This document provides instructions for filing dental benefit claims. It notes that submitting incomplete or fraudulent claims is illegal. It provides state-specific notices about insurance fraud. It instructs employees and dentists to complete different sections of the claim form, including treatment details and billing information. Dentists are asked to sign certifying the accuracy of the claim.
Uninsured and Underinsured Motories Coverage in LouisianaPeirce
This document provides an overview of uninsured and underinsured motorist insurance law in Louisiana. It discusses the insurance company's obligations, who and what is covered, exclusions to coverage, statutes of limitations, offsets and reimbursements related to settlements. It also addresses issues related to settling UM/UIM claims such as subrogation, avoiding bad faith, and mediating/arbitrating coverage disputes. Finally, it outlines topics involved in trying an UM/UIM claim such as discovery processes, expert witnesses, and trial defenses and strategies.
This document is effective from 1st September 2013 and supersedes all Terms of Business previously issued by us. It sets out the terms upon which we agree to act for our direct clients and contains details of our regulatory and statutory responsibilities. It also sets out some of your responsibilities.
This document provides information about New York's no-fault automobile insurance law. It explains that New York has a no-fault system where insurance will pay up to $50,000 for medical expenses and lost wages from a car accident, regardless of fault. It also describes the types of injuries and expenses covered, as well as the process for filing claims and pursuing legal action for pain and suffering if injuries are deemed "serious."
This document provides an overview of pay, allowances, and personal administration policies for Army Reserve personnel. It defines key terms, outlines procedures for updating personal details and emergency contacts, and describes entitlements such as travel reimbursement and insurance. Personnel are responsible for ensuring their personal information is accurate and reporting any changes in a timely manner, as this impacts pay and eligibility for allowances. The document is intended to help reservists understand administrative policies but does not constitute authority to claim payments.
The alleged Medicaid fraud covered by the settlement lasted for more than four years, from July 16, 2001 through at least December 31, 2005. The complaint was brought in 2003 under the qui tam provisions of federal and state False Claims Acts, after whistleblower relator Bernard Lisitza uncovered the conduct and reported the problem to the government. The investigation and prosecution was led by the Attorneys General Offices in Florida, Illinois, Ohio, Texas and several other states, and by the United States Attorney’s Office in Chicago. Qui tam Relator Lisitza pursued the case with the assistance of his attorneys, Michael I. Behn and Linda Wyetzner, of Behn & Wyetzner, Chartered, in Chicago.
This resolution agreement between HHS and Affinity Health Plan resolves an investigation into a breach of protected health information. Affinity will pay $1,215,780 and comply with a corrective action plan. The plan requires Affinity to retrieve photocopier hard drives containing PHI, conduct a security risk analysis, and update policies. If Affinity breaches the agreement or plan, HHS may impose civil money penalties. Both parties aim to resolve the issues without further legal action.
Joshua and Laura Tynes Petition for DivorceCaitlinPyle
This document is Laura Caitlin Tynes' original petition for divorce from her husband Joshua Phillip Tynes. Laura requests a no-fault divorce on the grounds of insupportability. She asks for a division of community property, either through agreement or court determination. Laura also requests several temporary orders from the court, including exclusive use of the marital residence, and injunctions preventing Joshua from threatening, harming, or interfering with Laura or marital property pending the divorce. No children were born of the marriage.
Adult & Pediatric Dermatology, P.C., of Concord, Mass., has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules with the Department of Health and Human Services, agreeing to a $150,000 payment. The practice will also be required to implement a corrective action plan to correct deficiencies in its HIPAA compliance program. Adult and Pediatric Dermatology is a private practice that delivers dermatology services in four locations in Massachusetts and two in New Hampshire. This case marks the first settlement with a covered entity for not having policies and procedures in place to address the breach notification provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of American Recovery and Reinvestment Act of 2009 (ARRA).
The HHS Office for Civil Rights (OCR) opened an investigation of Adult and Pediatric Dermatology upon receiving a report that an unencrypted thumb drive containing the electronic protected health information (ePHI) of approximately 2,200 individuals was stolen from a vehicle of one its staff members. The thumb drive was never recovered. The investigation revealed that Adult and Pediatric Dermatology had not conducted an accurate and thorough analysis of the potential risks and vulnerabilities to the confidentiality of ePHI as part of its security management process. Further, Adult and Pediatric Dermatology did not fully comply with requirements of the Breach Notification Rule to have in place written policies and procedures and train workforce members.
In addition to a $150,000 resolution amount, the settlement includes a corrective action plan requiring Adult and Pediatric Dermatology to develop a risk analysis and risk management plan to address and mitigate any security risks and vulnerabilities, as well as to provide an implementation report to OCR.
