HIPAA Journal

SEPTEMBER 8, 2022

The Michigan law firm, Warner Norcross and Judd LLP, has issued notification letters to 255,160 individuals advising them about an October 2021 security breach in which files containing their personal and protected health information were potentially accessed and exfiltrated from its systems. The breach was detected on October 22, 2021.

Fraud 118

Fraud Health Insurance Ransomware HIPAA 118

Verisys

DECEMBER 8, 2022

A professional career can take a provider across state lines, and through an evolution of various license types. In order to see the full picture of an individual, the comprehensive whole of each state licensing board across all license types must be searched. Take the process back another step.

Licensing 52

Licensing Medicaid Medicaid Fraud 52

Provider Trust

APRIL 26, 2023

However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. A travel nurse could be hired to work at a hospital located in a state where they are not licensed to practice. For starters, each state has its own process, rules, and regulations for monitoring licensed nurses.

Licensing 52

Licensing Nurses Compliance COVID-19 52

Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. The psychologist was convicted of four counts of healthcare fraud.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

Provider Trust

JUNE 1, 2022

Organizations across the healthcare continuum have experienced several workforce trends that are creating gaps in license monitoring and verifications. In this post, we’ll explore three current challenges impacting the healthcare license and credential verification process. See our Telehealth Credentialing Guide for more information.

Licensing 52

Licensing Nurses COVID-19 Compliance 52

HIT Consultant

DECEMBER 10, 2021

What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. Licensed Clinical Social Worker. For more information, download the full report here.

Fraud 98

Fraud COVID-19 Nurses Licensing 98

Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

Provider Trust

MARCH 13, 2023

State licensing boards nationwide have annulled the licenses of dozens of nurses who obtained fake degrees and used them to gain or secure employment. In Delaware, 26 nursing licenses were revoked when the nurses’ credentials were tied to the scheme. ProviderTrust recommends conducting license verification monthly.

Fraud 52

Fraud US Department of Health and Human Services Licensing Compliance Officers 52

HIPAA Journal

SEPTEMBER 8, 2022

The Michigan law firm, Warner Norcross and Judd LLP, has issued notification letters to 255,160 individuals advising them about an October 2021 security breach in which files containing their personal and protected health information were potentially accessed and exfiltrated from its systems. The breach was detected on October 22, 2021.

Fraud 93

Fraud Health Insurance Ransomware HIPAA 93

HIPAA Journal

APRIL 25, 2024

Several class action lawsuits have been filed against City of Hope National Medical Center, a National Cancer Institute (NCI)-designated cancer treatment and research center, over a recently disclosed data breach that exposed the protected health information of more than 827,000 individuals.

Fraud 124

Fraud Health Insurance HIPAA Licensing 124

HIPAA Journal

NOVEMBER 12, 2024

Cyberattacks involving unauthorized access to patient information have been reported by Physical Medicine & Rehabilitation Center in New Jersey (4,083 records) and Orthopedics Rhode Island(500 records). Passwords were reset and policies and procedures have been reviewed.

Health Insurance 49

Health Insurance Fraud Licensing HIPAA 49

HIPAA Journal

APRIL 24, 2023

Utah has updated its data breach regulations and from May 3, 2023, will require a breached entity to send a notification to the Utah Attorney General in the event of a breach of the personal information of 500 or more Utah residents. The post Utah Updates Data Breach Notification Requirements appeared first on HIPAA Journal.

Fraud 105

Fraud Licensing HIPAA Governance 105

Provider Trust

JANUARY 26, 2022

It’s no secret–when fraud enters healthcare, things get risky. But how exactly does the HHS-OIG (Office of Inspector General), the main body responsible for conducting investigations into suspected fraudulent activity, address healthcare fraud and assess future risk of these bad actors?

Fraud 52

Fraud US Department of Health and Human Services Medicaid Medicaid 52

HIPAA Journal

JULY 4, 2024

SkinCure Oncology has notified 13,434 patients about an email attack that occurred in June 2023, and the Wisconsin Department of Health Services has announced a breach of the personal information of 19,150 Medicaid recipients. Further information can be contained by calling SkinCure Oncology’s helpline – (866) 528-8844.

