This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
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.
Five former employees of Methodist Hospital in Memphis, TN, including a recently-licensed Registered Nurse, were indicted by a federal grand jury for allegedly selling medical information about car accident victims to personal injury attorneys and chiropractors. Harvey could receive up to 70 years in prison, pay a fine of $1.75
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?
A former nurse employed by the Roswell Park Comprehensive Cancer Center in Buffalo, NY, has been sentenced to 37 months in prison for tampering with and stealing controlled medications intended for cancer patients. Mulvey, 30, of Grand Island, NY, worked as a registered nurse at Roswell Park between February 2018 and June 2018.
The Department of Health and Human Services’ Office for Civil Rights is the main enforcer of HIPAA compliance; however, state Attorneys General also play a role in enforcing compliance with the Rules of the Health Insurance Portability and Accountability Act (HIPAA). million individuals and for delayed breach notifications.
The Wilsonville, OR-based home health care service provider and nursing home operator, Avamere Holdings, is facing a class action lawsuit over a major data breach that affected 96 senior living and healthcare facilities and resulted in the exposure of the protected health information of more than 380,000 individuals.
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. The Office of Inspector General (OIG) Monitors and enforces compliance with regulations that prevent fraud, waste, and abuse in healthcare programs.
This was in response to the growing level of healthcare fraud and abuse and an alleged “compliance disconnect” at the executive level in many hospitals and health systems. The biggest influence for the creation of the seven elements of a compliance program (fraud prevention) is sometimes overlooked.
The theft of protected health information places patients and health plan members at risk of identity theft and fraud, but by far the biggest concern is the threat to patient safety. Healthcare data breaches were reported by HIPAA-regulated entities in 49 states, Washington D.C., million records in 2021 to 51.9 million records in 2022.
The scheme 25 people were charged with wire fraud – administrators and employees of three Florida nursing schools as well as recruiters. The recruiters sought out individuals that were willing to pay $10,000 to $15,000 for fake nursing school documents that allowed them to take national nursing licensure examinations.
Brands have increasingly shifted focus from merely engaging healthcare professionals (HCPs) to achieving healthcare outcomes through improved script lifts, in partnership with HIPAA-certified, data-compliant platforms, all thanks to advanced AI solutions that are helping brands reach HCPs at scale and with precision.
Louis in Missouri agreed to a $300,000 settlement for employing an excluded charge nurse and billing services to Federal health care programs, and in February Baptist Health System in Kentucky settled similar allegations with HHS-OIG for $184,000.
An addiction treatment center in Utah and an Ohio nursing center have been forced to pay civil monetary penalties after employing individuals on the Department of Health and Human Services Office of Inspector General (HHS-OIG) exclusion list. A settlement was agreed that involved a civil monetary penalty of $243,000.
The OIG is making major investments to systematically detect and prosecute fraud. In this guidance it’s clear the OIG expects healthcare organizations and suppliers to understand their role and responsibilities to fight fraud, waste, and abuse. We all should be a LOT more prepared!
The consequences of a successful attack can be far-reaching, including identity theft, insurance fraud, and even threats to patient care through compromised medical devices and systems.
Fraud, Waste, and Abuse (FWA) Training Fraud, Waste, and Abuse (FWA) training is designed to help healthcare professionals detect, prevent, correct, and report fraudulent, wasteful, and abusive practices within the Medicare system. Attestation: Providers must complete training within 90 days of their hire date and annually thereafter.
Hearing about these pain points from stakeholders is why I’d “repackage HIPAA” if I were a regulator for a day. In that manner, businesses that remained “outside of the purview of HIPAA” would be impacted. I hear patients discouraged and disgusted when they can’t get access to their own data even in 2023!
Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community.
We summarize enforcement trends and deliver the latest compliance and HIPAA developments to your inbox with our Monthly Compliance News Report. MPA’s clients use the News Report to find ideas for compliance and HIPAA training, and identify areas where policies or audits are needed. Twelve new HIPAA enforcements.
But with so many competing training programs — everything from HIPAA and regulatory compliance to handwashing and job-specific training — it’s difficult to break through the noise and gain traction. As organizations harden their security posture in response to specific threats, new threats emerge that companies may not be aware of.
This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, and pharmacies.
Azura Vascular Care said individuals who had sensitive information exposed such as Social Security numbers have been offered complimentary identity protection, credit monitoring, and fraud resolution services. The post Azura Vascular Care Reports Data Breach Affecting 348,000 Patients appeared first on HIPAA Journal.
