Healthcare IT Today

JANUARY 2, 2023

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. We are going to see an increased demand for privacy-preserving technology in 2023, and therefore more investment in the space. during 2023. Check out our community’s healthcare Security and Risk predictions.

Ransomware 109

Ransomware Fraud Compliance Telemedicine 109

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

Fierce Healthcare

APRIL 22, 2023

COVID fraud takedowns: Feds charge 18 people, including doctors, with raking in nearly $500B from scams hlandi Sat, 04/22/2023 - 20:51

Fraud 81

Fraud Doctors 81

Healthcare IT Today

JUNE 3, 2023

Read more… Know Your Patient and Prevent Insurance Fraud. For busy CISOs, fraud prevention can easily slip under the radar. Verifying patient identity and requiring authentication on an ongoing basis can help safeguard providers against fraud , said Bala Kumar at Jumio.

Fraud 91

Fraud 91

Healthcare IT Today

MAY 6, 2023

Read more… Preventing Genetic Testing Fraud: 5 Actions for Health Plans. Medicare payments for genetic testing quadrupled from 2016 to 2019, which has unfortunately led to a rise in a rise in fraud, waste, and abuse. On the heels of ViVE and HIMSS, they also discuss whether in-person conferences are back.

Fraud 91

Fraud Doctors Medicare Medicare 91

Compliancy Group

FEBRUARY 16, 2024

This month, fraud in the medical industry has been making headlines fairly frequently. We also covered two Medicaid fraud schemes , one resulting in billions of dollars in billing for medical supplies that were never received. Each charge also comes with five years probation, while the fraud charge includes 18 months of house arrest.

Fraud 52

Fraud Licensing Medicaid Medicaid 52

HealthIT Answers

MARCH 31, 2024

22 for civil fraud and false claims settlements and judgments recovered for taxpayers by the agency in fiscal 2023, or from Oct. The post Justice Department Sleeping at the Healthcare Fraud Wheel appeared first on Health IT Answers. By David R. Burda - Here are the DOJ stats released on Feb. 1, 2022, through Sept.

Fraud 52

Fraud 52

HIT Consultant

JUNE 21, 2023

The success of the project has led the company to invest in further enhancing the new mobile solution to take payment at the point of delivery from October 2023. One of Apria’s priorities for the project was an easy installation, which is why they chose Pega’s low code, off-the-shelf solution to integrate into their existing system.

Fraud 98

Fraud Health Insurance Compliance 98

HIPAA Journal

APRIL 25, 2024

City of Hope National Medical Center identified suspicious activity within its network on October 13, 2023, and the forensic investigation confirmed there had been unauthorized access by a third party between September 19, 2023, and October 12, 2023.

Fraud 117

Fraud Health Insurance HIPAA Licensing 117

HIPAA Journal

OCTOBER 21, 2022

A pharmaceutical sales rep has pleaded guilty to conspiring to commit healthcare fraud and wrongfully disclosing and obtaining patients’ protected health information in an elaborate healthcare fraud scheme involving criminal HIPAA violations. Alario pleaded guilty to his role in the healthcare fraud scheme earlier this month.

Fraud 63

Fraud HIPAA FDA Health Insurance 63

Bill of Health

OCTOBER 30, 2023

By Bobby Stroup 2023 is the year of the emoji lawsuit. In another legal case, a “moon” emoji was found to be possible evidence of securities fraud. This year a “thumbs-up” emoji was found to be part of a legally binding contract. This legal evolution may seem a bit strange.

Doctors 290

Doctors Hospitals Fraud Health Insurance 290

Verisys

JANUARY 2, 2024

The post December 2023 Bad Actors Roundup appeared first on Verisys. Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Million Civil Settlement with Total Access Urgent Care Over False Claims Allegations Full story Former Co-Owners of New Jersey Marketing Company Sentenced to Prison in $8.8

Fraud 52

Fraud Licensing Doctors Medicare 52

Med-Net Compliance

SEPTEMBER 20, 2022

The defendant was also convicted for falsification of records designed to prevent detection of this fraud and aggravated identity theft for falsely corresponding with Medicare under the name of another physician. Million Healthcare Fraud Scheme appeared first on Med-Net. He is scheduled to be sentenced on Jan.

Fraud 59

Fraud US Department of Health and Human Services Medicare Medicare 59

American Medical Compliance

APRIL 6, 2023

In January 2023, federal investigators convicted twenty-five people in Miami as part of a scheme to get counterfeit nursing school degrees and find jobs for aspiring nurses. Incidence of Healthcare Fraud Numerous scammers view this as a method to make quick, yet unlawful, money. 2023, January 27). Reference NPR.

Fraud 52

Fraud Nurses Licensing Compliance 52

Med-Net Compliance

OCTOBER 27, 2022

The psychologist was convicted of four counts of healthcare fraud. He is scheduled to be sentenced on April 18, 2023, and faces a maximum penalty of 10 years in prison on each count. The post Nursing Home Psychologist Convicted of Healthcare Fraud Scheme appeared first on Med-Net.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

The Health Law Firm Blog

JULY 17, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

Fraud 52

Fraud FDA Licensing Nurses 52

The Health Law Firm Blog

JUNE 26, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

Fraud 52

Fraud FDA Licensing Nurses 52

The Health Law Firm Blog

AUGUST 22, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

Fraud 52

Fraud FDA Licensing Nurses 52

The Health Law Firm Blog

AUGUST 8, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. By George F. Indest III, J.D.,

Fraud 52

Fraud FDA Licensing Nurses 52

Compliancy Group

FEBRUARY 12, 2024

Fraud in healthcare has run rampant in recent years, as evident by two incidents in which healthcare organizations billed insurance companies for things patients never received. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

Fraud 52

Fraud Medicare Medicare US Department of Health and Human Services 52

HIT Consultant

FEBRUARY 23, 2023

Because of the highly immutable data this type of healthcare data fabric or digital network provides, the instances of fraud and abuse could be significantly reduced. Let’s reinvent healthcare in 2023, not based on our current reality, but on a new way of thinking about interoperability , courageously embracing “possibility thinking.”

