HIPAA Journal

NOVEMBER 12, 2024

The affected individuals had some or all of the following information exposed: name, address, date of birth, Social Security number, driver’s license number, financial account number, medical record number, patient ID number, Medicare/Medicaid number, health insurance information, medical diagnosis and treatment information, prescription information, (..)

HIPAA 72

HIPAA Licensing Health Insurance Medicaid 72

HIPAA Journal

OCTOBER 17, 2022

The exposed information included names, dates of birth, Social Security numbers, driver’s license numbers, clinical/diagnosis information, health insurance member ID numbers, medical record numbers, and Medicare or Medicaid numbers.

Health Insurance 124

Health Insurance Licensing Fraud HIPAA 124

HIPAA Journal

MARCH 25, 2022

AHA discovered the email breach in early September 2021 and determined on December 2, 2021, that files containing the protected health information of its healthcare provider clients had been accessed. UMC was a victim of a REvil ransomware attack in June 2021 that resulted in the theft of the protected health information of 1.3

Health Insurance 118

Health Insurance Licensing Ransomware Fraud 118

Physician Credentialing Company

SEPTEMBER 19, 2024

Therefore, it is necessary to verify the legitimacy of all providers’ credentials before enrolling them in health insurance plans. Liability issues can even result in the termination of their license. Some health insurance companies allow providers to bill on their NPI numbers under the supervision of senior physicians.

Malpractice 52

Malpractice Medicare Medicare Medicaid 52

HIPAA Journal

SEPTEMBER 9, 2022

Those emails contained patient information such as names, dates of birth, Social Security numbers, medical information, health insurance information, driver’s license numbers, and state ID numbers. The information exposed varied from patient to patient. Notification letters were sent to all affected individuals in August.

Licensing 111

Licensing Health Insurance Fraud HIPAA 111

HIPAA Journal

OCTOBER 7, 2022

On August 5, 2022, Anthem discovered that an unauthorized individual had gained access to a database and downloaded files containing plan members’ protected health information, including names, addresses, dates of birth, phone numbers, email addresses, Medicare ID numbers, and Medicaid ID numbers.

HIPAA 110

HIPAA Health Insurance Medicaid Medicaid 110

HIPAA Journal

JUNE 16, 2023

Idaho Medicaid Recipients Affected by Data Breach at Claims Processor The Idaho Department of Health and Welfare has confirmed that the personal information of 2,501 Medicaid recipients has potentially been accessed and/or obtained in a data breach at its claims processor, Gainwell Technologies.

Medicaid 91

Medicaid Medicaid HIPAA Health Insurance 91

HIPAA Journal

MARCH 10, 2022

The files exfiltrated from its systems included the protected health information of patients. Individuals whose Social Security number, driver’s license, state identification number, or financial account information may have been involved have been offered complimentary credit monitoring services. Dr. Douglas C.

Ransomware 132

Ransomware Licensing Health Insurance HIPAA 132

Physician Credentialing Company

OCTOBER 25, 2024

Its purpose is to provide mental health support to people with psychological problems while using various forms of therapy that have to be scientifically proven and evidence-based. Only licensed mental health professionals are permitted to send the bill for the services offered defined by code 90834. Who can Bill CPT Code 90834?

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

MedTrainer

MAY 7, 2024

Benefits of Enrolling Your Providers With UnitedHealthcare Here are some key advantages of becoming an in-network provider with UnitedHealthcare: Expanded Revenue Opportunities: UnitedHealthcare is the 4th largest health insurer in the U.S.,

Malpractice 52

Malpractice Licensing Medicaid Medicaid 52

Healthcare Law Blog

JANUARY 25, 2023

Introduction: Defining Interprofessional Consultation In a January 5, 2023, letter to state health officials, the Centers for Medicare & Medicaid Services (“CMS”) clarified a Medicaid and Children’s Health Insurance Program (“CHIP”) policy on the coverage and payment of interprofessional consultations (the “Guidance”).

