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.

Fraud 59

Fraud COVID-19 Health Insurance Compliance 59

The Health Law Firm

NOVEMBER 4, 2021

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 of New York. By George F. Indest III, J.D.,

Fraud 40

Fraud Health Insurance 40

HIPAA Journal

MAY 2, 2024

BioPlus Specialty Pharmacy Services has proposed a settlement to resolve a class action lawsuit that was filed in response to a 2021 data breach that exposed the data of up to 350,000 patients.

Fraud 109

Fraud HIPAA Health Insurance Compliance 109

Hall Render

FEBRUARY 4, 2022

billion from False Claims Act (“FCA”) cases in the federal fiscal year 2021, “the second largest annual total in False Claims Act history” and more than doubling the FCA recoveries for the DOJ from fiscal year 2020. Whistleblowers themselves received $237 million in 2021. Health Care Fraud Actions.

Fraud 40

Fraud Governance Medicare Medicare 40

HIPAA Journal

SEPTEMBER 8, 2022

The Michigan law firm, Warner Norcross and Judd LLP, has issued notification letters to 255,160 individuals advising them about an October 2021 security breach in which files containing their personal and protected health information were potentially accessed and exfiltrated from its systems.

Fraud 111

Fraud Health Insurance Ransomware HIPAA 111

HIPAA Journal

MARCH 25, 2022

The forensic investigation revealed the email accounts were accessed by unauthorized individuals between April 7, 2021, and June 2, 2021. AHA provided notice about the attack on January 6, 2021. UMC was a victim of a REvil ransomware attack in June 2021 that resulted in the theft of the protected health information of 1.3

Health Insurance 119

Health Insurance Licensing Ransomware Fraud 119

HIPAA Journal

MARCH 11, 2022

Legal action is being taken against Logan Health and subsidiary, sister, and related entities of Logan Health over a data breach that occurred in 2021 and affected 213,543 Logan Health Medical Center patients. The lawsuit points out that data breach was one of several to have affected Logan Health.

HIPAA 122

HIPAA Health Insurance Medical Billing Fraud 122

HIPAA Journal

SEPTEMBER 12, 2023

Seymour, IN-based Schneck Medical Center has settled a lawsuit with the Indiana attorney general, Todd Rokita, over a 2021 ransomware attack and data breach that affected 89,707 Indiana residents.

HIPAA 98

HIPAA Ransomware Health Insurance Fraud 98

Innovaare Compliance

MARCH 24, 2024

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.

Fraud 52

Fraud Health Insurance Medicaid Medicaid 52

HIPAA Journal

SEPTEMBER 8, 2022

The Michigan law firm, Warner Norcross and Judd LLP, has issued notification letters to 255,160 individuals advising them about an October 2021 security breach in which files containing their personal and protected health information were potentially accessed and exfiltrated from its systems.

Fraud 79

Fraud Health Insurance Ransomware HIPAA 79

HIPAA Journal

FEBRUARY 14, 2023

Hackers gained access to Umass Memorial Health’s email environment between June 24, 2020 and January 7, 2021, as a result of responses to phishing emails. Claims may also be submitted for extraordinary losses up to a maximum of $5,000, which can include documented, unreimbursed losses to fraud and identity theft.

Fraud 104

Fraud Licensing Health Insurance HIPAA 104

HIPAA Journal

JANUARY 16, 2023

A settlement proposed by Rehoboth McKinley Christian Health Care Services to resolve claims related to February 2021 cyberattack has been approved by a New Mexico federal judge. Patients were notified about the data breach in May 2021. In June 2021, a lawsuit – Charlie et al. District Court Judge Steven C.

Fraud 112

Fraud Health Insurance HIPAA Hospitals 112

HIPAA Journal

APRIL 15, 2022

The incident involved the exposure and potential theft of the protected health information of 318,400 patients, including names, addresses, birth dates patient account numbers, medical record numbers, health insurance information, testing, diagnostic, treatment, and claims information.

Electronic Medical Records 125

Electronic Medical Records HIPAA Health Insurance Fraud 125

HIPAA Journal

MARCH 1, 2023

The Albuquerque, NM-based health insurance provider, True Health New Mexico, has proposed a settlement to resolve claims related to a 2021 data breach that affected 62,983 members of its health plans.

