Health Care Law Brief

JUNE 5, 2023

We previously wrote about the United States Department of Justice’s (“ DOJ ”) Civil Cyber-Fraud Initiative (“ CCFI ”), which “aims to hold accountable entities or individuals that put U.S. FHKC shut down its website’s application portal shortly thereafter.

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Fraud Due Diligence Medicaid Medicaid 52

HIPAA Journal

DECEMBER 31, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was introduced to simplify the administration of healthcare, eliminate wastage, prevent healthcare fraud, and ensure employees could maintain healthcare coverage between jobs. What is HIPAA and Who Does It Apply To? What is considered a HIPAA violation?

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HIPAA Due Diligence Compliance Fraud 133

Hall Render

NOVEMBER 1, 2023

This Safe Harbor Policy (“Policy”) is aimed at incentivizing acquiring companies to identify and timely disclose misconduct discovered during the due diligence and post-acquisition integration process. Transactions that might have been abandoned or restructured due to the discovery of misconduct can now potentially move forward.

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Due Diligence Compliance Fraud 40

Healthcare Law Blog

APRIL 3, 2023

These concerns come about as part of an evolving emphasis by the government on preventing fraud and abuse in health care. Participants also discussed the use of the False Claims Act (“FCA”) as a tool for healthcare fraud enforcement. On March 25, 2021, the U.S. The case ultimately settled, with the PE firm paying $1.5

Due Diligence 52

Due Diligence Fraud Governance Compliance 52

Verisys

JULY 20, 2023

3: Allowing a physician to treat patients before credentialing is completed Courts have held hospitals liable when a physician falsifies credentials, and the hospital fails to do its due diligence in verifying them. Therefore, due diligence requires background checks to identify current and historical adverse actions.

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Due Diligence Malpractice Licensing Hospitals 52

Verisys

JULY 27, 2023

Backed by FACIS ® ( Fraud Abuse Control Information System ), the most comprehensive data platform in the healthcare industry, the accuracy of Verisys’ screening, verification, and monitoring services exceeds the standard set by the Office of Inspector General (OIG). Verisys was created over 30 years ago to address this very issue.

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Compliance Due Diligence Licensing Fraud 52

Verisys

JULY 5, 2023

That is, until there is a fine, civil monetary penalty, or public lawsuit caused by patient negligence or fraud. Verisys performs verification and due diligence on all possible matches identified through the screening process to determine true and correct matches. Verisys was created over 30 years ago to address this very issue.

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Compliance Due Diligence Licensing Fraud 52

Verisys

JULY 22, 2024

integrated FACIS® (Fraud and Abuse Control Information System), a comprehensive sanction and exclusion database for healthcare providers, into its vetting process. By uncovering a candidate’s hidden history of fraud and sanctions, Tabb Inc. ” – Brian Bodkin, Founder Tabb Inc. The Solution Tabb Inc.

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Due Diligence Fraud Hospitals Licensing 52

Verisys

JULY 22, 2024

integrated FACIS® (Fraud and Abuse Control Information System), a comprehensive sanction and exclusion database for healthcare providers, into its vetting process. By uncovering a candidate’s hidden history of fraud and sanctions, Tabb Inc. ” – Brian Bodkin, Founder Tabb Inc. The Solution Tabb Inc.

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Due Diligence Fraud Hospitals Licensing 52

HIT Consultant

FEBRUARY 9, 2023

PCI DSS – The Payment Card Industry Data Security Standard (PCI DSS) is a set of security requirements that helps organizations protect their payment systems from data breaches, fraud, and theft of cardholder data. Organizations must require their cloud vendors to be third-party audited.

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Regulatory Compliance Due Diligence Compliance HIPAA 52

Healthcare Law Blog

FEBRUARY 2, 2023

We commonly see definitions of “Fraud”, “Debt”, “Knowledge”, “Loss” and “Material Adverse Effect” (as well as “Fundamental Representations” and “Specified Representations”, as noted above) specified in LOIs or in schedules thereto. Schedule certain defined terms. Define purchase price adjustments.

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Due Diligence Fraud Compliance 52

Provider Trust

MAY 17, 2022

For healthcare organizations, vendor services require a more thorough and specific due diligence in order to assess risk and to document compliance with any or all of the following regulations and laws listed below: . How to ensure vendor compliance.

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Compliance Medicare Medicare Due Diligence 52

MedTrainer

AUGUST 2, 2023

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. But how do you know which one to choose?

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Provider Trust

MAY 18, 2022

This case is unique as the private equity firm that funded the purchase of South Bay facilitated, and its partners paid for part of the damages given the PE firm’s role and knowledge gained during due diligence and review of the operations and billing practices of South Bay. Get Daily Vendor Monitoring.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

AIHC

JUNE 6, 2023

Due-diligence is necessary to ensure their system has been tested, is compliant to government and payer standards and is affordable moving forward as AI evolves and our system or contract service with the company advances. AI technology would empower these professionals. Beware of new companies offering such services.

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Compliance Medical Billing HIPAA Due Diligence 59

Health Law RX

AUGUST 10, 2021

It based its position on the grounds that Ancor, through its due diligence prior to the purchase of Alliance, learned about the alleged conduct and had the ability to remedy the conduct after the closing of the transaction. The DOJ also contended that Ancor caused Alliance to submit false claims to governmental programs.

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Due Diligence Compliance Governance Fraud 40

Verisys

FEBRUARY 6, 2025

By maintaining up-to-date records and conducting regular re-credentialing, healthcare organizations can demonstrate due diligence in ensuring their nursing staff meets all regulatory requirements. Thorough credentialing also helps mitigate legal and financial risks associated with employing unqualified or improperly licensed nurses.

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Nurses US Department of Health and Human Services Licensing Regulatory Compliance 52

AIHC

JUNE 6, 2023

Due-diligence is necessary to ensure their system has been tested, is compliant to government and payer standards and is affordable moving forward as AI evolves and our system or contract service with the company advances. AI technology would empower these professionals. Beware of new companies offering such services.

Compliance 52

Compliance Medical Billing HIPAA Due Diligence 52

Hall Render

JANUARY 11, 2023

As payor coverage expands for certain telemedicine services and technology, app and digital health technology developers will need to do their due diligence in determining coverage and reimbursement under federal and state health care programs and be cognizant of any fraud and abuse laws that apply under the various programs.

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Compliance HIPAA FDA Due Diligence 40

Healthcare Law Blog

AUGUST 8, 2022

On August 5, President Biden signed two bills into law that extend to ten years the statute of limitations for civil and criminal enforcement actions for fraud on the Paycheck Protection Program (“PPP”) and Economic Injury Disaster Loans (“EIDL”).

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Fraud Due Diligence COVID-19 Governance 52

Verisys

JULY 13, 2023

Throughout that process, he was still on our payroll, and we hadn’t been doing our due diligence to screen him.” These issues can cause reputational damage to the manufacturer if they aren’t monitoring their faculty. He was sentenced to life in prison, and the story received national attention.

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Compliance Due Diligence Pharmaceutical Industry Fraud 52