HIT Consultant

NOVEMBER 9, 2023

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

Medicaid 64

Medicaid Medicaid Health Insurance COVID-19 64

AIHC

SEPTEMBER 25, 2024

There is value in learning from another organization’s lessons publicly posted by a government authority, such as the Department of Justice (DOJ), Centers for Medicare & Medicaid Services (CMS), the HIPAA enforcement agency, the Office of Civil Rights (OCR) or the Federal Bureau of Investigations (FBI).

Fraud 52

Fraud Compliance Compliance Officers Licensing 52

HIPAA Journal

APRIL 14, 2023

The Iowa Department of Health and Human Services (DHHS) has confirmed that the personal information of 20,800 Iowans who receive Medicaid was exposed in a cyberattack at a subcontractor of one of its business associates between June 30, 2022, and July 5, 2022. Notifications were mailed to affected individuals on April 10, 2023.

Medicaid 117

Medicaid Medicaid Ransomware HIPAA 117

HIPAA Journal

MARCH 15, 2023

FHKC is a state-created entity that offers health and dental insurance to children in Florida between the ages of 5 and 18. FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida.

Health Insurance 99

Health Insurance HIPAA Fraud Due Diligence 99

Kaiser Permanente

JANUARY 1, 2022

Medicaid and the Children’s Health Insurance Program (CHIP) have served as critical supports to children, pregnant women, parents, seniors, and individuals with disabilities – covering 80 million individuals during the COVID-19 pandemic. Since February 2020, Medicaid enrollment has grown sharply to cover an additional 9.9

Medicaid 92

Medicaid Medicaid Medicare Medicare 92

HIPAA Journal

AUGUST 10, 2023

Four more entities have confirmed they were affected by the mass hacks of the MOVEit Transfer file transfer solution and had protected health information stolen. It is currently unclear exactly how many Medicaid recipients were affected. The incident occurred at a third-party claims processor, TMG Health.

Medicaid 52

Medicaid Medicaid Health Insurance HIPAA 52

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

MARCH 16, 2023

Florida Medical Clinic, NorthStar Emergency Medical Services, Denver Public Schools, Wichita Urology Group, and The Bone & Joint Clinic have recently reported hacking incidents and the exposure and potential theft of protected health information. 95% of the compromised files only included an individual’s name.

Electronic Medical Records 68

Electronic Medical Records Health Insurance Ransomware HIPAA 68

Bill of Health

OCTOBER 17, 2024

AB 3030 requires that health care providers disclose when they have used generative AI to create communications with patients. SB 1223 amended the California Consumer Privacy Act of 2018 to include neural data as sensitive personal information, whose collection and use companies can be directed to limit.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

Healthcare Law Blog

JANUARY 20, 2023

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] Please refer to our prior blog for more information on CalAIM.

Medicaid 52

Medicaid Medicaid Medicare Medicare 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. The helpline is manned Monday to Friday from 8:00 a.m. to 5:30 p.m. Central Time. Central Time.

Medicaid 123

Medicaid Medicaid Fraud Licensing 123

Healthcare IT Today

FEBRUARY 26, 2023

Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job. Proposed fixes include improved health insurance literacy – which could help could help 3.8

Medicaid 101

Medicaid Medicaid FDA Health Insurance 101

Bill of Health

JANUARY 23, 2024

Medicaid pays for more than 40% of births in the U.S., Examining efforts at the federal and state level, I highlight three options, leveraging Medicaid as a policy lever. In the past, when individuals were Medicaid-eligible due to pregnancy, federal law required states to provide coverage for at least 60 days postpartum.

Medicaid 113

Medicaid Medicaid Patient Satisfaction Health Insurance 113

HIPAA Journal

APRIL 29, 2024

A Portland, ME-based accounting and consulting firm has recently reported a data breach to the Maine Attorney General that involved the personal information of 1,107,354 individuals. A vendor was engaged to conduct a review of the affected files, and that process was completed on April 2, 2024.

Health Insurance 119

Health Insurance Health Analytics HIPAA Medicaid 119

HIPAA Journal

AUGUST 14, 2023

The information security firm Kon Briefing has been tracking the incidents and reports that at least 670 organizations fell victim to the attacks and more than 41 million records are now confirmed as having been compromised. Maximus handles the department’s communications with Medicaid recipients.

Medicaid 97

Medicaid Medicaid HIPAA Health Insurance 97

Health Care Law Brief

FEBRUARY 2, 2024

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

AUGUST 14, 2023

The Colorado Department of Health Care Policy and Financing (HCPF), which oversees the state’s Medicaid program and the Child Health Plan Plus (CHP+) program, has recently confirmed that the protected health information of 4,091,794 individuals was compromised. HCPF said its own systems were not affected.

Medicaid 96

Medicaid Medicaid HIPAA Health Insurance 96

HIT Consultant

MARCH 8, 2022

The steep incline in unemployment and fears that millions of people would lose their health coverage drove the declaration of the national public health emergency (PHE) on January 31, 2020. Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. .

Public Health 98

Public Health Medicaid Medicaid COVID-19 98

HIPAA Journal

NOVEMBER 12, 2024

Health & Palliative Services of the Treasure Coast in Florida and Universal Health Corporation in Virginia have discovered unauthorized access to their email systems and the exposure of patients’ protected health information.

