The Health Law Firm Blog

MARCH 14, 2024

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. Indest III, J.D.,

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The Health Law Firm Blog

FEBRUARY 1, 2024

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. Indest III, J.D.,

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The Health Law Firm Blog

DECEMBER 19, 2022

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. Indest III, J.D.,

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The Health Law Firm Blog

NOVEMBER 7, 2022

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. Indest III, J.D.,

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The Health Law Firm Blog

APRIL 15, 2024

Board Certified by The Florida Bar in Health Law On February 16, 2024, a Parkland, Florida, man agreed to plead guilty to organizing a Medicare fraud scheme worth $110 million. Indest III, J.D., The federal prosecution is taking place in the U.S. District Court for the District of Massachusetts.

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The Health Law Firm Blog

MARCH 25, 2024

Board Certified by The Florida Bar in Health Law On February 16, 2024, a Parkland, Florida, man agreed to plead guilty to organizing a Medicare fraud scheme worth $110 million. Indest III, J.D., The federal prosecution is taking place in the U.S. District Court for the District of Massachusetts.

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MedTrainer

SEPTEMBER 20, 2023

This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud. Part two of this blog post provides specific tips, checklists, and which reports you need to be survey-ready.

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The Health Law Firm Blog

JANUARY 8, 2024

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. Indest III, J.D.,

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American Medical Compliance

FEBRUARY 9, 2024

In this blog, we will explore the crucial role of compliance officers in healthcare organizations, shedding light on the challenges they face and the formidable responsibilities they shoulder. It is not just about following rules but about maintaining the highest standards of patient care and ethical behavior.

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Verisys

NOVEMBER 8, 2023

Providers, employers, health plans, and payers use these numbers for billing purposes. CMS.gov The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the creation of a standard, unique health identifier for healthcare providers, which the NPI satisfies.

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Total HIPAA

MARCH 22, 2023

Insurance agents who handle protected health information (PHI) are required to comply with the Health Insurance Portability and Accountability Act (HIPAA). Failure to comply with HIPAA regulations can result in severe consequences for insurance agents and their clients. Enforcement Highlights.”

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Verisys

MARCH 6, 2025

Department of Health and Human Services (HHS) Enforces regulations like the Health Insurance Portability and Accountability Act (HIPAA) to ensure patient data privacy and security. State agencies Oversee the application of both state and federal rules governing healthcare practice, insurance, and licensure.

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YouCompli

MAY 11, 2022

CJ Wolf, MD writes enforcement action summaries for the YouCompli blog. In March of 2022, a New Jersey rheumatologist was convicted by a federal jury for defrauding Medicare and other health insurance programs. The doctor will be sentenced in July for multiple counts of healthcare fraud. Conclusion.

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MedTrainer

MARCH 8, 2024

This blog post will explore why compliance training is vital for an industry where mistakes or non-compliance can seriously affect patients, staff, and the organization. Fraud, Waste, and Abuse: Training should cover the key provisions of the False Claims Act and other laws that prohibit healthcare fraud, waste, and abuse.

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MedTrainer

FEBRUARY 1, 2024

These programs help to promote lawful and ethical conduct within healthcare organizations and minimize the risk of legal violations, such as fraud, abuse, and other unethical behaviors. We’ll answer that question in this blog along with assessments of a good corporate compliance process. What is Corporate Compliance in Healthcare?

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Healthcare Blog

NOVEMBER 9, 2023

The healthcare industry has extensive regulations, with laws such as the Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA) imposing stringent obligations on providers. It assists in identifying and addressing any concerns early on, lowering the likelihood of fraud, waste, and abuse.

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Medisys Compliance

NOVEMBER 6, 2023

This blog will provide a comprehensive orthopedic billing compliance checklist that healthcare providers can use to verify that their billing practices are compliant with all applicable laws and regulations. Stay up-to-date on all changes to regulatory requirements. Staying compliant with evolving regulations is critical.

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Verisys

DECEMBER 29, 2024

Providers, employers, health plans, and payers use these numbers for billing purposes and electronic data transmission. NPIs are critical for maintaining accountability across healthcare transactions, ensuring accurate reporting, and streamlining electronic communication across private and government health insurance programs.