Download the Corrective Action Plan(CAP) here >>
Tips s to providers: Almost all of the HIPAA/HITECH violations identified in the last few years is due to insufficient security risk analysis conducted by the providers or business associates.
Uninsured and Underinsured Motories Coverage in LouisianaPeirce
This document provides an overview of uninsured and underinsured motorist insurance law in Louisiana. It discusses the insurance company's obligations, who and what is covered, exclusions to coverage, statutes of limitations, offsets and reimbursements related to settlements. It also addresses issues related to settling UM/UIM claims such as subrogation, avoiding bad faith, and mediating/arbitrating coverage disputes. Finally, it outlines topics involved in trying an UM/UIM claim such as discovery processes, expert witnesses, and trial defenses and strategies.
This document is effective from 1st September 2013 and supersedes all Terms of Business previously issued by us. It sets out the terms upon which we agree to act for our direct clients and contains details of our regulatory and statutory responsibilities. It also sets out some of your responsibilities.
This document provides information about New York's no-fault automobile insurance law. It explains that New York has a no-fault system where insurance will pay up to $50,000 for medical expenses and lost wages from a car accident, regardless of fault. It also describes the types of injuries and expenses covered, as well as the process for filing claims and pursuing legal action for pain and suffering if injuries are deemed "serious."
This document provides an overview of pay, allowances, and personal administration policies for Army Reserve personnel. It defines key terms, outlines procedures for updating personal details and emergency contacts, and describes entitlements such as travel reimbursement and insurance. Personnel are responsible for ensuring their personal information is accurate and reporting any changes in a timely manner, as this impacts pay and eligibility for allowances. The document is intended to help reservists understand administrative policies but does not constitute authority to claim payments.
The alleged Medicaid fraud covered by the settlement lasted for more than four years, from July 16, 2001 through at least December 31, 2005. The complaint was brought in 2003 under the qui tam provisions of federal and state False Claims Acts, after whistleblower relator Bernard Lisitza uncovered the conduct and reported the problem to the government. The investigation and prosecution was led by the Attorneys General Offices in Florida, Illinois, Ohio, Texas and several other states, and by the United States Attorney’s Office in Chicago. Qui tam Relator Lisitza pursued the case with the assistance of his attorneys, Michael I. Behn and Linda Wyetzner, of Behn & Wyetzner, Chartered, in Chicago.
This resolution agreement between HHS and Affinity Health Plan resolves an investigation into a breach of protected health information. Affinity will pay $1,215,780 and comply with a corrective action plan. The plan requires Affinity to retrieve photocopier hard drives containing PHI, conduct a security risk analysis, and update policies. If Affinity breaches the agreement or plan, HHS may impose civil money penalties. Both parties aim to resolve the issues without further legal action.
Joshua and Laura Tynes Petition for DivorceCaitlinPyle
This document is Laura Caitlin Tynes' original petition for divorce from her husband Joshua Phillip Tynes. Laura requests a no-fault divorce on the grounds of insupportability. She asks for a division of community property, either through agreement or court determination. Laura also requests several temporary orders from the court, including exclusive use of the marital residence, and injunctions preventing Joshua from threatening, harming, or interfering with Laura or marital property pending the divorce. No children were born of the marriage.
Adult & Pediatric Dermatology, P.C., of Concord, Mass., has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules with the Department of Health and Human Services, agreeing to a $150,000 payment. The practice will also be required to implement a corrective action plan to correct deficiencies in its HIPAA compliance program. Adult and Pediatric Dermatology is a private practice that delivers dermatology services in four locations in Massachusetts and two in New Hampshire. This case marks the first settlement with a covered entity for not having policies and procedures in place to address the breach notification provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of American Recovery and Reinvestment Act of 2009 (ARRA).
The HHS Office for Civil Rights (OCR) opened an investigation of Adult and Pediatric Dermatology upon receiving a report that an unencrypted thumb drive containing the electronic protected health information (ePHI) of approximately 2,200 individuals was stolen from a vehicle of one its staff members. The thumb drive was never recovered. The investigation revealed that Adult and Pediatric Dermatology had not conducted an accurate and thorough analysis of the potential risks and vulnerabilities to the confidentiality of ePHI as part of its security management process. Further, Adult and Pediatric Dermatology did not fully comply with requirements of the Breach Notification Rule to have in place written policies and procedures and train workforce members.
In addition to a $150,000 resolution amount, the settlement includes a corrective action plan requiring Adult and Pediatric Dermatology to develop a risk analysis and risk management plan to address and mitigate any security risks and vulnerabilities, as well as to provide an implementation report to OCR.
