MedTrainer

JUNE 28, 2023

In healthcare especially, fraud is something responsible providers need to be on the lookout for. It’s why many organizations choose to work with a Certified Fraud Examiner as part of their ongoing efforts to remain responsible and compliant with financial best practices. What is a Certified Fraud Examiner?

Fraud 52

Fraud Compliance Governance Compliance Officers 52

HIPAA Journal

SEPTEMBER 30, 2022

The plaintiffs alleged the security failures were in violation of the Health Insurance Portability and Accountability Act, although the lawsuit was filed over the violation of state laws. The plaintiffs also took issue with how Magellan Health handled the data breach and the delay in issuing notifications.

Fraud 105

Fraud HIPAA Health Insurance 105

HIPAA Journal

MAY 2, 2024

Hackers gained access to the BioPlus network for more than 2 weeks between October and November 2021, and potentially stole names, dates of birth, contact information, health insurance information, prescription information, and Social Security numbers.

Fraud 108

Fraud HIPAA Health Insurance Compliance 108

HIPAA Journal

AUGUST 4, 2022

The forensic investigation confirmed that names, addresses, diagnoses, treatment information, patient account numbers, billing information, dentists’ names, payment card information, and health insurance information had potentially been compromised. Individuals were notified about the breach in December 2020.

Fraud 122

Fraud HIPAA Health Insurance 122

HIPAA Journal

JULY 4, 2024

The types of data involved varied from individual to individual and may have included names, addresses, dates of birth, Social Security numbers, health insurance information, and/or health information. Pinnacle said it is implementing enhanced security measures to prevent similar incidents in the future.

Electronic Medical Records 106

Electronic Medical Records Health Insurance Ransomware Fraud 106

HIPAA Journal

SEPTEMBER 7, 2022

Before file encryption, the attackers potentially accessed or acquired documents from its systems that contained names, addresses, dates of birth, Social Security numbers, health insurance information, and medical treatment information.

HIPAA 114

HIPAA Ransomware Fraud Health Insurance 114

American Medical Compliance

MARCH 15, 2024

Among the various areas of compliance, Fraud, Waste, and Abuse (FWA) compliance stands out as a critical pillar. The Department of Justice recently revealed charges against 78 individuals involved in healthcare fraud schemes. Compliance with physician self-referral law requires strict adherence to its provisions.

Compliance 88

Compliance Fraud HIPAA Health Insurance 88

HIPAA Journal

JUNE 28, 2023

The total settlement fund has not been disclosed; however, all class members are entitled to claim up to $1,500 as reimbursement for ordinary expenses, which are documented expenses that were incurred as a result of the data breach.

Hospitals 87

Hospitals Fraud Licensing HIPAA 87

Compliancy Group

AUGUST 28, 2024

The Importance of HR Compliance Training Courses Compliance regulations in healthcare are designed to help organizations prevent fraud, waste, and abuse. As regulations evolve, employees need to know what changes they must make in their operations and which important new documents they should be aware of.

Compliance 97

Compliance Fraud Regulatory Compliance HIPAA 97

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. Ordinary claims are capped at $250 per person.

Fraud 121

Fraud Licensing HIPAA Health Insurance 121

HIPAA Journal

DECEMBER 27, 2022

The breached information included names, addresses, Social Security numbers, birthdates, client identification numbers, medical diagnostic and treatment information, and health insurance information.

Fraud 118

Fraud HIPAA Health Insurance 118

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 108

Fraud Ransomware Health Insurance HIPAA 108

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 103

Fraud Licensing Health Insurance HIPAA 103

HIPAA Journal

APRIL 25, 2023

On February 13, 2023, NationsBenefits confirmed that the data compromised in the attack included protected health information such as name, address, phone number, gender, date of birth, health insurance number, medical ID number, Social Security number, date(s) of service, medical device or product purchased, and provider/caregiver name.

Health Insurance 95

Health Insurance Public Health Ransomware Fraud 95

HIPAA Journal

FEBRUARY 15, 2023

The attack was detected and blocked by Electromed on June 16, 2021, and the forensic investigation confirmed that files were accessed – and potentially stolen – that included customers’ first and last names, mailing addresses, medical information, and health insurance information.

Ransomware 95

Ransomware Fraud Licensing Health Insurance 95

HIPAA Journal

JANUARY 16, 2023

Rehoboth McKinley Christian Health Care Services – was filed on behalf of Alicia Charlie, Leona Garcia Lacey, Darrell Tsosie, and a minor child, represented by his guardian Gary Hicks. Rehoboth McKinley Christian Health Care Services had argued that there was no actionable duty to protect the plaintiffs’ data, but U.S.

Fraud 110

Fraud Health Insurance HIPAA Hospitals 110

MedTrainer

SEPTEMBER 20, 2023

This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Compliance isn’t just about meeting state or federal requirements; it’s about maintaining clean and easy-to-access policies, incident reports, safety plans, HR documents, and more. Certification.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

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.

HIPAA 103

HIPAA Fraud Licensing Health Insurance 103

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 111

HIPAA Ransomware Malpractice Health Insurance 111

HIPAA Journal

JANUARY 1, 2023

Most state that HIPAA is an acronym of the Health Insurance Portability and Accountability Act of 1996 and that it led to the development of standards for the privacy of Protected Health Information. However, at the time, the healthcare insurance industry was governed by a hotchpotch of federal and state legislation.