HIPAA 49

HIPAA Licensing Health Insurance Medicaid 49

MRO Compliance

NOVEMBER 13, 2023

Morrell brings with her more than 25 years of government affairs experience covering both state and federal rulemaking tied to Medicare, Medicaid, commercial insurance and health IT. Morrell spent over a decade at Health Net, Inc. For more information, visit www.mrocorp.com. . – November 13 , 2023 – MRO Corp.,

Governance 133

Governance Health Insurance Medicaid Medicaid 133

HIPAA Journal

JULY 4, 2023

Murfreesboro Medical Clinic & SurgiCenter (MMC) in Tennessee has recently confirmed that the protected health information of more than half a million patients was compromised in what it describes as “a series of attacks on our network and IT systems,” which were discovered on or around April 24, 2023.

Medicaid 96

Medicaid Medicaid Health Insurance Licensing 96

HIPAA Journal

JUNE 16, 2023

EpiSource Confirms Breach of its AWS Environment The Gardena, CA-based medical coding vendor, EpiSource, has confirmed that the protected health information of patients of its healthcare clients has been exposed and potentially compromised in a February 2023 cyberattack on its Amazon Web Services (AWS) environment.

Medicaid 104

Medicaid Medicaid HIPAA Health Insurance 104

C&M Health Law

JANUARY 18, 2023

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

Medicaid 52

Medicaid Medicaid Federal Policy Health Outcomes 52

Bill of Health

DECEMBER 6, 2023

By Hannah Rahim Many mental health provider directories for private and public insurance plans contain inaccurate or outdated provider information , which creates a misleading illusion of accessible care. These ghost networks result in many patients being unable to access essential mental health care.

Governance 147

Governance Medicaid Medicaid Medicare 147

HIPAA Journal

OCTOBER 7, 2022

Anthem has confirmed that the protected health information of certain plan members has been compromised in a data breach at its vendor, Choice Health. Choice Health was provided with the data of plan members to perform its contracted duties. CareOregon Reports August 2022 Mailing Error.

HIPAA 118

HIPAA Health Insurance Medicaid Medicaid 118

MedTrainer

SEPTEMBER 20, 2023

Below are a variety of resource links to refer to for more information as you equip yourself with the knowledge needed to pass a survey. This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). CMS wants the industry and public to be fully informed.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

Healthcare It News

JUNE 3, 2022

Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents.

Public Health 262

Public Health Health Insurance Professionals ACA Medicaid 262

Kaiser Health News

APRIL 16, 2024

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

ACA 141

ACA Health Insurance Governance Medical Billing 141

HIPAA Journal

FEBRUARY 15, 2022

South Shore Hospital engaged a team of third-party computer forensics experts to investigate the security breach and determine whether patient information was accessed or stolen. The investigation confirmed names, Social Security numbers, and plan selection information had been exposed.

Hospitals 128

Hospitals Health Insurance HIPAA Medicaid 128

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

AIHC

NOVEMBER 12, 2024

Written by Gabriella Neff, RHIA, CHA, CHC, CHRC, CHPC This past year, in 2024, revisions were made to clarify hospital guidelines related to informed consent specifically addressing UIEs (unconsented intimate exams) to patients while under anesthesia. OCR recently issued an FAQ focusing on this right. [6]

Informed Consent 52

Informed Consent HIPAA Compliance Hospitals 52

HIPAA Journal

MARCH 15, 2023

Independent Living Systems, LLC (ILS), a Miami, FL-based provider of third-party administrative services to managed care organizations, has recently informed the Maine Attorney General that it suffered a data breach that has affected up to 4,226,508 individuals – the largest healthcare data breach to be reported so far this year.

HIPAA 126

HIPAA Health Insurance Medicaid Medicaid 126

HIT Consultant

JULY 17, 2023

Cessation of PHE telehealth, prescribing, and mental health access exceptions could impact the Medicaid population the most. Twenty-one percent of Medicaid enrollees have mild, moderate, or severe SUD, compared to 16% of commercially insured individuals. And as of the latest data, 7.3% And as of the latest data, 7.3%

Public Health 98

Public Health Medicaid Medicaid Electronic Medical Records 98

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

Compliancy Group

NOVEMBER 1, 2024

HIPAA The Health Insurance Portability and Accountability Act (HIPAA) requires protecting the security and privacy of medical records and all patient data. HITECH The Health Information Technology for Economic and Clinical Health Act (HITECH Act ) is an extension of HIPAA and part of the 2009 American Recovery and Reinvestment Act.

Compliance 52

Compliance HIPAA Electronic Medical Records Fraud 52

Bill of Health

OCTOBER 27, 2023

By Adithi Iyer In my last piece , I discussed the hypothetical successor of 23andme — a tissue-based direct-to-consumer testing service I’ve called yourtissueandyou — and the promise and perils that it might bring in consumer health information and privacy. Consumer protections for this type of information are, in a word, complicated.

HIPAA 162

HIPAA FDA Informed Consent Health Insurance 162

HIPAA Journal

MARCH 14, 2022

Capital Region Medical Center (CRMC) in Jefferson City, MO has recently confirmed patient information was accessed by unauthorized individuals in a December 2021 cyberattack that took its network and phone systems offline for several days. It was initially unclear if patient information had been compromised but that has now been confirmed.

Electronic Medical Records 142

Electronic Medical Records Health Insurance HIPAA Licensing 142