Remove Fraud Remove HIPAA Remove Medicaid
article thumbnail

HIPAA 2024 Year in Review – Ransomware, Risk Analysis, and Right of Access Remedies

Compliancy Group

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. Monitor and safeguard its health information systems activity.

article thumbnail

2024 DOJ False Claims Act Settlements in Healthcare Recover $1.67B

Compliancy Group

A classic example is Medicare fraud. Providers who bill Medicare for services they did not actually provide and who present the bill with the knowledge that the service was not performed have committed Medicare fraud. The DOJ has focused much of its anti-fraud efforts on pursuing these cases, litigating several of them in 2024.

Fraud 98
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

How to Conduct Effective Compliance Audits 

American Medical Compliance

Audits serve as a critical defense against fraud and inefficiency while fostering trust in your practice. For instance, an individual who unknowingly violates HIPAA will pay a $100 fine per violation with an annual maximum of $25,000 for those who repeat violation, according to the National Institutes of Health.

article thumbnail

What is HIPAA?

HIPAA Journal

What is HIPAA? HIPAA is an acronym for the Health Insurance Portability and Accountability Act. So how did HIPAA evolve from being a vehicle for improving the portability and continuity of health insurance coverage to being one of the most comprehensive and detailed federal privacy laws? What is HIPAA Title II?

HIPAA 103
article thumbnail

What is a HIPAA Violation?

HIPAA Journal

To best answer the question what is a HIPAA violation, it is necessary to explain what HIPAA is, who it applies to, and what constitutes a violation; for although most people believe they know what a HIPAA compliance violation is, evidence suggests otherwise. What is HIPAA and Who Does It Apply To?

HIPAA 133
article thumbnail

Fraud-Proofing Your Telehealth Strategy

HIT Consultant

Capturing and combatting fraud in today’s healthcare landscape requires the convergence of innovation and experience to drive value beyond the margins. Organizations must take a multi-layered approach to identify, address, and prevent fraud. The second type, indirect fraud, involves several bad actors that coordinate their efforts.

Fraud 98
article thumbnail

10 Charged Over BEC Scams Targeting Medicare, Medicaid, and Private Insurance Programs

HIPAA Journal

million being defrauded from Medicaid, Medicare, and private health insurance programs. Five state Medicaid programs, two Medicare Administrative Contractors, and two private health insurers were tricked into changing the bank account details for payments. Medicare, Medicaid, and private health insurers suffered losses of more than $4.7

Medicaid 102