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MedTrainer

JULY 25, 2024

Adhering to the Health Insurance Portability and Accountability Act (HIPAA) standards is crucial to uphold compliance and regulatory requirements for any health organization. This act safeguards patients’ protected health information (PHI) and health plans and defines security and privacy regulations regarding patient data.

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MedTrainer

JANUARY 31, 2024

It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. These laws require healthcare providers to establish internal controls and compliance programs to prevent fraud and abuse in the healthcare system. Who started the first healthcare compliance program?

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Compliancy Group

MARCH 19, 2024

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services.

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MedTrainer

JANUARY 30, 2024

In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them. Additionally, compliance programs address a wide range of potential issues, including fraud, waste, and abuse.

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MedTrainer

JANUARY 31, 2024

In this blog, we’ll discuss the structured framework for managing risks and maintaining the highest standards of care and integrity in the healthcare industry. For the organization itself, compliance programs are the guardians that can help potentially prevent medical errors and regulatory violations, and mitigate other compliance risks.

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MedTrainer

JULY 30, 2024

Included in this blog post are the results of an audit on Wisconsin requirements. Clearly healthcare organizations take Wisconsin training requirements seriously. MedTrainer’s healthcare policy experts often conduct state analyses of training requirements to share with customers. What Is Required for Wisconsin Compliance Training?

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MedTrainer

JUNE 11, 2024

Included in this blog post are the results of an audit on Florida requirements. One other requirement specific to Florida is a course on the IRAS (Incident Reporting and Analysis System). MedTrainer’s healthcare policy experts often conduct state analyses of training requirements to share with customers.

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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.

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MedTrainer

OCTOBER 17, 2023

In this blog post, we’ll discuss the answer to: “Why do healthcare facilities have corporate compliance programs?” Prevention of Fraud and Abuse Corporate compliance works as a shield against potential fraud and abuse. Compliance programs ensure that facilities handle this data with care.

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MedTrainer

JANUARY 26, 2024

In this blog, we will outline what is non-compliance in healthcare, highlight various non-compliance activities, and explore how healthcare compliance software plays a crucial role in combating non-compliance.

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MedTrainer

JULY 31, 2024

Included in this blog post are the results of an audit on Tennessee requirements. Of note, Tennessee does not require cultural competency, except for behavioral health organizations and providers. Meeting Tennessee training requirements for compliance is critical to maintain this level of excellence.

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MedTrainer

JUNE 11, 2024

Texas also passed Bill 300, which requires employees responsible for the security of protected health information (PHI) to take an additional training. Included in this blog post are the results of an audit on Texas requirements. This list should be used as a guide and does not replace your own comprehensive analysis.

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MedTrainer

JUNE 10, 2024

Included in this blog post are the results of an audit on California requirements. Domestic violence training is required based on licensing. MedTrainer’s healthcare policy experts often conduct state analyses of training requirements to share with customers. What Is Required for California Compliance Training?

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MedTrainer

JUNE 10, 2024

Included in this blog post are the results of an audit on New York requirements. Hospitals must also have training and a written plan for domestic violence, and sexual harassment training is required for all employers. MedTrainer’s healthcare policy experts often conduct state analyses of training requirements to share with customers.

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Verisys

JANUARY 8, 2024

This includes adherence to standards set by the Health Insurance Portability and Accountability Act (HIPAA) , the Centers for Medicare & Medicaid Services (CMS), and other regulatory bodies. The audit evaluates if the healthcare organization follows billing and coding standards to prevent fraud and abuse.

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Hall Render

FEBRUARY 4, 2022

Of that, $5 billion relates to health care fraud involving drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians. Health Care Fraud Actions. Hall Render blog posts and articles are intended for informational purposes only.

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MedTrainer

JUNE 29, 2023

By promoting equity and fairness in healthcare delivery, regulations prevent discrimination, ensure equal access to care, and reduce health disparities. Stark Law prohibits physicians from referring patients for certain designated health services to entities with which they have financial relationships, to avoid conflicts of interest.

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Verisys

FEBRUARY 12, 2024

This includes clinical risks, financial risks, cybersecurity threats, and compliance risks with laws and regulations such as HIPAA (Health Insurance Portability and Accountability Act) in the United States. It’s about ensuring that the organization meets external legal requirements as well as internal policies and procedures.

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MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Compliance efforts shifted toward protecting patient information.

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