Compliancy Group

FEBRUARY 16, 2024

This month, fraud in the medical industry has been making headlines fairly frequently. In one case, the dentist himself was involved, practicing on a revoked license. We also covered two Medicaid fraud schemes , one resulting in billions of dollars in billing for medical supplies that were never received.

Fraud 52

Fraud Licensing Medicaid Medicaid 52

HIPAA Journal

NOVEMBER 16, 2022

According to the breach report filed with the Maine Attorney General, it took until October 3, 2022, to confirm that an unauthorized third party had accessed the email system, which included sensitive information of its members. Notification letters were sent to affected individuals on October 31, 2022.

HIPAA 111

HIPAA Licensing Health Insurance Fraud 111

HIPAA Journal

SEPTEMBER 9, 2022

That process concluded on June 24, 2022. Those emails contained patient information such as names, dates of birth, Social Security numbers, medical information, health insurance information, driver’s license numbers, and state ID numbers. The information exposed varied from patient to patient.

Licensing 119

Licensing Health Insurance Fraud HIPAA 119

HIPAA Journal

DECEMBER 19, 2022

On September 9, 2022, 365 Data Centers notified Avem Health Partners that an unauthorized third party had gained access to its servers. The breach was detected on May 16, 2022, with the investigation confirming there may have been unauthorized access to data stored on those servers prior to May 14, 2022. The DOL and the U.S.

Fraud 107

Fraud Licensing HIPAA Health Insurance 107

HIPAA Journal

MAY 25, 2022

The break-in was discovered on March 4, 2022, with the subsequent investigation confirming on April 22, 2022, that six boxes of paper documents had been stolen from the facility, which included files relating to patients served by SAC Health in 1997 and between 2006 and 2020. Lifespan Services Suffers Ransomware Attack.

Ransomware 137

Ransomware Fraud HIPAA Licensing 137

HIPAA Journal

NOVEMBER 23, 2022

The attack occurred between January 26 and January 28, 2022, and while the attack was detected by the firm’s endpoint security solution shortly after the ransomware was executed, it was not possible to prevent the encryption of certain files on its network.

Ransomware 122

Ransomware Fraud Licensing HIPAA 122

HIPAA Journal

JULY 20, 2022

While data theft could not be determined, the affected email accounts contained the protected health information of patients of 19 of its hospitals, including names, birth dates, health insurance information, Social Security numbers, driver’s license, and healthcare data. The lawsuit, filed in the Circuit Court of the City of St.

Fraud 128

Fraud Licensing HIPAA Health Insurance 128

HIPAA Journal

JANUARY 17, 2023

The security breach was detected on June 29, 2022, when staff members were prevented from accessing files. Leading third-party cybersecurity experts were engaged to investigate the incident and determine the nature and scope of the breach and confirmed that the threat actors had access to its network between June 15, 2022, and June 29, 2022.

Ransomware 120

Ransomware Fraud HIPAA Licensing 120

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). MFCUs reported 1,143 total convictions in FY 2023—a marked decrease from 1,327 convictions in FY 2022.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

HIPAA Journal

MARCH 25, 2022

Ultimate Care said no reports have been received that indicate there has been any misuse of patient information; however, as a precaution against identity theft and fraud, individuals whose Social Security numbers were impacted have been offered complimentary one-year memberships with a credit monitoring service.

Health Insurance 120

Health Insurance Licensing Ransomware Fraud 120

HIPAA Journal

APRIL 15, 2022

A lawsuit has been filed against the in-home respiratory care provider, SuperCare Health, over a cyberattack and data breach that was reported to the Department of Health and Human Services on March 28, 2022. A subset of individuals also had their Social Security numbers and/or driver’s license numbers exposed.

Electronic Medical Records 124

Electronic Medical Records HIPAA Health Insurance Fraud 124

HIPAA Journal

AUGUST 2, 2023

Notification letters will be sent to the affected individuals in the coming weeks and credit monitoring, fraud consultation, and identity theft restoration services will be offered. A third-party data review company was provided with the files on December 22, 2022, and provided the results of the analysis to SHS on May 16, 2023.