Download the Corrective Action Plan(CAP) here >>
Tips s to providers: Almost all of the HIPAA/HITECH violations identified in the last few years is due to insufficient security risk analysis conducted by the providers or business associates.
The document outlines the terms of service for using the OPesa loan service. It states that by using the service, users agree to provide truthful personal information, keep their account secure, pay applicable fees on top of any loans received, repay loans by the due date or have their loan rolled over with additional fees, and that their information may be used for credit reporting purposes. It also states that the company can modify the terms at any time and is not liable for any damages incurred by the user.
(1) Cal.Educ.Code §56507 - Provides notice requirements for parties intending to use attorneys in special education due process hearings. Allows for attorney fee awards to prevailing parties.
(2) Cal.Fam.Code §3452 - Allows courts to award necessary expenses including attorney fees to prevailing parties in family law cases, unless inappropriate. Prohibits imposing costs on states without authorization.
(3) Cal.Food&Agric.Code §226 - Establishes annual funding for Bureau of Market Enforcement litigation expenses. Outlines cost sharing between funds if annual amount is exceeded. Awards costs and fees to prevailing civil parties involving the Bureau.
Introduction of LIC Accidental Death and disability benefit rider 2nd jan 2014LICJitpats
1) The document describes an Accidental Death and Disability Benefit Rider that provides additional insurance benefits in cases of accidental death or disability.
2) The rider can be opted for at any time before age 70 and pays out an additional sum equal to the rider sum assured if the insured dies or becomes totally and permanently disabled due to an accident within 180 days.
3) Several exclusions apply such as death/disability caused by suicide, war, criminal acts, accidents while engaging in dangerous activities, or occurring more than 180 days after the accident.
Now’s Your Chance To Win A Custom PC Built By Newegg TVInfiniteSweeps
Now’s Your Chance to Win a Custom PC Built by Newegg TV. Head to the NewEgg Blog website and follow the instructions to win. Grand prize is valued at over $2,400!
http://www.infinitesweeps.com/44869
Statewide Insurance Brokers Pty Ltd is a West Australian insurance brokerage established in 1970 that provides insurance advice, placement, and broking services. With over 250 years of combined expertise across insurance, finance, and administrative services, Statewide is committed to providing clients with high-quality financial services. Statewide is authorized to provide general insurance advice and products to both retail and wholesale clients under its Australian Financial Services License.
This document contains an identity theft affidavit and complaint form completed by Adalberto Cervantes Rodriguez. It includes his personal information, details about fraudulent accounts and inquiries he believes were opened using his identity, and sections to file a police report or have his affidavit witnessed. The form provides a way for identity theft victims to document the crime and disputes with creditors for the purpose of removing fraudulent information from their credit reports.
IIAC Young Agents - Protecting Your Insureds\' Private InformationJason Hoeppner
Personal information security and breach notification requirements are topics that all independent insurance agencies need to be aware of and be prepared for operationally in the event of a loss of clients\' information.
Trial Strategy: When Will a U.S. Court Assert Jurisdiction Over a Foreign In...NationalUnderwriter
The globalization of commerce is leading to more and more situations where a U.S. company is insured by an overseas insurance carrier. What does it take for a policyholder to be able to sue a foreign insurer in a U.S. court? A recent decision by a federal district court in Washington illustrates the analysis that courts undertake to determine whether a foreign carrier is subject to their jurisdiction.
Defendants Hyatt Corporation, AB/FH DFW Property, LLC, and The Services Companies filed an original answer in response to a lawsuit filed by Jacquelyn Medina. The defendants made a general denial of all claims and allegations in the plaintiff's petition. They asserted 13 defenses including sole proximate cause, failure to mitigate damages, contributory negligence, and rights under Texas civil practice law. The defendants joined the plaintiff's request for a jury trial and requested the plaintiff disclose information required under Texas rules of civil procedure.
This document outlines the key details of a Broadform Public and Products Liability Insurance Policy, including:
1) The policy provides coverage for legal liability under sections A (public liability) and B (products liability), as well as extensions for product recall expenses and errors/omissions.
2) The limits of liability and deductible amounts are specified. Defense costs and supplementary payments are additional to the limits.
3) The policy lists numerous exclusions to coverage, including for aircraft, defective work, products liability, property damage, vehicles, advertising injury, asbestos, and more.
4) Important definitions, conditions, and notices regarding the insured's duty of disclosure and privacy are also included.
