Healthcare IT News - Telehealth

SEPTEMBER 2, 2021

"We will continue to support the unprecedented COVID-19 public health effort by holding accountable people who use deceptive tactics to profit from the pandemic," he said. THE LARGER TREND. At HIMSS21 this past month , representatives from the Office of Inspector General for the U.S.

COVID-19 165

COVID-19 Medicare Medicare Public Health 165

Healthcare IT News - Telehealth

SEPTEMBER 12, 2024

The company partnered with InterSystems to adopt the IRIS for Health platform to offer interoperability based on FHIR standards. The InterSystems integration also allows didgUgo to leverage AI for fraud prevention. didgUgo offers a software-based check-in/check-out solution to health, aged care, and disability providers.

Doctors 163

Doctors Governance Fraud Hospitals 163

HIPAA Journal

AUGUST 31, 2022

The Health Sector Cybersecurity Coordination Center (HC3) has issued a warning to the healthcare and public health sector (HPH) about one of the most capable and aggressive cybercrime syndicates currently in operation – Evil Corp. Evil Corp has been the subject of multiple law enforcement operations.

Ransomware 141

Ransomware Fraud Governance Public Health 141

HIPAA Journal

MARCH 24, 2022

14 of the 16 critical infrastructure sectors reported at least one ransomware attack, although the healthcare and public health sector was the worst affected, accounting for 148 of those attacks, followed by financial services with 89 attacks, and the information technology sector with 74.

Ransomware 137

Ransomware Public Health Fraud HIPAA 137

Healthcare Law Today

DECEMBER 22, 2022

Many of the telehealth flexibilities that became popular with both patients and clinicians during the COVID-19 pandemic will expire when the public health emergency (PHE) ends. The alert outlines seven characteristics that could suggest any given arrangement that poses a risk of fraud or abuse.

Telemedicine 119

Telemedicine Fraud Doctors COVID-19 119

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

AIHC

JUNE 14, 2024

Abuse According to Title 8 Public Health and Welfare § 192.2400 of the Department of Health and Senior Services, “ Abuse ”, the infliction of physical, sexual, or emotional injury or harm including financial exploitation by any person, firm, or corporation and bullying. These scams are outlined in more detail below.

Fraud 52

Fraud Elder Abuse Governance Compliance 52

Medisys Compliance

JANUARY 16, 2025

Temporary Telehealth Flexibilities: During the COVID-19 Public Health Emergency (PHE), CMS allowed expanded telehealth coverage for behavioral health services. Behavioral health providers should: Prepare for audits: Maintain thorough documentation to support claims during audits.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Fraud 59

HIPAA Journal

OCTOBER 6, 2022

Victims included the Champaign-Urbana Public Health District and the University of California San Francisco, which had files encrypted on the servers used by its School of Medicine. The gang also stepped up attacks on the sector during the COVID-19 pandemic. A ransom of $1.14 Vachon-Desjardins also agreed to forfeit $21.5

Ransomware 114

Ransomware Fraud COVID-19 HIPAA 114

Healthcare IT News - Telehealth

APRIL 18, 2022

Concerns of fraud have dogged conversations around telehealth expansion beyond the public health emergency. "This Agreement is neither an admission of liability by PPOA nor a concession by the United States or the State of Florida that its claims are not wellfounded," according to the agreement. and the Civil Actions."

COVID-19 179

COVID-19 Telemedicine Fraud Public Health 179

Healthcare IT News - Telehealth

JANUARY 26, 2022

The evergreen concern about virtual care is that of fraud, waste and abuse and how to balance it with the demonstrated value of extended medical services to patients who are either geographically or economically underserved.

Fraud 148

Fraud Telemedicine COVID-19 Licensing 148

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. But what exactly is considered fraud, waste, and abuse? These complaints can trigger an audit. Risk Assessment.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

Healthcare IT Today

JANUARY 14, 2025

Machine learning models will track and evaluate real-world patient data and outcomes against financial value metrics supporting outcomes-based contracts while also detecting anomalies and potential fraud. Generative AI can personalize patient education, tailoring information to each person’s needs and comprehension.