HIPAA 83

HIPAA Health Insurance Fraud Governance 83

HIT Consultant

JUNE 21, 2023

Attendees I talked to spoke of the need for faster, lower cost, straight-through processing of documents and forms and better data insights and manageability. Although AI was the big theme in presentations, attendees were extremely focused on wanting concrete solutions and outcomes.

Fraud 98

Fraud Health Insurance Compliance 98

HIPAA Journal

DECEMBER 20, 2022

Work Health Solutions then verified contact information and sent notifications on November 9, 2022. The exposed files contained names, Social Security numbers, driver’s license numbers, health insurance information, and/or medical information. Patients of St. Patient Data Exposed in Cyberattack on Hawaiian Eye Center.

Health Insurance 102

Health Insurance Licensing Hospitals Fraud 102

Compliancy Group

DECEMBER 9, 2024

Carelessly discarding healthcare documents leaves protected health information (PHI) vulnerable. Non-compliance with Health Insurance Portability and Accountability Act (HIPAA) shredding requirements puts patients, employees, and your organization at risk for privacy breaches, fraud, and other threats.

HIPAA 52

HIPAA Compliance Records Management Fraud 52

Compliancy Group

JULY 10, 2024

If you hold this position, you likely understand what’s at stake in protecting health information and preventing fraud, abuse, and adverse incidents. Ensuring compliance with critical regulations falls on the compliance officer. We also discuss the steps and best practices that can guide you on how to be a good compliance officer.

Compliance Officers 64

Compliance Officers Compliance Fraud Electronic Medical Records 64

Healthcare IT Today

DECEMBER 21, 2023

Predominantly, the risk of fraud, theft, or abuse of customer or company information increases, which can cause regulatory violations resulting in significant fines and penalties. If healthcare providers fail to comply, the consequences can be costly.

Records Management 128

Records Management Regulatory Compliance Compliance HIPAA 128

HIPAA Journal

JANUARY 31, 2023

The lawsuit alleged the plaintiff and class members now face a high risk of identity theft and fraud as a result of the data breach and have incurred out-of-pocket expenses and lost time securing their accounts and protecting against the misuse of their personal and protected health information.

Ransomware 63

Ransomware Fraud Health Insurance HIPAA 63

HIPAA Journal

JUNE 2, 2023

An Arizona man has been sentenced to 54 months in jail for aggravated identity theft and criminal violations of the Health Insurance Portability and Accountability Act (HIPAA). Prunty and his co-conspirators attempted to steal more than $181,000 from the victims.

HIPAA 58

HIPAA Fraud Health Insurance Compliance 58

HIPAA Journal

NOVEMBER 17, 2022

Salud Family Health said affected employees and patients have been offered free credit monitoring and identity fraud protection services, and security policies and procedures are being reviewed and will be updated to protect against future cyberattacks. Documents Containing PHI of Patients of Hilario Marilao, M.D

Ransomware 84

Ransomware Health Insurance Fraud HIPAA 84

Compliancy Group

FEBRUARY 28, 2024

Within the US Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) is responsible for overseeing and administering various healthcare programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Compliance audits aren’t a “one size fits all” process.

Compliance 52

Compliance US Department of Health and Human Services Fraud Medicare 52

American Medical Compliance

OCTOBER 25, 2024

These regulations secure sensitive health information and uphold the financial integrity of healthcare organizations. Audits serve as a critical defense against fraud and inefficiency while fostering trust in your practice. A powerful way to ensure this is through regular compliance audits.

Compliance 85

Compliance Fraud Compliance Framework HIPAA 85

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 99

Ransomware HIPAA Fraud Licensing 99

HIPAA Journal

DECEMBER 7, 2022

The review of those files revealed they contained information such as names, Social Security numbers, driver’s license numbers, government-issued ID numbers, financial information, medical information, and health insurance information. Notification letters started to be sent to affected individuals on November 18, 2022.

COVID-19 Vaccine 93

COVID-19 Vaccine COVID-19 Department of Veterans Affairs Licensing 93

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.

HIPAA 52

HIPAA Compliance Health Insurance Fraud 52

Healthcare Blog

NOVEMBER 9, 2023

These documents should serve as a roadmap for employees. Department of Health and Human Services – Office of Inspector General (HHS-OIG) recommends that healthcare providers of all types establish a compliance program to prevent and mitigate violations of federal healthcare program rules and regulations.

Compliance 98

Compliance Compliance Officers ACA Patient Satisfaction 98

HIPAA Journal

MAY 1, 2023

The document review took until March 21, 2023, and notification letters were sent on April 20, 2023. The information exposed and potentially stolen in the attack included names, dates of birth, billing and claims data, treatment details, medical record numbers, prescriptions, health insurance information, and Social Security numbers.

Health Insurance 58

Health Insurance Fraud HIPAA Hospitals 58

Compliancy Group

JUNE 3, 2024

What To Know When Navigating HIPAA Incidents Health Insurance Portability and Accountability Act (HIPAA) regulations already require healthcare-based businesses to have a response plan while operational. For many compliance officers, though, it’s not only about the documentation tracking — it’s about the overall savings.

Compliance 59

Compliance Compliance Officers HIPAA Fraud 59

YouCompli

MAY 11, 2022

They perform procedures and surgeries, admit patients to hospitals, and document in the medical record. . 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.

Compliance Officers 52

Compliance Officers Fraud Compliance Medicare 52