Medicaid 123

Medicaid Medicaid Fraud Licensing 123

HIPAA Journal

APRIL 23, 2024

A cybersecurity firm was engaged to investigate the disruption and confirmed that unauthorized individuals accessed its network and exfiltrated files containing the personal information of residents. It took more than 10 months (April 10, 2024) to determine the types of information involved and the number of individuals affected.

Ransomware 115

Ransomware Fraud Licensing HIPAA 115

Compliancy Group

OCTOBER 1, 2024

Compliance with Medicare and other programs requires relevant staff to take regular fraud, waste, and abuse (FWA) training. Components of Medicare FWA Training An essential learning outcome of FWA training is differentiating fraud, waste, and abuse. Importance of FWA Training First and foremost, training in FWA compliance is the law.

Fraud 52

Fraud Compliance Medicare Medicare 52

HIPAA Journal

MAY 22, 2024

Superior Air-Ground Ambulance Service, a leading ambulance and EMS provider serving Illinois, Indiana, Michigan, Ohio, and Wisconsin, has confirmed that the protected health information of 858,238 patients was exposed or stolen in a cyberattack in May 2023.

Fraud 85

Fraud Licensing HIPAA Health Insurance 85

HIPAA Journal

DECEMBER 19, 2022

A review of the files on the compromised servers confirmed that protected health information such as patient names, dates of birth, Social Security numbers, driver’s license numbers, health insurance information, and diagnosis and treatment information had been exposed. The DOL and the U.S.

Fraud 110

Fraud Licensing HIPAA Health Insurance 110

HIPAA Journal

JUNE 28, 2023

Good Samaritan Hospital in San Jose, CA, has agreed to settle a class action lawsuit that was filed in response to a data breach that exposed the protected health information of up to 233,835 individuals. A lawsuit – Young, et al.

Hospitals 102

Hospitals Fraud Licensing HIPAA 102

Verisys

NOVEMBER 8, 2023

Providers must use their NPI when transmitting any electronic health information in connection with a transaction. The NPI does not replace other identification numbers such as a provider’s taxpayer identification number (TIN), Drug Enforcement Administration registration, license number, or Social Security number. Who Needs an NPI?

Fraud 97

Fraud HIPAA Medicare Medicare 97

Verisys

FEBRUARY 8, 2024

Here’s how Verisys can support pharmaceutical manufacturers in this critical area: Comprehensive Background Screening and Credentialing: Verisys’ FACIS (Fraud and Abuse Control Information System) is a key tool for screening and continuous monitoring of healthcare providers.

Compliance 52

Compliance Licensing Fraud 52

HIPAA Journal

NOVEMBER 16, 2022

Unauthorized individuals have gained access to the email system of the Administrative Fund of the Detectives’ Endowment Association of the Police Department of the City of New York (NYCDEA) and potentially viewed or obtained the protected health information of 21,544 individuals.

HIPAA 114

HIPAA Licensing Health Insurance Fraud 114

HIPAA Journal

AUGUST 2, 2023

Notification letters will be sent to the affected individuals in the coming weeks and credit monitoring, fraud consultation, and identity theft restoration services will be offered. A third-party data review company was provided with the files on December 22, 2022, and provided the results of the analysis to SHS on May 16, 2023.

Licensing 95

Licensing Electronic Medical Records Ransomware Health Insurance 95

Provider Trust

AUGUST 6, 2024

These three factors each contribute to your overall impact on eradicating fraud, waste, and abuse within the healthcare system. At a minimum, you should verify the licenses and credentials of every provider employed at your organization at hire and expiration. See Our Impact Compliance Program 1. What about vendors?

Compliance 52

Compliance Licensing Fraud 52

The Health Law Firm Blog

DECEMBER 6, 2023

Most insurers obtain a report from the Medical Information Bureau ("MIB") and use this in determining the risk you pose and, hence, your policy premium. [.] When you apply for insurance, an insurance company will look at various factors regarding your history to determine how much your insurance policy will cost.

