Compliancy Group

OCTOBER 28, 2024

Health and Human Services (HHS) Department’s efforts to eliminate fraud, waste, and abuse. Its compliance program guidance (CPG) has improved the efficiency and effectiveness of Medicare and many other federal programs. More specifically, the 2024 guidance for nursing facilities focuses on several areas.

Nurses 52

Nurses Compliance Nursing Homes Compliance Officers 52

Compliancy Group

FEBRUARY 26, 2024

In the evolving healthcare industry, adhering to compliance rules and standards while staying on top of regulatory changes is paramount. A comprehensive hospital compliance work plan is pivotal for achieving these objectives. What Are Hospital Compliance Work Plans?

Compliance 52

Compliance US Department of Health and Human Services Hospitals Compliance Officers 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

Verisys

APRIL 2, 2024

March 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Secure your success by choosing Verisys.

Fraud 52

Fraud Telemedicine Licensing Doctors 52

Verisys

MAY 13, 2024

April 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. The post April 2024 Bad Actors Roundup appeared first on Verisys. Secure your success by choosing Verisys.

Fraud 52

Fraud COVID-19 Doctors Licensing 52

Verisys

FEBRUARY 9, 2024

January 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 The post January 2024 Bad Actors Roundup appeared first on Verisys.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Verisys

AUGUST 13, 2024

July 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. The post July 2024 Bad Actors Roundup appeared first on Verisys. Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M

Fraud 52

Fraud Doctors Licensing Medicare 52

Verisys

AUGUST 13, 2024

July 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. The post July 2024 Bad Actors Roundup appeared first on Verisys. Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M

Fraud 52

Fraud Doctors Licensing Medicare 52

AIHC

SEPTEMBER 3, 2024

Celebrating the Healthcare Compliance Officer The American Institute of Healthcare Compliance is recognizing healthcare Compliance Officers – hats off to you! The primary goal of a compliance officer is to mitigate risk. This involves investigating complaints and conducting internal auditing and monitoring for compliance.

Compliance Officers 52

Compliance Officers Compliance Fraud Medicare 52

Verisys

JUNE 17, 2024

May 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. The post May 2024 Bad Actors Roundup appeared first on Verisys. Attorney Announces $2.5

Fraud 52

Fraud Doctors Licensing Compliance 52

Verisys

JULY 25, 2024

June 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 The post June 2024 Bad Actors Roundup appeared first on Verisys.

Fraud 52

Fraud Nursing Homes COVID-19 Licensing 52

Verisys

JULY 25, 2024

June 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 The post June 2024 Bad Actors Roundup appeared first on Verisys.

Fraud 52

Fraud Nursing Homes COVID-19 Licensing 52

Medisys Compliance

AUGUST 21, 2024

In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced several crucial updates to radiation oncology billing guidelines. These changes affect coding, reimbursement, and compliance requirements, making it essential for providers to stay informed to maximize reimbursement and avoid penalties.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medicaid Medicaid 59

Compliancy Group

MAY 15, 2024

As we move deeper into 2024, hospitals must increasingly focus on compliance with regulations set forth by the Office of Inspector General (OIG). This guide outlines the OIG’s hospital compliance priorities and provides actionable advice on ensuring your hospital meets these rigorous standards.

Compliance 52

Compliance Hospitals Fraud Regulatory Compliance 52

Compliancy Group

DECEMBER 20, 2024

In 2024, the Department of Health and Human Services (HHS) Office for Civil Rights announced a series of enforcement actions against entities that violated, or potentially violated, one or more HIPAA rules. This HIPAA 2024 Year in Review article discusses these actions. The $950,000 settlement agreement subjects HVHS to a 3-year CAP.

Ransomware 52

Ransomware HIPAA Fraud Electronic Medical Records 52

Health Care Law Brief

FEBRUARY 7, 2024

Department of Health and Human Services Office of Inspector General’s (OIG) core responsibility is to promote efficiency and economy in myriad programs by eliminating fraud, waste and abuse. Copyright 2024 Compliance Today , a publication of the Health Care Compliance Association (HCCA).

Compliance 52

Compliance Fraud Regulatory Compliance 52

HIPAA Journal

JANUARY 11, 2024

OIG in healthcare stands for the Department of Health and Human Services (HHS) Office of Inspector General (OIG) – the Office within the HHS responsible for reducing waste, fraud, and abuse in HHS programs and improving efficiency.

Fraud 92

Fraud HIPAA Compliance Medicare 92

MedTrainer

JANUARY 31, 2024

Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program? It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. What is Healthcare Compliance?

Compliance 52

Compliance Fraud Governance ACA 52

Medisys Compliance

NOVEMBER 26, 2024

Skilled Nursing Facility (SNF) billing compliance is a critical aspect of healthcare revenue cycle management, ensuring accurate reimbursement and adherence to Medicare regulations. As healthcare providers navigate the complexities of SNF billing, maintaining compliance is essential to avoid penalties, denials, and financial losses.

Compliance 52

Compliance Medical Billing Outsourcing Medicare Medicare 52

Compliancy Group

DECEMBER 9, 2024

Jefferson Dental Cente r, a South Bend, Indiana dental practice operated by Dr. Lorraine Celis, experienced a ransomware attack on November 15, 2024. In its notification, Jefferson Dental states that it discovered, on November 15, 2024, that its computer network systems were not working.

