HIPAA Journal

JUNE 8, 2023

The Iowa Department of Health and Human Services has announced there have been three separate breaches of the protected health information of Iowa Medicaid recipients in the past two months – two hacking incidents and an impermissible disclosure, all three of which involved third-party contractors.

Medicaid 98

Medicaid Medicaid Ransomware Health Insurance 98

Healthcare IT News - Telehealth

JUNE 12, 2020

The Centers for Medicare and Medicaid Services relaxed requirements around reimbursements early in the pandemic, contributing to the upswing in countrywide telehealth visits. introduced a bill that would mandate a study on the effects of telehealth, noting that data informs policy changes. " WHY IT MATTERS. Robin Kelly, D-Ill.,

Medicare 217

Medicare Medicare Nursing Homes Medicaid 217

Verisys

APRIL 2, 2025

How to Acquire a Pharmacy License The process of becoming a licensed pharmacy can be complex even if you have experience, as every state has different documentation requirements. Pharmacies must obtain all the necessary licenses to meet the necessary professional standards before they can legally begin operation.

Licensing 52

Licensing Compliance Medicaid Medicaid 52

Medisys Compliance

DECEMBER 24, 2024

Medicare Reimbursement Medicare covers teletherapy under specific guidelines: Eligible Providers: Includes licensed clinical social workers (LCSWs), clinical psychologists, and other licensed professionals. Check state-specific Medicaid guidelines to ensure compliance.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Healthcare IT News - Telehealth

JANUARY 12, 2021

From a regulatory and policy perspective, the reforms would: Require Medicaid telehealth reimbursement for services regardless of where the patient or provider is located in a non-facility setting. Develop interstate licensing reciprocity for states in the Northeast region for specialties with historical access shortage.

COVID-19 218

COVID-19 Telemedicine Medicaid Medicaid 218

Verisys

APRIL 3, 2025

For healthcare organizations, the NPDB is more than just a screening toolits a safeguard for crucial and confidential information. Licensure actions Disciplinary actions from state medical boards, like suspensions or revoked licenses. Other adverse actions Things like voluntarily giving up a license while under investigation.

Malpractice 52

Malpractice Licensing Compliance Hospitals 52

Healthcare IT Today

NOVEMBER 3, 2024

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. Oracle Health News Plenty of headlines from Nashville and the Oracle Health Summit.

Medical Billing 89

Medical Billing Licensing Medicaid Medicaid 89

Verisys

APRIL 3, 2025

In traditional credentialing, healthcare organizations manually collect and verify information from licensing boards, medical schools, and past employersa process that can take a significant amount of time to complete. To learn more about credentialing for hospitals , Medicaid providers , and retail pharmacies , contact us today.

Licensing 52

Licensing Malpractice Compliance Nurses 52

Verisys

MARCH 6, 2025

Credentialing involves a detailed review of a provider’s qualifications, including their: Education Work experience Certifications Licenses Professional standing This process ensures that patients see professionals who are properly trained and certified to provide the level of care they require.

Licensing 52

Licensing Compliance Nurses Malpractice 52

AIHC

DECEMBER 27, 2024

Informed consent is a cornerstone of ethical medical practice. of them expressed a correct understanding of what constitutes informed consent. [3] Thus, the implied consent approach undermines the ethical principle of informed consent by creating a significant gap in the important communication process.

Informed Consent 98

Informed Consent Bioethics ADA Medical Personnel 98

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 117

Medicaid Medicaid Fraud Licensing 117

HIPAA Journal

FEBRUARY 16, 2022

Family Christian Health Center (FCHC) in Illinois has announced it was the victim of a ransomware attack in November 2021 that compromised the protected health information of 31,000 patients. The attackers compromised FCHC’s old dental system which contained the PHI of patients who had received dental services prior to August 31, 2020.

Ransomware 130

Ransomware Hospitals Licensing HIPAA 130

HIPAA Journal

MARCH 10, 2022

A round-up of 6 cyberattacks that have recently been reported by healthcare providers and business associates that resulted in the exposure and possible theft of patients’ protected health information. The files exfiltrated from its systems included the protected health information of patients. Duncan Regional Hospital.

Ransomware 139

Ransomware Licensing Health Insurance HIPAA 139

Verisys

MARCH 6, 2025

Similarly, insurance companies that process thousands of claims daily require up-to-date provider information to avoid claims delays and denials. Inadequate Data Validation Without proper validation processes, organizations risk relying on outdated or incorrect information. What Is Provider Data Quality?

