, Author at The Honest Approach

admin | Posted on July 1, 2022 |

July 1, 2022

The FBI Internet Crime Complaint Center (IC3) issued a warning to employers that stolen Personally Identifiable Information (PII) and Deepfakes are being used by bad actors to apply for remote work and work-from-home positions. The types of positions being targeted by these bad actors include: information technology and computer programming, database, and software related job functions. If hired, these bad actors could have “access to customer PII, financial data, corporate IT databases and/or proprietary information.”

False Claims Act Violations

admin | Posted on June 30, 2022 |

June 30, 2022

Molina Healthcare, Inc. (Molina) and its previously owned subsidiary, Pathways of Massachusetts (Pathways), have agreed to pay $4.625 million to resolve allegations that it violated the False Claims Act by submitting reimbursement claims while violating several regulations related to the licensure and supervision of staff.

Investigation Into MA Organizations

admin | Posted on June 20, 2022 |

June 30, 2022

The American Hospital Association has asked the Department of Justice (DOJ) and Centers for Medicare & Medicaid Services (CMS) to look into commercial payers that routinely deny access to care and services.

DOJ Reaches $22.7 Million Settlement with Providence Over Medically Unnecessary Neurosurgery Procedures

admin | Posted on June 15, 2022 |

Thomas Sullivan Last Updated May 30, 2022

The Department of Justice had a $22.7 million settle with Providence Health & Services Washington (Providence) to resolve allegations that Providence inappropriately billed claims to federal programs (Medicare, Medicaid, Tricare, etc.) for services that were not medically necessary.

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Peoples Health Network (Contract H1961) Submitted to CMS

admin | Posted on June 6, 2022 |

Of the 242 unique enrollee-years that were audited, 98 had validated medical records that supported the HCC (Hierarchical Condition Categories) diagnoses submitted. The other 144 unique enrollee-years diagnoses were not supported by the medical records, because Peoples Health was not able to locate the medical records.

HHS to stop reimbursing providers for vaccine administration

admin | Posted on April 17, 2022 |

Starting April 5, HHS will no longer adjudicate claims submitted for vaccine administration due to a lack of funds.

Digital Maturity Helps in the Fight Against Pandemics

admin | Posted on April 17, 2022 |

In the face of such an unprecedented storm in the form of a pandemic, the need for information sharing, collaboration and rapid system development took on new urgency. There are truly remarkable examples globally of healthcare providers’ agility and innovation.

In charting a future course for healthcare, let’s think bigger

admin | Posted on April 4, 2022 |

AI, augmented reality, biomedical sensors and beyond – by mapping out a clear vision now, we can widen our ambitions and improve modernization strategies to better harness the vast potential offered by technology advances.

US Department of Labor announces enforcement, effort for focused inspections in hospitals, nursing care facilities treating COVID-19 patients

admin | Posted on April 4, 2022 |

For two years, millions of the nation’s healthcare workers have been battling the coronavirus. Many have endangered themselves as they care for those who contract COVID-19 while working in high-risk settings that expose themselves and their families.

Personalized healthcare driven by an explosion of patient needs

admin | Posted on March 31, 2022 |

Rich Corbridge, CIO at Boots UK and Ireland, discusses how the pandemic transformed clinician and patient attitudes toward technology and how digital tools can help improve personalized healthcare.