COVID-19 96

COVID-19 Fraud Hospitals 96

The Health Law Firm Blog

JANUARY 2, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On October 18, 2023, an ex-Navy officer was sentenced to 30 months in prison after he pleaded guilty to conspiracy to commit wire fraud for his role in an [.] Indest III, J.D.,

Fraud 52

Fraud Nurses Licensing Doctors 52

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

FEBRUARY 22, 2023

On February 10, 2023, CentraState confirmed it had suffered a ransomware attack that disrupted its computer systems. On February 20, 2023, a lawsuit was filed in the Monmouth County Superior Court by attorney Benjamin Johns, which named Rita Sorrentino-Poggi of Manalapan as the plaintiff.

Ransomware 107

Ransomware Fraud Health Insurance HIPAA 107

Healthcare IT Today

JANUARY 19, 2024

According to the 2023 ForgeRock Breach Report , healthcare has consistently ranked as the most targeted industry by cybercriminals for the past five years. The 2023 Verizon Breach Report further highlights vulnerabilities with the healthcare sector, identifying web applications as the number one attack vector.

Fraud 123

Fraud Governance Ransomware Compliance 123

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. As of August 2023, losses have already exceeded those in 2022 by 40%.

Fraud 52

Fraud Elder Abuse Governance Compliance 52

Provider Trust

MARCH 21, 2023

Grimm gave a lecture at the 2023 RISE National Conference in early March 2023 about Medicare Advantage, or Medicare Part C, and the increased risk of fraud due to the rapid growth of healthcare programs. As Medicare Advantage continues to grow, the risk of provider-level fraud will also increase.

Fraud 52

Fraud Medicare Medicare US Department of Health and Human Services 52

American Medical Compliance

MAY 22, 2023

million to settle allegations that it paid kickbacks to healthcare providers committing fraud violations. US Efforts to Crack Down on Fraud Violations Kickbacks are illegal under the False Claims Act because they can lead to overuse or misuse of medical products, harming patients and increasing healthcare costs. DePuy Synthes, Inc.

Fraud 52

Fraud Compliance Governance Doctors 52

HIPAA Journal

MARCH 1, 2023

No evidence of misuse of plan member data was identified at the time of issuing notification letters; however, as a precaution against identity theft and fraud, complimentary credit monitoring and identity theft protection services were offered to affected individuals. Claims must be submitted no later than August 14, 2023.

Fraud 108

Fraud Ransomware Health Insurance HIPAA 108

American Medical Compliance

FEBRUARY 15, 2023

The Dental Healthcare Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Trust is core to the provider-patient relationship.

Fraud 52

Fraud Medicare Medicare Compliance 52

HIPAA Journal

JULY 4, 2024

SkinCure Oncology has notified 13,434 patients about an email attack that occurred in June 2023, and the Wisconsin Department of Health Services has announced a breach of the personal information of 19,150 Medicaid recipients. SkinCure Oncology believes files in those email accounts were viewed and potentially obtained in the attack.

Medicaid 115

Medicaid Medicaid Fraud Licensing 115

Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

HIPAA Journal

MARCH 7, 2023

Affected individuals were notified about the data breach in February 2023 and were offered complimentary credit monitoring services. The attempted fraudulent activity occurred between December 2022 and February 2023, before being informed by the defendants about the data breach.

Fraud 120

Fraud Health Insurance Doctors HIPAA 120

The Health Law Firm

JUNE 1, 2023

is Board Certified by The Florida Bar in Health Law On May 19, 2023, jurors rendered a verdict to federal prosecutors in a trial against executives from a Miami clinical drug trial company and a local doctor. By George F. Indest III, J.D., The History of Allegations.

Fraud 52

Fraud Doctors 52

HIPAA Journal

MAY 18, 2023

The breach was detected by NextGen on March 30, 2023, and the forensic investigation confirmed hackers had access to its network between March 29, 2023, and April 14, 2023. The investigation determined that the credentials stolen by the hackers came from other sources and did not appear to have been stolen from NextGen.

Ransomware 124

Ransomware Fraud HIPAA 124

Provider Trust

AUGUST 9, 2023

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released its latest 2023 Spring Semiannual Report to Congress, providing a comprehensive overview of its activities from October 2022 to March 2023. Led by acting Inspector General Christi A. What is the HHS-OIG Semiannual Report to Congress?

Nursing Homes 52

Nursing Homes COVID-19 Fraud Medicaid 52

MedTrainer

JANUARY 10, 2024

It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. The OIG is making major investments to systematically detect and prosecute fraud. It may seem a little early to do some spring cleaning, but not when it comes to compliance!

Compliance 94

Compliance Fraud HIPAA Compliance Officers 94