Licensing 96

Licensing Electronic Medical Records Ransomware Health Insurance 96

The Health Law Firm

MARCH 9, 2023

Board Certified by The Florida Bar in Health Law In late February 2023, multiple states began taking action against licensed practical nurses (LPNs) and registered nurses (RNs) because of the FBI's "Operation Nightingale." Indest III, J.D., This is also being pushed by the National Council of State Boards of Nursing (NCBSN).

Nurses 75

Nurses Licensing Fraud 75

The Health Law Firm Blog

APRIL 18, 2022

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.].

Licensing 40

Licensing Medicaid Medicaid Fraud 40

HIPAA Journal

APRIL 1, 2022

On March 24, 2022, SRHD announced that its IT department discovered a compromised email account, with the investigation recently confirming that the employee responded to a phishing email on February 24, 2022, and disclosed credentials that allowed the account to be accessed.

Fraud 141

Fraud HIPAA Licensing Health Insurance 141

Healthcare Law Today

DECEMBER 22, 2022

Department of Health and Human Services Office of Inspector General (HHS-OIG) Special Fraud Alert on telefraud, and the rise of asynchronous telehealth, among other topics. In July 2022, HHS-OIG published a Special Fraud Alert about arrangements with telemedicine companies to serve as an extra level of guidance to the industry at large.

Telemedicine 119

Telemedicine Fraud Doctors COVID-19 119

HIPAA Journal

DECEMBER 20, 2022

Work Health Solutions, a San Jose, CA-based occupational health services provider, has confirmed that the protected health information of 13,157 individuals has been exposed and potentially obtained by unauthorized individuals who had access to an employee email account between February 16, 2-022 and March 24, 2022.

Health Insurance 110

Health Insurance Licensing Hospitals Fraud 110

Provider Trust

APRIL 26, 2023

However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. Nurse Strikes and Interim Solutions Present Licensure Challenges In 2021 and 2022, hospitals like Mount Sinai in New York and St. It’s no wonder nurse strikes have been on the rise.

Licensing 52

Licensing Nurses Compliance COVID-19 52

HIPAA Journal

FEBRUARY 16, 2023

The investigation confirmed hackers had access to, and potentially stole, the protected health information of patients such as names, Social Security numbers, driver’s license information, dates of birth, health insurance, medical treatment information, and financial account information. A lawsuit – McHenry v.

HIPAA 107

HIPAA Fraud Licensing Health Insurance 107

HIPAA Journal

DECEMBER 7, 2022

In October 2022, Urology of Greater Atlanta in Georgia reported a data breach to the HHS’ Office for Civil Rights that had affected 79,795 patients. In some cases, Social Security numbers, driver’s license numbers, or financial account information, were also exposed. At the time it was unclear exactly how that information was breached.

COVID-19 Vaccine 103

COVID-19 Vaccine COVID-19 Department of Veterans Affairs Licensing 103

HIPAA Journal

MARCH 22, 2023

The plaintiff and class members now face an increased risk of identity theft and fraud as their private information is now in the hand of cybercriminals. Cardiovascular Associates in Alabama is facing a class action lawsuit over a recently reported hacking incident in which patients protected health information (PHI) was stolen.

HIPAA 111

HIPAA Fraud Licensing Health Insurance 111

Healthcare IT Today

FEBRUARY 9, 2024

A 2022 Deloitte survey of U.S. Even worse, up to 10% of this spending is rife with waste, abuse, and fraud. For health payers and agencies, AI so far has been mostly applied to claims processing, member engagement, and identification of suspected cases of fraud, waste, and abuse. In other words, nearly half of all U.S.

Fraud 128

Fraud Governance Hospitals Licensing 128

HIPAA Journal

JANUARY 27, 2023

The cyberattack was detected on January 27, 2022, and systems were taken offline to contain the attack. Data theft could not be ruled out, but at the time of issuing notifications, no reports had been received to suggest that sensitive information has been used for identity theft or fraud.

Ransomware 107

Ransomware HIPAA Fraud Licensing 107

HIPAA Journal

SEPTEMBER 12, 2023

The information stolen in the attack included names, addresses, dates of birth, Social Security numbers, driver’s license numbers, financial account information, payment card information, diagnoses, and health insurance information.