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

JULY 31, 2023

The Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) has confirmed that the PHI of approximately 612,000 current Medicare recipients was exposed in this incident and up to 645,000 individuals in total. The CMS said it is working with Maximus to provide notice to the affected individuals.

Governance 79

Governance Medicare Medicare Ransomware 79

Healthcare IT News - Telehealth

OCTOBER 2, 2020

Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program. Recommended voluntary billing codes, modifiers and place-of-service designations for telehealth and other virtual health care services.

US Department of Health and Human Services 151

US Department of Health and Human Services COVID-19 Medicaid Medicaid 151

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

MARCH 14, 2022

CRMC said at this stage of the investigation it does not appear that the attackers gained access to its electronic medical record database; however, the files accessed or potentially accessed by the attackers included information such as patient names, addresses, birth dates, medical information, and health insurance information.

Electronic Medical Records 136

Electronic Medical Records Health Insurance HIPAA Licensing 136

HIPAA Journal

OCTOBER 11, 2022

It was not possible to determine if any emails or file attachments were opened or acquired by the attacker. Additional safeguards have been implemented to improve the security of its email environment.

Licensing 79

Licensing HIPAA Health Insurance Medicaid 79

Verisys

NOVEMBER 8, 2023

Providers, employers, health plans, and payers use these numbers for billing purposes. CMS.gov The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the creation of a standard, unique health identifier for healthcare providers, which the NPI satisfies.

Fraud 97

Fraud HIPAA Medicare Medicare 97

HIPAA Journal

MAY 16, 2022

The investigation into the breach determined multiple employee email accounts had been compromised, with the review of those accounts confirming they contained patient information such as names, birthdates, addresses, and health insurance member IDs. Financial information and Social Security numbers were not exposed.

Health Insurance 116

Health Insurance Ransomware HIPAA Licensing 116

HIPAA Journal

SEPTEMBER 14, 2022

MATLV said the investigation did not uncover any evidence indicating the misuse of patient information, but parts of the network that were accessed by the attackers contained files that included the protected health information of 75,628 individuals, which may have been viewed or exfiltrated in the attack.

Ransomware 96

Ransomware Licensing HIPAA Health Insurance 96

MedTrainer

DECEMBER 7, 2023

The Medicaid and Health program of Idaho provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities in the state, offering a range of medical and health-related services.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

Health Populi

MAY 21, 2020

Nearly every respondent in the study reported having health insurance coverage. Among those covered with insurance, one-half had employer-sponsored insurance, 1 in 4 Medicare, and 13%, individual cover. Another 8% had Medicaid or a state health insurance program.

COVID-19 161

COVID-19 Doctors Health Insurance Medicare 161

HIPAA Journal

MARCH 6, 2023

The types of information exposed varied from individual to individual and may have included names, addresses, medical information, health insurance information, Medicaid identification numbers, driver’s licenses, account and routing numbers, and Social Security numbers.

Electronic Medical Records 85

Electronic Medical Records HIPAA Licensing Nurses 85

HIPAA Journal

OCTOBER 18, 2022

A review of the account confirmed no financial information was compromised; however, there may have been unauthorized access to names, dates of birth, Social Security numbers, medical record numbers, health insurance information, and limited clinical information related to billing, such as diagnosis codes and treatment information.

HIPAA 124

HIPAA Health Insurance Licensing Medicaid 124

HIPAA Journal

OCTOBER 17, 2022

The types of data potentially obtained by the attackers varied from individual to individual, and may have included the following data elements: name, contact information, demographic information, diagnosis, treatment information, information regarding mental/physical condition, medical record number, patient number, health insurance information, billing/claim (..)

Licensing 58

Licensing HIPAA Health Insurance Medicaid 58

HIPAA Journal

APRIL 25, 2023

On February 13, 2023, NationsBenefits confirmed that the data compromised in the attack included protected health information such as name, address, phone number, gender, date of birth, health insurance number, medical ID number, Social Security number, date(s) of service, medical device or product purchased, and provider/caregiver name.

