Remove Due Diligence Remove Fraud Remove Medicaid
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Settlement Agreed with Florida Children’s Health Insurance Website Contractor to Resolve False Claims Act Allegations

HIPAA Journal

FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida. While Jelly Bean Communications Design acted as a business associate under HIPAA, the action was taken over violations of the False Claims Act under the Department of Justice’s 2021 Civil Cyber-Fraud Initiative.

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Another Resolution by DOJ Pursuant to its Civil Cyber-Fraud Initiative Highlights Continued Efforts to Hold Companies Accountable for Ensuring Data are Secured

Health Care Law Brief

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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What is a HIPAA Violation?

HIPAA Journal

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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8 Common Provider Credentialing Mistakes and How to Avoid Them

Verisys

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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Understanding Compliance for Healthcare Vendors

Provider Trust

Federal regulators such as the HHS-OIG, the Department of Justice (DOJ), the Centers for Medicare and Medicaid Services (CMS), and others have regulations and guidelines regarding the prohibition of reimbursements of federal healthcare dollars (Medicaid, Medicare, CHIPS, TriCare, and others) to excluded vendors.

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How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

In addition, the suit involved alleged submission of false claims for reimbursement to the Massachusetts Medicaid Agency. Bay Mental Health Centers (hereinafter referred to as “South Bay”) employee involving false claims for reimbursement of services provided by unlicensed and improperly supervised social workers and counselors at South Bay.

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What Is Provider Credentialing?

MedTrainer

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?