Fraud 110

Fraud Ransomware Health Insurance HIPAA 110

HIPAA Journal

FEBRUARY 15, 2023

The medical device manufacturer Electromed has proposed a $850,000 settlement to resolve claims related to a June 2021 ransomware attack and data breach involving the protected health information of 47,200 individuals.

Ransomware 97

Ransomware Fraud Licensing Health Insurance 97

HIPAA Journal

FEBRUARY 16, 2023

The Nashville, TN-based health system, Advent Health Partners, has proposed a $500,000 settlement to resolve claims related to a September 2021 data breach involving the protected health information of 61,072 patients. Advent Health Partners detected a breach of its email environment in early September 2021.

HIPAA 104

HIPAA Fraud Licensing Health Insurance 104

HIPAA Journal

JUNE 13, 2023

Point32Health is the second largest insurer in Massachusetts and serves more than 2.4 Point32Health was formed following the merger of Harvard Pilgrim Health Care and Tufts Health Plan in 2021. Harvard Pilgrim Health Care Inc. Harvard Pilgrim Health Care, Inc. million customers. and Point32Health, Inc.

Ransomware 103

Ransomware Fraud Health Insurance HIPAA 103

HIPAA Journal

AUGUST 5, 2022

The cyberattack was discovered by VPN Solutions on or around October 31, 2021, and the forensic investigation confirmed that the information potentially compromised in the attack included names, addresses, dates of birth, diagnostic and treatment information, health insurance information, and Social Security numbers.

Electronic Medical Records 102

Electronic Medical Records Health Insurance Fraud HIPAA 102

HIPAA Journal

SEPTEMBER 29, 2022

Choice Health worked with its service provider to ensure the database was secured and additional data security measures have been implemented to prevent similar occurrences in the future.

Health Insurance 119

Health Insurance Medicare Medicare Fraud 119

HIPAA Journal

DECEMBER 27, 2022

On or around August 1, 2021, Morley Companies, a Saignaw, MI-based provider of business services, suffered a cyberattack in which hackers gained access to parts of its network. Morley Companies has agreed to settle a class action lawsuit filed on behalf of individuals affected by a major data breach that occurred on or around August 1, 2022.

Fraud 119

Fraud HIPAA Health Insurance 119

HIPAA Journal

JANUARY 25, 2023

Logan Health has agreed to settle a class action lawsuit related to a 2021 hacking incident that exposed the protected health information of 213,543 individuals. Under the terms of the settlement, Logan Health has agreed to create a fund of $4.3 million to cover claims from individuals affected by the breach.

Medical Billing 95

Medical Billing Fraud HIPAA Health Insurance 95

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. According to the FBI, more than $43 billion was lost to these scams between June 2016 and December 2021, and in 2021 alone, the FBI Internet Crime Complaint Center received reports of losses of $2,395,953,296 to BEC scams.

Medicaid 88

Medicaid Medicaid Medicare Medicare 88

HIPAA Journal

AUGUST 4, 2022

A third-party cybersecurity firm was engaged to assist with the investigation and confirmed that a limited number of employee email accounts had been accessed by an unauthorized third party between October 5, 2021, and May 15, 2022, as a result of responses to phishing emails. OrthoArizona Notifies Patients About October 2021 Cyberattack.

Health Insurance 81

Health Insurance Fraud HIPAA 81

HIPAA Journal

MARCH 28, 2023

A New York law firm that suffered a LockBit ransomware attack has agreed to pay a financial penalty of $200,000 to the New York Attorney General to resolve alleged violations of New York General Business Law and the Privacy and Security Rules of the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA 112

HIPAA Ransomware Malpractice Health Insurance 112

HIPAA Journal

OCTOBER 6, 2022

Mon Health is facing a class action lawsuit over a hacking incident that allowed unauthorized individuals to gain access to its network for an 11-day period in December 2021. The lawsuit, which names Monongalia Health Systems Inc. and affiliated hospitals, Monongalia County General Hospital Co.,

HIPAA 104

HIPAA Fraud Hospitals Health Insurance 104

HIPAA Journal

APRIL 1, 2022

On January 24, 2022, SRHD announced that an employee email account had been compromised on December 21, 2021. Buffalo, NY-based Ciox Health provides health information management services to healthcare providers and insurers. CMMHC identified potentially malicious activity in its email environment on October 21, 2021.