The document is a legal opinion from the South Carolina Attorney General regarding whether the South Carolina Department of Social Services can enter into indemnification agreements as part of its contractual arrangements. The Attorney General concludes that DSS generally lacks authority to enter into indemnification agreements under state law because such agreements violate statutes requiring funding to be specifically appropriated and limiting the state's waiver of sovereign immunity. The Attorney General suggests alternative contract language or purchasing liability insurance instead of including indemnification clauses.
This document provides advice to protect one's identity and finances during and after a divorce. It recommends securing personal records and digital assets, monitoring credit, notifying credit bureaus of fraud alerts, protecting access to financial accounts/insurance policies, and using caution on social media regarding the divorce to avoid issues in court. Overall, the document stresses being prepared, securing important documents and accounts, and consulting legal advice when going through divorce proceedings.
This document summarizes the key details of a general liability and products insurance policy, including:
1) It is underwritten by certain underwriters at Lloyds and effected through Genesis Underwriting Pty Ltd.
2) It complies with the Insurance Code of Practice and outlines the complaint handling process, defining complaints and the steps to take to resolve disputes.
3) It provides information on privacy policies, duty of disclosure requirements, and how personal information is collected, used, and disclosed in accordance with privacy laws.
This document is a prenuptial agreement between two parties getting married. It outlines that each party's property and assets acquired before and during the marriage will remain separate. It details what constitutes separate vs. community property. It also establishes terms for contributing to shared living expenses during the marriage and divides responsibility for debts incurred before vs. during the marriage. The agreement states that in the event of a divorce, each party's proportionate interest in increases in home value will reflect their relative monetary and non-monetary contributions during the marriage.
This document outlines the pre-trial stipulation for a case between plaintiff Traian Bujduveanu and defendants Dismas Charities, Inc., Ana Gispert, Derek Thomas, and Adams Lashanda. It summarizes the facts of the case, including that the plaintiff was transferred to the Dismas facility to serve out his sentence before release, but was then returned to prison for violating rules. It lists the contested issues to be litigated including whether the defendants violated the plaintiff's constitutional rights and whether he sustained damages. It also lists the motions that have been filed, witnesses and exhibits to be presented at the estimated 4-5 day trial.
Oregon Health & Science University HIPAA Finesdata brackets
This resolution agreement is between the US Department of Health and Human Services (HHS) and Oregon Health & Science University (OHSU) to resolve HHS investigations of two data breaches at OHSU involving unsecured protected health information. OHSU agrees to pay HHS $2.7 million and comply with the terms of a corrective action plan, which requires OHSU to conduct a risk analysis, develop a risk management plan, implement encryption of mobile and network connected devices, and provide status updates to HHS. The agreement resolves alleged violations of HIPAA privacy and security rules related to the data breaches and ensures OHSU's ongoing compliance during a three year term.
Catholic Health Care Services Resolution Agreement and Corrective Action PlanAlex Slaney
Catholic Health Care Services of the Archdiocese of Philadelphia settlement, Resolution Agreement and Corrective Action Plan as a result of violating the HIPAA Security Rule for ePHI
The document outlines penalties for misusing consent forms and improperly disclosing or using private information collected by the U.S. Department of Housing and Urban Development (HUD) and property owners participating in HUD programs. It states that knowingly making false statements to the government or misusing social security numbers are felonies, and negligent disclosure of information can result in civil lawsuits. It also provides application instructions and requirements for prospective tenants, including submitting an application, background check fee, proof of identity documents, and policies regarding pets and smoking.
False claims policy fraud protocol state of georgiascreaminc
1) Acumen Fiscal Agent, LLC is committed to complying with federal and state false claims laws, which aim to prevent fraud and abuse in government healthcare programs.
2) These laws make it possible to recover damages and penalties from individuals who submit false claims to the government. They also allow whistleblowers to file lawsuits on behalf of the government.
3) Acumen's policy requires all employees and partners to be educated on these laws. It also mandates reporting potential fraud and prohibits retaliation against whistleblowers. Violators will face disciplinary action.
The document discusses insurance fraud, outlining what constitutes insurance fraud, penalties for committing insurance fraud, partners in fighting insurance fraud like the Division of Insurance Fraud and National Insurance Crime Bureau, and responsibilities of claims adjusters to be aware of fraud indicators and consult special investigation units if fraud is suspected. Insurance fraud is a serious crime that costs consumers an estimated $80 billion annually, so combating fraud protects consumers and helps control insurance costs.
