Blog - Archive for Health Care Law News

Under a recent settlement with the U.S. Department of Health and Human Services (HHS), Affinity Health Plan, Inc., settled potential violations of the HIPAA Privacy and Security Rules for $1,215,780. HHS-OCR’s investigation revealed that Affinity impermissibly disclosed (without consent) the protected health information of up to 344,579 individuals when it returned multiple photocopiers to a Read more →

Tags : HIPAA compliance , United States Department of Health and Human Services

On December 26th, 2013, HHS-OCR announced a $150,000 dollar settlement with Adult & Pediatric Dermatology, P.C.(APDerm), a Concord, Massachusetts-based private practice for alleged HIPAA violations discovered during an HHS-OCR investigation following a reported breach. As background, on October 7th, 2011,APDerm notified HHS that an unencrypted USB memory drive containing protected health information (PHI) had been Read more →

Tags : HIPAA compliance

Earlier today, the OIG launched an online submission process for its voluntary Self-Disclosure Protocol. This online disclosure tool is designed to make it even easier for providers who wish to voluntarily disclose self-discovered evidence of potential fraud to OIG. According to the OIG’s associated press release, “Self-disclosure gives providers the opportunity to avoid the costs Read more →

Tags : Florida Healthcare Law , Healthcare compliance

On May 17, 2013, HHS published a rule change that will allow state Medicaid programs to use federal funds to data mine for erroneous and false claims. The rule change is expected to generate an estimated $60 million in additional recoveries over the next decade. In order to obtain a portion of the approximately $12 Read more →

Tags : medicaid audit , Medicare Audit

In order to avoid erroneous billing practices for “New Patient” Evaluation and Management services, CMS issued Change Request 8165 which informs Medicare contractors about changes to Medicare’s Common Working File system that detects errors in billing.  According to Medicare manuals, “New Patient” is defined as: a patient who has not received any professional services, i.e., Read more →

Tags : medicaid audit , Medicare Audit