Fraud 137

Fraud HIPAA Licensing Health Insurance 137

HIPAA Journal

DECEMBER 19, 2022

A review of the files on the compromised servers confirmed that protected health information such as patient names, dates of birth, Social Security numbers, driver’s license numbers, health insurance information, and diagnosis and treatment information had been exposed. The DOL and the U.S.

Fraud 105

Fraud Licensing HIPAA Health Insurance 105

HIPAA Journal

MARCH 21, 2023

MRHS discovered unauthorized access to its computer systems on November 8, 2022, and determined hackers had exfiltrated files from its systems more than a year earlier on October 30, 2021. The lawsuits allege the victims of these breaches now face a substantial risk of fraud, identity theft, and other misuses of their personal data.

Hospitals 74

Hospitals Fraud Health Insurance HIPAA 74

HIPAA Journal

NOVEMBER 16, 2022

Unauthorized individuals have gained access to the email system of the Administrative Fund of the Detectives’ Endowment Association of the Police Department of the City of New York (NYCDEA) and potentially viewed or obtained the protected health information of 21,544 individuals.

HIPAA 98

HIPAA Licensing Health Insurance Fraud 98

HIPAA Journal

DECEMBER 7, 2022

Urology of Greater Atlanta Notifies Almost 80,000 Patients About August 2021 Data Breach. Urology of Greater Atlanta has now confirmed that it was the victim of a cyberattack that was detected on August 29, 2021. The VA concluded that there was a low risk of misuse of that information.

COVID-19 Vaccine 95

COVID-19 Vaccine COVID-19 Department of Veterans Affairs Licensing 95

HIPAA Journal

FEBRUARY 13, 2023

iCare Acquisitions has proposed a $3 million settlement to resolve claims from individuals affected by a 2021 data breach that affected almost 3.3 million 20/20 Eye Care Network and 20/20 Hearing Care Network health plan members.

HIPAA 74

HIPAA Fraud Health Insurance 74

HIT Consultant

MAY 9, 2023

During the month of the breach, a cybercriminal was able to access various confidential files, including patient data such as names, contact details, treatments, diagnoses, patient account numbers, their dentist’s names as well as billing details and health insurance data. As a result, patients feared an increased risk of fraud.

Ransomware 95

Ransomware Fraud Health Insurance HIPAA 95

HIPAA Journal

MAY 25, 2022

SAC Health said it is unaware of any actual or attempted misuse of patient data as a result of the break-in; however, as a precaution against identity theft and fraud, affected individuals have been offered complimentary credit monitoring services. Notification letters were sent to those individuals on May 3, 2022.

Ransomware 134

Ransomware Fraud HIPAA Licensing 134

Compliancy Group

MAY 27, 2022

The law firm BakerHostetler published its annual Data Security Incident Response Report based on findings from 1,270 data security incidents managed by the firm in 2021. . The lawsuit further states that warnings had been issued to the healthcare sector about the threat of Hive ransomware attacks as early as June 2021.

HIPAA 98

HIPAA Ransomware Compliance Hospitals 98

HIPAA Journal

NOVEMBER 21, 2022

The Wisconsin-based dermatology practice, Forefront Dermatology, has agreed to settle a class action lawsuit filed on behalf of patients whose protected health information (PHI) was compromised in a ransomware attack in late May 2021. Forefront Dermatology has affiliated practices in 21 states and Washington D.C.

Ransomware 68

Ransomware Fraud HIPAA Licensing 68

Health Care Law Brief

JUNE 24, 2022

The Department of Health and Human Services (“HHS”), Office for Civil Rights (“OCR”), recently issued new regulatory guidance relating to covered entities’ HIPAA-compliant use of remote communication technologies for audio-only telehealth services.

HIPAA 52

HIPAA Fraud Compliance COVID-19 52

HIPAA Journal

JANUARY 27, 2023

The forensic investigation and document review concluded on December 28, 2022, and confirmed that the attackers had access to its network between December 31, 2021, and January 27, 2022, and may have viewed or obtained files that contained protected health information.

Ransomware 101

Ransomware HIPAA Fraud Licensing 101