HIPAA 103

HIPAA Ransomware Health Insurance Fraud 103

HIPAA Journal

APRIL 18, 2023

The lawsuit was filed in response to a breach of a Microsoft 365-hosted business email account that was detected on April 14, 2022. The lawsuit alleges the plaintiff and class members face imminent and impending injury from the increased risk of identity theft and fraud. Klinger of Milberg Coleman Bryson Phillips Grossman.

HIPAA 102

HIPAA Fraud Licensing Health Insurance 102

Healthcare Compliance Blog

MARCH 10, 2022

Complaints of resident abuse in a Michigan nursing home led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursing home while her license was suspended, which is a felony.

Nursing Homes 59

Nursing Homes Nurses Licensing Fraud 59

HIPAA Journal

APRIL 25, 2023

The email account breach was detected on February 13, 2023, and the forensic investigation confirmed the email account was accessed between June 16, 2022, and July 18, 2022. TRPHD said suspicious activity was detected within its server infrastructure on November 9, 2022.

Health Insurance 106

Health Insurance Public Health Ransomware Fraud 106

HIPAA Journal

NOVEMBER 15, 2022

Anesthesiology firms started reporting data breaches to the Department of Health and Human Services’ Office for Civil Rights in September 2022, with the notification letters to patients indicating there had been a data breach at their anesthesia management services organization. The notification letters failed to name that company.

HIPAA 83

HIPAA Fraud Licensing Health Insurance 83

Provider Trust

JANUARY 18, 2023

In October 2022, the South Carolina Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old South Carolina woman named Alyssa Beth Steele for working as a registered nurse despite not having a license. Pursuant to federal regulations, the SCMFCU is authorized to investigate and prosecute any acts of Medicaid provider fraud.

Nurses 52

Nurses Licensing Fraud Medicaid 52

HIPAA Journal

JULY 4, 2023

As a precaution against identity theft and fraud, affected individuals have been offered 24 months of complimentary credit monitoring services. In March 2022, an unauthorized individual accessed the email account of an employee.

Medicaid 97

Medicaid Medicaid Health Insurance Licensing 97

HIPAA Journal

SEPTEMBER 28, 2022

At the time of issuing notifications, Wolfe Clinic had not received any reports of identity theft and fraud related to the Eye Care Leaders data breach. Reiter Affiliated Companies Reports June 2022 Cyberattack. The attack was detected on July 4, 2022, when certain systems were made unavailable. million patients.

Electronic Medical Records 75

Electronic Medical Records Ransomware Fraud HIPAA 75

Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.

Licensing 52

Licensing Fraud Compliance Nurses 52

Healthcare Law Blog

MARCH 24, 2022

The Requestor’s enrollment specialist, under the guidance of a licensed clinical supervisor, determines the type of services and frequency of recovery coaching using an evidence-based, automated algorithm. Therefore, the OIG determined that the risk is low an entity would become a Customer to “generate business or reward referrals.”.

Fraud 96

Fraud Licensing 96

HIPAA Journal

NOVEMBER 17, 2022

Salud Family Health Provides Update on September 2022 Ransomware Attack. Colorado-based Salud Family Health, a Federal Qualified Health Center (FQHC), has recently provided an update on a September 2022 cyberattack and has confirmed that patient data was potentially stolen.

Ransomware 81

Ransomware Health Insurance Fraud HIPAA 81

Healthcare Compliance Blog

MARCH 11, 2022

A Boston registered nurse (RN) has pled guilty to one count of tampering with a consumer product and one count of obtaining a controlled substance by fraud and deception. The RN is scheduled for sentencing in August 2022. On November 6, 2020, the RN was working the night shift on a dementia unit in the nursing home.

Nurses 59

Nurses Nursing Homes Fraud Licensing 59

HIPAA Journal

MARCH 2, 2023

A third-party cybersecurity firm assisted with the investigation but found no instances of fraud or identity theft; however, as a precaution, the 21,325 affected patients have been offered complimentary credit monitoring and identity theft protection services.

Medicare 70

Medicare Medicare Fraud HIPAA 70

HIT Consultant

NOVEMBER 24, 2022

. – Prescription hearing aids will require a consumer to have a prescription for a hearing aid from a physician, audiologist or a licensed hearing instrument specialist. As of now, there are no OTC hearing aid products on the market since the rules didn’t go into effect until October 17, 2022. – Fraud.

FDA 98

FDA Public Health Fraud Medicare 98