Compliance 52

Compliance Licensing Doctors Malpractice 52

Verisys

FEBRUARY 10, 2025

Key updates include: Shortened verification timeframes Stricter ongoing monitoring Enhanced information integrity standards To remain compliant, healthcare organizations must accelerate credentialing verification, implement continuous monitoring systems, and strengthen data security.

Licensing 40

Licensing Compliance Medicaid Medicaid 40

Provider Trust

SEPTEMBER 29, 2022

A 49-year-old Brownsville, TX man named Fernando Mendez was taken into custody in early September after being charged with defrauding Medicaid. Mendez, who was a physician assistant at CCI Therapy Counseling Centers International, was working with a suspended medical license. How Often Should You Verify Employee Licenses?

Licensing 52

Licensing Fraud Medicaid Medicaid 52

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 134

Health Insurance Licensing Fraud HIPAA 134

Verisys

APRIL 3, 2025

Data inaccuracies: A misspelled name, incorrect license number, or missing documentation might seem minor, but they can lead to license and certification rejections, compliance violations, and delayed insurance reimbursementspotentially causing financial and operational headaches.

US Department of Health and Human Services 52

US Department of Health and Human Services Licensing Compliance Malpractice 52

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

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

Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare. As such, providers should prioritize billing compliance.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

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 117

Licensing Health Insurance Fraud HIPAA 117

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

Medisys Compliance

MARCH 9, 2025

Clinical Social Workers (LCSWs): Licensed to provide mental health services, including psychotherapy and counseling. Licensed Professional Counselors (LPCs) & Licensed Mental Health Counselors (LMHCs): These professionals are increasingly recognized by Medicare. It is not intended as legal or billing advice.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Services 59

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 117

Health Insurance Licensing Ransomware Fraud 117

HIPAA Journal

MAY 19, 2022

Legal action was taken on behalf of the individuals affected by the breach, with the class including all individuals residing in the United States and its territories who were notified in November 2019 that their information had been exposed. The breach was reported to the HHS’ Office for Civil Rights as affecting 114,007 individuals.

Licensing 122

Licensing HIPAA Health Insurance Medicaid 122

Compliancy Group

NOVEMBER 25, 2024

Providers can appear on this list for a range of reasons varying from convictions related to Medicare or Medicaid fraud or even cases of patient abuse or licensing issues. In simpler terms, it’s often difficult to check multiple systems against the information they may have without feeling that something may have been missed.

Compliance 52

Compliance Fraud Medicaid Medicaid 52

Medisys Compliance

APRIL 19, 2023

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

Medicaid 52

Medicaid Medicaid Medical Billing Outsourcing Licensing 52

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

Verisys

MARCH 6, 2025

The Centers for Medicare and Medicaid Services (CMS) Regulates reimbursement policies and ensures healthcare organizations adhere to the standards necessary to participate in federal healthcare programs. Credentialing, Licensing, and Education. Failure to comply with regulations can result in the loss of these essential credentials.

Compliance 52

Compliance HIPAA Licensing Governance 52

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. No financial information, Social Security numbers, or driver’s license numbers were taken.

HIPAA 112

HIPAA Health Insurance Medicaid Medicaid 112

HIPAA Journal

MAY 25, 2022

Social Action Community Health System (SAC Health) has recently notified 149,940 patients that documents containing their protected health information were stolen in a break-in at an off-site storage location where patient records were stored. Notification letters were sent to those individuals on May 3, 2022.

Ransomware 136

Ransomware Fraud HIPAA Licensing 136

MedTrainer

MARCH 30, 2024

Step-By-Step Provider Enrollment Process There are many reasons provider enrollments are delayed: incorrect information, missing documents, busy credentialers, and slow-moving payers. CAQH Profile Management Streamline your enrollment processes with the most up-to-date provider information at your fingertips.

Malpractice 98

Malpractice Licensing Medicaid Medicaid 98

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 13, 2022

The Philadelphia, PA-based national human services nonprofit organization, Resources for Human Development (RHD), has recently confirmed that a hard drive containing the protected health information of 46,673 individuals has been stolen. Training has also been provided to employees on best practices for protecting confidential information.

Ransomware 117

Ransomware HIPAA Licensing Health Insurance 117

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 101

Medicaid Medicaid HIPAA Health Insurance 101

Healthcare IT Today

NOVEMBER 2, 2023

Since January 2022 , the Centers for Medicare & Medicaid Services (CMS) and other federal agencies have had their eyes on California with the launch of the nation’s largest-ever program to transform the healthcare system for vulnerable communities.

Medicaid 120

Medicaid Medicaid Licensing Medicare 120