ACA 79

ACA Medicaid Medicaid Fraud 79

Healthcare IT News - Telehealth

SEPTEMBER 9, 2020

In a virtual public meeting this past Friday, members of the Medicare Payment Advisory Commission discussed how – and whether – to permanently expand telehealth in Medicare. And last but not least, large-scale fraud. "Number one, increasing volumes will drive increased cost.

Medicare 168

Medicare Medicare Public Health HIPAA 168

HIPAA Journal

JANUARY 23, 2024

Holmes, along with former company president Ramesh Balwani, were charged with criminal fraud for making false claims about the company’s technology and misleading investors. Balwani was convicted of conspiracy to commit wire fraud against Theranos’s patients and investors and was sentenced to 12 years and 11 months in prison.

Fraud 88

Fraud FDA Medicaid Medicaid 88

HIT Consultant

MAY 11, 2023

1 Today, the National Healthcare Anti-Fraud Association (NHCAA) conservatively estimates that healthcare FWA costs the nation about $68 billion annually, representing 3% of the nation’s $2.26 2 FWA estimates from commercial health plans range as high as $230 billion annually, or 10% of total healthcare spending.

Fraud 98

Fraud Governance Public Health 98

Health Care Law Brief

JUNE 2, 2022

The onset of the COVID-19 public health emergency (“PHE”) led to a surge in the use of telehealth by health care providers. For example, the Department of Justice has aggressively pursued health care fraud claims against individuals and entities involved in non-compliant telehealth models. Provider Licenses.

Public Health 52

Public Health Compliance COVID-19 Licensing 52

HIPAA Journal

APRIL 25, 2023

Data breaches have recently been announced by Santa Clara Family Health Plan, United Steelworkers Local 286, Robeson Health Care Corporation, Two Rivers Public Health Department, and NewBridge Services. TRPHD said suspicious activity was detected within its server infrastructure on November 9, 2022.

Health Insurance 104

Health Insurance Public Health Ransomware Fraud 104

HIPAA Journal

MAY 24, 2024

The Department of Health and Human Services (HHS) Health Sector Cybersecurity Coordination Center (HC3) has issued a warning to the healthcare and public health (HPH) sector about business email compromise (BEC) attacks.

Fraud 78

Fraud Ransomware Public Health HIPAA 78

Compliance Now

JANUARY 11, 2022

The guidance also expressly provides that these tests must be made available without an order or individualized assessment by a public health provider. Avoiding Fraud. Plans are permitted to take reasonable steps to avoid fraud as long as they do not “create significant barriers.” Reimbursement Programs.

COVID-19 100

COVID-19 Fraud Public Health Compliance 100

Compliancy Group

APRIL 27, 2022

The publication covers a significant trend in cybersecurity: More and more, healthcare organization data breaches are being caused by internal (employee) action as opposed to actions from outside third parties. Healthcare employees who misuse access rights to steal patient data to commit some other form of financial fraud.

Fraud 98

Fraud Compliance HIPAA Public Health 98

HIT Consultant

NOVEMBER 24, 2022

– Delivery model : Whether to ship OTC products to a hearing clinic where the consumer can receive professional diagnosis, fitting and support, or ship directly to the consumer’s home thereby providing convenience but no professional support (and increased fraud risk), or offer both options? – Fraud. Potential pitfalls.

FDA 98

FDA Public Health Fraud Medicare 98

Med-Net Compliance

SEPTEMBER 14, 2022

Shortly thereafter, the home health agency terminated the aide’s employment and reported her to the Nurse Aide Registry and the Department of Public Health (DPH). A subsequent investigation by DPH resulted in a suspension of the aide’s license and a referral to the Attorney General’s Medicaid Fraud Division.

US Department of Health and Human Services 59

US Department of Health and Human Services Fraud Medicaid Medicaid 59

HIPAA Journal

JANUARY 12, 2023

As cyberattacks like ransomware become more sophisticated, this survey hammers home the urgent need for automation and actionable risk insights to help supply chain leaders effectively manage inventory, cyber risk, fraud, and supplier redundancy.”.

