HIPAA Journal

MARCH 30, 2023

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.

Compliance 110

Compliance Compliance Officers Fraud HIPAA 110

HIPAA Journal

JANUARY 24, 2023

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.

HIPAA 138

HIPAA Ransomware Hospitals Fraud 138

Health Care Performance

FEBRUARY 21, 2023

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.

Nurses 52

Nurses Licensing Fraud Hospitals 52

Healthcare IT Today

DECEMBER 30, 2024

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.

US Department of Health and Human Services 91

US Department of Health and Human Services Nurses Medicare Medicare 91

HIPAA Journal

NOVEMBER 11, 2024

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.

Fraud 78

Fraud Medicaid Medicaid HIPAA 78

MedTrainer

JANUARY 10, 2024

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!

Compliance 94

Compliance Fraud HIPAA Compliance Officers 94

HIPAA Journal

MARCH 7, 2025

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.

Fraud 51

Fraud Nurses Licensing HIPAA 51

HIT Consultant

SEPTEMBER 4, 2024

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.

Ransomware 111

Ransomware HIPAA Compliance Doctors 111

MedTrainer

AUGUST 8, 2024

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.

Medicare 93

Medicare Medicare Compliance Medicaid 93

Healthcare IT Today

SEPTEMBER 19, 2023

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!

Hospitals 139

Hospitals HIPAA Nurses Governance 139

Hall Render

NOVEMBER 25, 2024

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.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

Health Care Performance

AUGUST 25, 2022

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.

Compliance 52

Compliance Nursing Homes HIPAA Fraud 52

HIT Consultant

MAY 4, 2023

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.

Hospitals 97

Hospitals HIPAA Regulatory Compliance Compliance 97

MedTrainer

SEPTEMBER 20, 2023

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.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

HIPAA Journal

FEBRUARY 8, 2024

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.

Ransomware 91

Ransomware Electronic Medical Records Licensing Health Insurance 91

HIPAA Journal

MARCH 29, 2024

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.

Fraud 83

Fraud HIPAA Health Insurance Nurses 83

Verisys

DECEMBER 29, 2024

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?

HIPAA 52

HIPAA Fraud Health Insurance Medicare 52

Compliancy Group

AUGUST 31, 2023

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.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52

MedTrainer

OCTOBER 4, 2023

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.

Compliance 52

Compliance Fraud HIPAA Governance 52

Compliancy Group

SEPTEMBER 16, 2024

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.

Compliance 52

Compliance Compliance Officers Fraud Electronic Medical Records 52

MedTrainer

JULY 30, 2024

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.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

MedTrainer

JUNE 11, 2024

It’s even possible to offer courses that meet regulatory requirements and qualify for CE.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

MedTrainer

JANUARY 30, 2024

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?

Governance 52

Governance Compliance Nursing Homes Medicaid 52

MedTrainer

MARCH 8, 2024

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.

Compliance 52

Compliance Nursing Homes HIPAA Nurses 52

Health Care Law Brief

JUNE 2, 2022

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?

Public Health 52

Public Health Compliance COVID-19 Licensing 52

Healthcare Law Blog

NOVEMBER 9, 2023

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].

Compliance 52

Compliance Compliance Officers Fraud Medicare 52

MedTrainer

JULY 31, 2024

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.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

MedTrainer

JUNE 11, 2024

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.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

MedTrainer

JUNE 10, 2024

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.

Compliance 52

Compliance Licensing HIPAA Compliance Framework 52

MedTrainer

JUNE 10, 2024

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.

Compliance 52

Compliance HIPAA Compliance Framework ADA 52

AIHC

SEPTEMBER 21, 2023

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.

HIPAA 59

HIPAA Compliance Nurses Fraud 59

Compliancy Group

APRIL 17, 2024

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.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

MedTrainer

JANUARY 30, 2024

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.

Compliance 52

Compliance Compliance Officers Fraud Medicaid 52

AIHC

SEPTEMBER 5, 2023

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.

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

Health Law RX

NOVEMBER 22, 2023

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.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

MedTrainer

JULY 29, 2024

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.

Compliance 52

Compliance US Department of Health and Human Services Regulatory Compliance Compliance Officers 52

MedTrainer

JANUARY 26, 2024

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.

Regulatory Compliance 52

Regulatory Compliance Compliance Compliance Officers HIPAA 52