Licensing 52

Licensing Fraud Nurses 52

HIPAA Journal

SEPTEMBER 9, 2022

Birmingham, AL-based Henderson & Walton Women’s Center (HWWC) has recently notified 34,306 patients that some of their protected health information may have been compromised as a result of a hacker gaining access to the email account of one of its employees. The information exposed varied from patient to patient.

Licensing 123

Licensing Health Insurance Fraud HIPAA 123

HIPAA Journal

NOVEMBER 23, 2022

Third-party security experts were engaged to investigate the nature and scope of the attack, with the investigation concluding on or around May 2, 2022, that files containing the protected health information of patients and employees may have been accessed and exfiltrated from its network.

Ransomware 126

Ransomware Fraud Licensing HIPAA 126

HIPAA Journal

OCTOBER 17, 2022

Phoenix, AZ-based Valle del Sol Community Health has notified 70,268 patients that some of their protected health information has been exposed. Valle de Sol said the investigation indicated unauthorized individuals had access to files containing sensitive patient data and that patient information may have been acquired.

Health Insurance 136

Health Insurance Licensing Fraud HIPAA 136

Provider Trust

APRIL 18, 2024

Since that time, the organization has uniquely led the way in providing innovative solutions that uphold data integrity for ongoing exclusion monitoring, timely license and credential verification, and healthcare vendor data collection. To learn more, visit providertrust.com.

Compliance 52

Compliance Licensing Fraud Medicaid 52

Compliancy Group

JUNE 7, 2024

The onboarding process is pivotal in ensuring employees understand their job duties, engage in best cybersecurity practices, and comply with important regulations like the Health Insurance Portability and Accountability Act, Occupational Health and Safety Administration, and prevention of Fraud, Waste, and Abuse in healthcare.

US Department of Health and Human Services 52

US Department of Health and Human Services Electronic Medical Records Compliance Fraud 52

MedTrainer

SEPTEMBER 5, 2024

This confidential clearinghouse primarily aims to safeguard public interest and healthcare quality while reducing fraud and abuse. A CVO gathers information and verifies providers’ credentials through multiple sources on behalf of their own or other organizations, ultimately granting privileges to the specific health system.

Malpractice 52

Malpractice Fraud Licensing Compliance 52

MedTrainer

FEBRUARY 5, 2024

This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. Information about the employer’s Taxpayer Identification Number (TIN) , practice location, and protocol agreements are also needed.

Licensing 52

Licensing Governance Compliance Fraud 52

Verisys

FEBRUARY 16, 2023

Transition Process Oregon: License Suspensions and Terminations of Orders by Operation of Law and Continuing Education Deficiencies: Oregon Administrative Rule 847-001-0035 has been amended to expand the reasons for which the Executive Director or Medical Director may issue final orders. The information is fluid and evolving.

Licensing 52

Licensing Nurses Fraud Compliance 52

Verisys

MAY 11, 2023

Publication of Notice – Operation Nightingale Oregon : The Oregon Medical Board has proposed a new rule to add “license denials” as a class of cases exempt from the 90-day timeline requirements. This new rule would allow a longer timeline due to board meeting schedules and the complexity of license denial cases.

Licensing 52

Licensing Nurses Medicaid Medicaid 52

HIPAA Journal

MARCH 25, 2022

Ultimate Care said no reports have been received that indicate there has been any misuse of patient information; however, as a precaution against identity theft and fraud, individuals whose Social Security numbers were impacted have been offered complimentary one-year memberships with a credit monitoring service.

Health Insurance 124

Health Insurance Licensing Ransomware Fraud 124

HIPAA Journal

MARCH 22, 2023

Cardiovascular Associates in Alabama is facing a class action lawsuit over a recently reported hacking incident in which patients protected health information (PHI) was stolen. The plaintiff and class members now face an increased risk of identity theft and fraud as their private information is now in the hand of cybercriminals.

HIPAA 114

HIPAA Fraud Licensing Health Insurance 114

Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.

Licensing 52

Licensing Fraud Compliance Nurses 52