Electronic Medical Records 109

Electronic Medical Records Ransomware Fraud Public Health 109

Healthcare Compliance Blog

FEBRUARY 3, 2022

Bassett stated, “Vaccination fraud is a serious crime. It creates a threat to public health and undermines the safety of our healthcare professionals who are working around the clock to get us through the pandemic.

COVID-19 Vaccine 59

COVID-19 Vaccine COVID-19 Nursing Homes Nurses 59

HIT Consultant

JULY 19, 2024

Anti-Scam Software: Consider using security software with anti-phishing and anti-fraud protection. Secure Payment Methods: Avoid using debit cards for online purchases. Monitor credit card statements for unauthorized charges.

Doctors 105

Doctors Fraud Licensing Public Health 105

Healthcare Law Blog

DECEMBER 12, 2022

The COVID-19 Public Health Emergency (“PHE”) led to a rapid expansion in the utilization of telehealth. Now, almost three years later, governmental entities have focused their attention on telehealth services and the potential for fraud and abuse. in healthcare fraud for fraudulent telemedicine schemes. Looking Forward.

COVID-19 52

COVID-19 Fraud Telemedicine Public Health 52

Health Populi

MARCH 29, 2019

Welcome to health politics in America as of March 2019, according to The Public and High U.S. Health Care Costs , a poll conducted by POLITICO and the Harvard T.H. Chan School of Public Health.

Hospitals 105

Hospitals Medicare Medicare Governance 105

Verisys

APRIL 3, 2025

Criminal convictions related to healthcare Felonies or misdemeanors involving fraud, patient abuse, or drug-related offenses. Regulatory Requirements for Reporting Various laws mandate NPDB reporting to maintain transparency and protect public health. Civil judgments Lawsuits that reveal unethical behavior or misconduct.

Malpractice 52

Malpractice Licensing Compliance Hospitals 52

Healthcare Law Blog

MAY 8, 2023

Department of Health and Human Services (“HHS”) is responsible for detecting and preventing fraud, waste, and abuse in federal health care programs. The majority of the advisory opinions involved arrangements that the OIG determined would generate prohibited remuneration, but presented minimal risk of fraud and abuse.

Fraud 52

Fraud COVID-19 Public Health Compliance 52

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.

Licensing 52

Licensing Fraud Compliance Nurses 52

MedTrainer

SEPTEMBER 20, 2023

There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud. Transparency is a primary pillar of CMS in order to encourage and promote safe and ethical patient care. Breaking the law can inevitably result in not only fines, but hefty legal burdens (time and money), and even jail time.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

Bill of Health

AUGUST 2, 2022

The administrative funds go towards things like preventing fraud, determining eligibility, and providing nutrition education. Most of this goes towards supporting state administration of the program, and states contribute around an equal amount to administrative costs. With UBNI, none of this would be necessary.

Governance 147

Governance COVID-19 Fraud Public Health 147

Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

HIPAA Journal

JANUARY 12, 2023

Before the introduction of HIPAA, healthcare fraud was rife and was costing the healthcare industry around $7 billion a year. The standardization of healthcare transactions has helped to reduce significantly reduce fraud. These updates will help healthcare providers deliver better care and improve patient outcomes.

HIPAA 106

HIPAA Compliance Fraud COVID-19 106

Health Populi

APRIL 24, 2018

” The brief answer is that the country experienced a huge fraud incident discovered in 2017 , involving 18 networks of corruption leading to at least 42 criminal cases. The resulting monetary loss was calculated to be at least $160 mm of fraud in 2017 alone. health ecosystem stakeholders.

Health Insurance 74

Health Insurance Fraud Hospitals Doctors 74

YouCompli

JULY 12, 2022

National fraud takedown: $1.1 Department of Justice (DOJ) announced a national health care fraud enforcement action involving over $1.4 billion alleged losses, telemedicine related fraud accounted for the vast majority at $1.1 billion in false and fraudulent telehealth claims. In Fall 2021, the U.S.

COVID-19 52

COVID-19 Medicare Medicare Telemedicine 52