVID-19 Medicare 166

Healthcare Compliance Blog

FEBRUARY 15, 2022

billion in settlements and judgments have been recovered by the Department of Justice Department (DOJ) related to civil cases involving fraud and false claims in fiscal year 2021. Whistleblowers filed 598 qui tam suits in fiscal year 2021, which resulted in $1.6 Billion in Fiscal Year 2021 appeared first on.

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Fraud Governance Compliance Medicare 59

Med-Net Compliance

JUNE 22, 2022

A registered nurse from a veteran’s hospital in Detroit pleaded guilty to charges related to COVID-19 vaccination record cards fraud. Her theft of the cards began at least as early as May 2021 and continued through September 2021. Participating in the fraud can result in the person(s) being prosecuted.

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COVID-19 Vaccine COVID-19 Fraud US Department of Health and Human Services 59

HIPAA Journal

JANUARY 31, 2023

Affected individuals were notified about the cyberattack in August 2021 and were offered complimentary credit monitoring and identity theft protection services. Claims of up to $2,500 will be accepted for documented extraordinary losses due to identity theft and fraud. A lawsuit – Lopez, et al.

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Ransomware Fraud Health Insurance HIPAA 63

Med Law Blog

FEBRUARY 10, 2022

Highmark Health issued a Press Release on February 7, 2022 announcing that it’s Financial Investigations and Provider Review (FIPR) department generated more than $245 million in savings related to fraud waste and abuse in 2021, the majority of which was in Pennsylvania–$184 million.

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Fraud 52

Provider Trust

APRIL 30, 2024

This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). This year’s report also shows greater participation from managed care organizations (MCOs) as a key trend.

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Fraud Medicaid Medicaid Licensing 52

Provider Trust

AUGUST 9, 2022

The Health Care Fraud and Abuse Control Program (HCFAC) protects patients and consumers by combating healthcare fraud and abuse. During the fiscal year 2021, the report states that the federal government won or negotiated over $5 billion in healthcare fraud judgments and settlements. Monetary Penalties. Key Takeaways. $5

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Fraud Medicaid Medicaid Medicare 52

Verisys

MARCH 23, 2023

3 Healthcare Fraud and Abuse Laws Providers Should Know About In 2021, the Department of Justice reported recovering over $5.5 billion from settlements due to fraud and false claims. Over $5 billion of the total amount recovered in 2021 was related to the healthcare industry. government or a government contractor.

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Fraud Medicaid Medicaid Medicare 52

JNC Compliance

SEPTEMBER 6, 2022

In this series, I shared that the government recovered five billion dollars from the healthcare False Claims Act in 2021, one of the most significant recoveries […]. The post 5 Tactics to Combat Healthcare Fraud appeared first on JNC Healthcare Compliance Group.

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Fraud Compliance Governance 52

American Medical Compliance

APRIL 6, 2023

Incidence of Healthcare Fraud Numerous scammers view this as a method to make quick, yet unlawful, money. Officials state that Florida, along with the rest of the nation, has been plagued by healthcare fraud. Between 2016 and 2021, the students spent a total of $114 million on falsified degrees, according to the publication.

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Fraud Nurses Licensing Compliance 52

HIPAA Journal

FEBRUARY 22, 2022

The breach came to light in June 2021 when files stolen in the attack were posted on the Marketo dark web leak site. Databreaches.net spotted the leaked data on the Marketo data leak site in June 2021 and contacted Sea Mar.

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Fraud HIPAA 121

The Health Law Firm Blog

JUNE 1, 2023

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. By George F. Indest III, J.D.,

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Fraud Doctors Medicaid Medicaid 52

The Health Law Firm Blog

MARCH 7, 2022

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. By George F. Indest III, J.D.,

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Fraud Doctors Medicaid Medicaid 52

Med-Net Compliance

JULY 7, 2022

A federal district judge in Miami sentenced the last of five defendants for his role in a healthcare fraud scheme operated out of a physical therapy clinic. According to evidence introduced in court, the billing fraud conspiracy resulted in more than $8 million in false claims being submitted to BCBS.

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Fraud COVID-19 Health Insurance Compliance 59

The Health Law Firm Blog

JANUARY 24, 2022

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. By George F. Indest III, J.D.,

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Fraud Doctors Medicaid Medicaid 52

The Health Law Firm Blog

FEBRUARY 10, 2023

Board Certified by The Florida Bar in Health Law On October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged health insurance fraud scheme to rip off the league's benefit plan, according to an indictment filed in the Southern District [.] By George F. Indest III, J.D.,

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Fraud Health Insurance Overpayment Overpayments 52

HIPAA Journal

APRIL 1, 2022

On January 24, 2022, SRHD announced that an employee email account had been compromised on December 21, 2021. Between June 24, 2021, and July 2, 2021, emails and attachments in a Ciox Health employee’s email account were downloaded by an unauthorized individual.

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Fraud HIPAA Licensing Health Insurance 136

The Health Law Firm

FEBRUARY 13, 2022

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. By George F. Indest III, J.D.,

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Fraud 52

Health Law Advisor

FEBRUARY 3, 2022

Department of Justice (DOJ) released its annual False Claims Act (FCA) enforcement statistics for fiscal year (FY) 2021. [1]. billion, FY 2021 marks DOJ’s largest annual total FCA recovery since FY 2014, and more than twice the $2.3 Marking another record, DOJ’s health care recoveries in FY 2021 in non- qui tam actions ($3.6

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Fraud COVID-19 Governance Medicare 52

Med-Net Compliance

JUNE 15, 2022

In October 2021, the California Department of Justice’s?Division Division of Medi-Cal Fraud and Elder Abuse (DMFEA) and the US Attorney’s Office for the Eastern District of California intervened in the? The post California Doctor to Pay over $9.48M, Sentenced to Prison, to Settle Fraud Allegations appeared first on Med-Net.

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Fraud Doctors Elder Abuse Medicare 59

The Health Law Firm Blog

JUNE 10, 2023

Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. By George F. Indest III, J.D., The doctor argued that the [.]

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Fraud Medicare Medicare Doctors 52

The Health Law Firm Blog

MARCH 16, 2022

Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. By George F. Indest III, J.D., The doctor argued that the.

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Fraud Medicare Medicare Doctors 52

Healthcare IT News - Telehealth

OCTOBER 28, 2020

"Mass adoption of this technology will lead to new cybercrime focus, with an emphasis on stealing patient data to enable fraud, target health data in ransomware attacks, trick patients in social engineering schemes, and target remote patient monitoring devices," wrote the report authors.

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