Ransomware 69

Ransomware Licensing HIPAA Compliance 69

Compliancy Group

FEBRUARY 28, 2024

Many industries have compliance rules and regulations to meet and follow, but few would argue that healthcare is one of the most stringent. Privacy and security – Compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations to protect patient privacy and data security is crucial.

Compliance 52

Compliance US Department of Health and Human Services Fraud Medicare 52

Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. Findings from OIG audits can identify compliance areas needing improvement.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Provider Trust

AUGUST 6, 2024

Healthcare compliance monitoring has never been easy. So, what makes an effective compliance monitoring program? The compliance spectrum helps organizations of all sizes identify the effectiveness of their compliance monitoring based on three key factors: population, primary sources, and frequency.

Compliance 52

Compliance Licensing Fraud 52

Innovaare Compliance

SEPTEMBER 22, 2024

Healthcare Payers, 2024 report, provides a strategic roadmap for healthcare payers, that we feel highlights emerging technologies and their expected impact over time. We’re excited to share that Inovaare has been recognized by Gartner as a Sample Vendor in the LLMs in Healthcare category within the 2024 Hype Cycle.

Regulatory Compliance 52

Regulatory Compliance Compliance Fraud 52

Provider Trust

APRIL 18, 2024

This comprehensive program provides healthcare organizations across the continuum of care a roadmap to implement top-tier compliance standards by addressing key population monitoring gaps, prioritizing financial efficiencies, and upholding community healthcare and success.

Compliance 52

Compliance Licensing Fraud Medicaid 52

HIPAA Journal

APRIL 25, 2024

City of Hope National Medical Center issued notification letters on April 2, 2024, and offered the affected individuals complimentary credit monitoring services. Class action lawsuits started to be filed soon after notification letters were mailed. The plaintiffs allege that injuries have been sustained as a result of the data breach.

Fraud 117

Fraud Health Insurance HIPAA Licensing 117

HIPAA Journal

JULY 9, 2024

Notifications were issued in May 2024, and complimentary credit monitoring services were offered to the affected individuals. The lawsuit alleges the plaintiff and class members face an ongoing risk of fraud, identity theft, and other misuses of their sensitive information as a result of the data breach.

Fraud 118

Fraud Health Insurance HIPAA Compliance 118

Compliancy Group

JULY 18, 2024

It’s becoming more well-known that billing is one of the most common compliance risk areas outlined by the Office of the Inspector General (OIG). The occurrence of these issues is consistent, and over time, they can result in thousands of dollars lost in compliance penalties. With the U.S.

Medical Billing 52

Medical Billing Compliance Fraud Compliance Officers 52

Healthcare Law Blog

MAY 11, 2023

The Department of Health and Human Services Office of Inspector General (OIG) recently announced changes to its process for informing healthcare industry stakeholders of new or updated Compliance Program Guidance (CPG). Historically, sector-specific CPG has been published in the Federal Register.

Compliance 52

Compliance Fraud Nurses Medicare 52

Healthcare Law Blog

NOVEMBER 9, 2023

In late April this year, the Office of Inspector General, Department of Health and Human Services (OIG) announced that it would make changes to its existing body of healthcare compliance program guidance (CPGs) as part of its current Modernization Initiative. [1] On November 6, 2023, OIG finally published the GCPG on its website [3].

Compliance 52

Compliance Compliance Officers Fraud Medicare 52

Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Innovaare Compliance

SEPTEMBER 17, 2024

Healthcare Payers, 2024 report, provides a strategic roadmap for healthcare payers, that we feel highlights emerging technologies and their expected impact over time. We’re excited to share that Inovaare has been recognized by Gartner as a Sample Vendor in the LLMs in Healthcare category within the 2024 Hype Cycle.

Regulatory Compliance 52

Regulatory Compliance Compliance Fraud 52

HIPAA Journal

MAY 2, 2024

If they were, class members can claim a cash payment of $50 and can claim up to $7,500 for documented expenses incurred as a result of the data breach, including 3 hours of lost time at $25 per hour, and any unreimbursed losses to identity theft and fraud.

Fraud 108

Fraud HIPAA Health Insurance Compliance 108

MedTrainer

SEPTEMBER 10, 2024

When talking about healthcare compliance education, these misunderstandings can have significant repercussions, from compliance gaps to inefficiencies in operations. Understanding common, but dangerous misconceptions about healthcare compliance education can potentially prevent your organization from these issues in the long run.

Compliance 52

Compliance Compliance Officers HIPAA Medicare 52

Healthcare IT Today

JANUARY 19, 2024

Healthcare organizations must prioritize implementing robust identity security measures in 2024 to safeguard both their operational integrity and the well-being of their patients and consumers. This is due to the fact that predicting whether fraud is possible requires context.

Fraud 123

Fraud Governance Ransomware Compliance 123

HIT Consultant

DECEMBER 18, 2024

Identity theft, fraud, and long-term financial harm are just a few examples of the personal fallout patients may face following a data breach. As per the Cost of Data Breach Report 2024 , the average cost of a data breach in healthcare reached $10.93 million in 2024.

Ransomware 95

Ransomware Fraud Doctors HIPAA 95

Healthcare IT Today

APRIL 25, 2024

On the morning of February 21, 2024, a ransom group, BlackCat, directed a cyberattack at Change Healthcare, owned by healthcare conglomerate UnitedHealth. As of mid-March, 117 other healthcare organizations have experienced a cybersecurity breach in 2024, potentially affecting around 13 million patients, according to the HHS.

Ransomware 126

Ransomware Compliance Fraud Governance 126