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Thursday, Oct 1 2020

Full Issue

Feds Charge 345 People With Health Care Fraud

The medical professionals are accused of submitting a total of $6 billion in bad claims for telehealth and substance abuse treatment, among other services. Also in the news: Clear View Behavioral Health in Colorado will lose its license; Anthem settles a cyberattack case; and hospitals are warned about Ryuk ransomware.

More than 340 individuals were charged with submitting $6 billion in fraudulent claims to federal healthcare programs and private insurers for telehealth consultations and substance abuse treatment, among other services, the Justice Department announced Wednesday, describing it as the largest healthcare fraud "takedown" in history. (Kacik, 9/30)

The Department of Justice charged 345 people across 51 federal districts in the largest healthcare fraud takedown in the agency's history. DOJ said the charges were in connection cases responsible for more than $6 billion in losses. Among those charged were more than 100 doctors, nurses and other medical professionals, according to DOJ. The billions in false claims were submitted to both public and private insurers, DOJ said, with more than $4.5 billion connected to telemedicine schemes. (Minemyer, 9/30)

Also —

The state of Colorado will work to revoke the license of, and has already shut down, a much-scrutinized mental health hospital in northern Colorado. Clear View Behavioral Health in Johnstown has been the subject of more than a dozen Denver7 investigations since January 2019. The state had taken prior action but earlier this year decided to re-issue the license to the mental health facility. (Kovaleski, 9/28)

Anthem agreed to pay $39.5 million to settle an investigation by state attorneys general into the massive 2015 cyber-attack that exposed the personal information of nearly 79 million of the health insurer's members and employees. The settlement resolves the last open investigation of the breach, in which hackers stole the names, birth dates, Social Security numbers, home addresses and other information of current and former members and workers. Anthem said it does not believe it violated the law regarding data security and did not admit to doing so in the settlement. (Livingston, 9/30)

HHS released important updates on the Ryuk ransomware, which is suspected in the recent cyberattack at King of Prussia, Pa.-based Universal Health Systems hospital. Ryuk ransomware is an encryption used by individuals to lock information within an organization's computer system. The information HHS released Sept. 29 urges organizations to take action to reduce the risk of attack, according to an American Hospital Association report. (9/30)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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