Health Insurance 95

Health Insurance Public Health Ransomware Fraud 95

HIPAA Journal

AUGUST 8, 2023

A comprehensive review of the affected files concluded on May 26, 2023, that the protected health information of 19,107 individuals had been compromised, including names, Social Security numbers, driver’s license numbers, medical treatment and/or diagnosis information, and health insurance information.

Ransomware 96

Ransomware Licensing HIPAA Health Insurance 96

HIPAA Journal

MAY 19, 2022

The breach was reported to the HHS’ Office for Civil Rights as affecting 114,007 individuals.

Licensing 120

Licensing HIPAA Health Insurance Medicaid 120

HIPAA Journal

MAY 30, 2023

MCNA), which also does business as MCNA Dental – a provider of dental benefits and services for state Medicaid and Children’s Health Insurance Programs – has recently reported a major data breach to the Maine Attorney General that has affected 8,923,662 individuals. Managed Care of North America, Inc.

Health Insurance 104

Health Insurance Medicaid Medicaid Ransomware 104

Kaiser Health News

JANUARY 19, 2022

” The changes are part of a 400-page proposed rule governing the federal health insurance marketplace and a few states that use the federal platform for their own exchanges. States also can revoke agents’ licenses. But they have only 60 days after discovering the fraudulent enrollment to do so.

ACA 80

ACA Health Insurance Licensing Governance 80

HIPAA Journal

APRIL 13, 2022

The hard drive was used for its Point-to-Point program in Exton, PA, and contained information such as names, Social Security Numbers, drivers’ license numbers, financial account information, payment card information, dates of birth, prescription information, diagnosis information, treatment information, treatment providers, health insurance information, (..)

Ransomware 122

Ransomware HIPAA Licensing Health Insurance 122

HIPAA Journal

AUGUST 31, 2023

In order to prevent a repeat of the incident, PurFood states in its breach notification letter that the company has taken a number of steps to strengthen its security network and is reviewing its existing policies and procedures to identify any additional measures and safeguards that may be necessary.

Medicare 52

Medicare Medicare HIPAA Medicaid 52

Healthcare Compliance Blog

MARCH 31, 2022

The agencies received millions of dollars in funding from Medicaid, which is funded in part by the federal government, and much of that money was meant to pay the wages and benefits of their aides. Under the Wage Parity Law, which is funded by Medicaid, aides are to be paid a minimum amount in total compensation.

Medicaid 59

Medicaid Medicaid Governance Fraud 59

Healthcare IT Today

AUGUST 17, 2022

They did say the following information may have been accessed by the unauthorized third party: Personal information involved in this incident may have included one or more of the following elements: (1) information to identify the individual (such as full name, date of birth, and address); (2) Social Security number, driver’s license/state ID number, (..)

Licensing 106

Licensing Hospitals Health Insurance Medicaid 106

Physician Credentialing Company

OCTOBER 26, 2024

A CBC with an automated differential must be ordered by a licensed healthcare provider. Billing & Reimbursement Guidelines Most health insurance plans, including Medicare and Medicaid, pay for CBC tests when deemed medically necessary. There are a few things which should be documented properly.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIPAA Journal

AUGUST 12, 2022

A review of the affected email accounts revealed they contained patient data such as names, client health insurance information, Medicaid information, Social Security numbers, and limited information related to services received at Living Innovations.

Licensing 68

Licensing Health Insurance HIPAA Medicaid 68

HIPAA Journal

MAY 25, 2022

The data includes names, dates of birth, ID numbers, expected due dates, referring physician names, sonographer names, ultrasound results, drug and alcohol use histories, other health information, and some records include credit card information and health insurance information.

Ransomware 133

Ransomware Fraud HIPAA Licensing 133

MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. Compliance in healthcare began to encompass billing, fraud, and abuse prevention.

Compliance 52

Compliance HIPAA Telemedicine ACA 52