Wyndemere Senior Care Wyndemere Senior Care LLC, a Wheaton, IL-based provider of independent & assisted living neighborhoods, skilled nursing, & memory care, has notified 6,846 individuals that some of their personal information has been exposed in a cyberattack. County Department of Mental Health appeared first on HIPAA Journal.
The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the development of a standard, unique health identifier for healthcare providers, which the NPI satisfies. Why Are NPI Numbers Necessary? Who Needs an NPI? What Are the Two Types of NPI Providers?
Healthcare compliance laws play a vital role in safeguarding patients’ rights, preventing fraud and abuse, and maintaining the integrity of healthcare systems. Office of Inspector General (OIG) Compliance Program Guidance Office of Inspector General (OIG) compliance program guidance is for individual providers like hospitals or nursing homes.
These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. These requirements are designed to protect patient rights, privacy, and safety, as well as to prevent fraud, abuse, and other improper practices within healthcare organizations.
In November, updates for 2024 appeared in the OIG General Compliance Program Guidance, including recommendations for Medicare, nursing facilities, and other industry-specific entities. Organizations should ramp up their risk assessment efforts.
Requirements vary by care setting (industry), employee role, a risk assessment, and more. It’s even possible to offer courses that meet regulatory requirements and qualify for CE.
Nursing Homes: Skilled nursing facilities, long-term care facilities, and other types of nursing homes. Additionally, compliance programs address a wide range of potential issues, including fraud, waste, and abuse. Is a Compliance Program Useful If It’s Not Mandated?
Download the Ultimate List of Training Requirements for Long-Term Care to see a full list of federal training requirements for nursing homes and skilled nursing staff broken down by role, with the applicable standard, CMS violation category, and frequency. Training requirements vary by employee role and specific healthcare setting.
For example, the Department of Justice has aggressively pursued health care fraud claims against individuals and entities involved in non-compliant telehealth models. Does the state prohibit licensees, including physicians, nurse practitioners, or pharmacies, from sharing their professional fees with third parties?
Thereafter, OIG said it planned to update existing industry-specific compliance program guidance (ICPG), which would include tailoring each to address fraud and abuse risk areas specific to a particular industry and describing the compliance measures that industry could take to reduce these risks [2].
Requirements vary by care setting (industry), employee role, a risk assessment, and more. It’s even possible to offer courses that meet regulatory requirements and qualify for CE.
Requirements vary by care setting (industry), employee role, a risk assessment, and more. It’s even possible to offer courses that meet regulatory requirements and qualify for CE.
Requirements vary by care setting (industry), employee role, a risk assessment, and more. It’s even possible to offer courses that meet regulatory requirements and qualify for CE.
Requirements vary by care setting (industry), employee role, a risk assessment, and more. It’s even possible to offer courses that meet regulatory requirements and qualify for CE.
This article is subsequent to the original article “ HIPAA, The Cures Act and Information Blocking Compliance ” and Article on Right of Access Vs Information Blocking Part 1 and Part 2.
Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. and cybersecurity threats. and cybersecurity threats. Medicare Advantage (M.A.): Organizations using M.A.
The professionals who manage compliance are the front lines of preventing medical errors, deterring fraud, and staying in good standing with federal payers like the Centers for Medicare and Medicaid Services (CMS). A bachelor’s degree in healthcare management, nursing, business, or a similar discipline is often preferred.
This compact does not apply to nurse practitioners (NPs) because they are licensed under state boards of nursing and not medicine. Only Consider Using HIPAA-Compliant Technology The HIPAA Rules establish standards to protect patients’ protected health information. This includes understanding various fraud and abuse laws.
Next, the OIG will begin publishing industry-specific CPGs to update prior CPGs that provided guidance for specific providers such as hospitals, clinical laboratories, hospices, Medicare Advantage (formerly known as Medicare+Choice) organizations, and nursing facilities. The Seven Elements of an Effective Compliance Program.
Training is required topics including fraud ( Stark Law ), HIPAA , and employee safety. This mandate extended to nursing facilities, skilled nursing facilities, and various healthcare entities, requiring them to implement effective compliance programs with specific core elements.
Certified HIPAA Professional (CHP): Several entities, such as ECFC, offer versions of a CHP certification. This designation is ideal for healthcare professionals tasked with ensuring compliance with the Health Insurance Portability and Accountability Act (HIPAA). It focuses on compliance within medical practices and clinics.
We organize all of the trending information in your field so you don't have to. Join 26,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content