From Report on Patient Privacy - Premera Blue Cross, which operates in Washington state and Alaska, has reported learning about a breach of 11 million of its records on Jan. 29 — the same day that Anthem, Inc., also said it learned that data for some 80 million individuals had been compromised (RPP 3/15, p. 1). Thus far, federal and state officials — and Premera itself — haven’t linked the two breaches publicly, although non-governmental IT experts have. Read more
From Report on Medicare Compliance - A federal district court in North Carolina on March 18 declined to compel HHS administrative law judges to comply with their statutory 90-day deadline to rule on appeals of claim denials. It granted a motion by HHS to throw out a case filed by Cumberland County Hospital System, doing business as Cape Fear Valley Health System, which sued over the delay at the Office of Medicare Hearings and Appeals (OMHA)… Read more
From Report on Medicare Compliance - An anonymous letter sent to the compliance officer at Memorial Hermann, a health system in Houston, led to the arrest of a manager in an alleged $9 million, 14-year embezzlement scheme. The case underscores the value of ensuring that employees know how to contact the compliance officer and use the hotline. Kenneth Joseph Wild II, 49, was accused of mail fraud and wire fraud in connection with the submission of phony… Read more
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