How to screen your prospective tenants properly 2013cweinberg
The document provides guidance to landlords on screening rental applicants. It advises that the primary goal is to find stable tenants who are good credit risks and will not damage property. Landlords can consider an applicant's credit, employment, income, rental history and conduct risks. The document outlines steps landlords should take, including using a rental application to obtain information, verifying the information provided, and obtaining a credit report with the applicant's consent. Landlords must follow fair housing laws and the Fair Credit Reporting Act when screening applicants.
This document provides guidance on coordination of benefits and responding to claim denials related to other insurance being primary. It discusses determining primary vs secondary coverage between different types of insurance plans. It emphasizes the importance of accurately verifying a patient's insurance coverage at the time of registration to avoid denials and issues with coordination of benefits later. It also provides sample language to respond to payers demanding refunds due to other insurance not being billed first.
The document outlines the terms of service for using the OPesa loan service. It states that by using the service, users agree to provide truthful personal information, keep their account secure, pay applicable fees on top of any loans received, repay loans by the due date or have their loan rolled over with additional fees, and that their information may be used for credit reporting purposes. It also states that the company can modify the terms at any time and is not liable for any damages incurred by the user.
(1) Cal.Educ.Code §56507 - Provides notice requirements for parties intending to use attorneys in special education due process hearings. Allows for attorney fee awards to prevailing parties.
(2) Cal.Fam.Code §3452 - Allows courts to award necessary expenses including attorney fees to prevailing parties in family law cases, unless inappropriate. Prohibits imposing costs on states without authorization.
(3) Cal.Food&Agric.Code §226 - Establishes annual funding for Bureau of Market Enforcement litigation expenses. Outlines cost sharing between funds if annual amount is exceeded. Awards costs and fees to prevailing civil parties involving the Bureau.
Introduction of LIC Accidental Death and disability benefit rider 2nd jan 2014LICJitpats
1) The document describes an Accidental Death and Disability Benefit Rider that provides additional insurance benefits in cases of accidental death or disability.
2) The rider can be opted for at any time before age 70 and pays out an additional sum equal to the rider sum assured if the insured dies or becomes totally and permanently disabled due to an accident within 180 days.
3) Several exclusions apply such as death/disability caused by suicide, war, criminal acts, accidents while engaging in dangerous activities, or occurring more than 180 days after the accident.
Now’s Your Chance To Win A Custom PC Built By Newegg TVInfiniteSweeps
Now’s Your Chance to Win a Custom PC Built by Newegg TV. Head to the NewEgg Blog website and follow the instructions to win. Grand prize is valued at over $2,400!
http://www.infinitesweeps.com/44869
Statewide Insurance Brokers Pty Ltd is a West Australian insurance brokerage established in 1970 that provides insurance advice, placement, and broking services. With over 250 years of combined expertise across insurance, finance, and administrative services, Statewide is committed to providing clients with high-quality financial services. Statewide is authorized to provide general insurance advice and products to both retail and wholesale clients under its Australian Financial Services License.
This document contains an identity theft affidavit and complaint form completed by Adalberto Cervantes Rodriguez. It includes his personal information, details about fraudulent accounts and inquiries he believes were opened using his identity, and sections to file a police report or have his affidavit witnessed. The form provides a way for identity theft victims to document the crime and disputes with creditors for the purpose of removing fraudulent information from their credit reports.
IIAC Young Agents - Protecting Your Insureds\' Private InformationJason Hoeppner
Personal information security and breach notification requirements are topics that all independent insurance agencies need to be aware of and be prepared for operationally in the event of a loss of clients\' information.
Trial Strategy: When Will a U.S. Court Assert Jurisdiction Over a Foreign In...NationalUnderwriter
The globalization of commerce is leading to more and more situations where a U.S. company is insured by an overseas insurance carrier. What does it take for a policyholder to be able to sue a foreign insurer in a U.S. court? A recent decision by a federal district court in Washington illustrates the analysis that courts undertake to determine whether a foreign carrier is subject to their jurisdiction.
Defendants Hyatt Corporation, AB/FH DFW Property, LLC, and The Services Companies filed an original answer in response to a lawsuit filed by Jacquelyn Medina. The defendants made a general denial of all claims and allegations in the plaintiff's petition. They asserted 13 defenses including sole proximate cause, failure to mitigate damages, contributory negligence, and rights under Texas civil practice law. The defendants joined the plaintiff's request for a jury trial and requested the plaintiff disclose information required under Texas rules of civil procedure.
This document outlines the key details of a Broadform Public and Products Liability Insurance Policy, including:
1) The policy provides coverage for legal liability under sections A (public liability) and B (products liability), as well as extensions for product recall expenses and errors/omissions.
2) The limits of liability and deductible amounts are specified. Defense costs and supplementary payments are additional to the limits.
3) The policy lists numerous exclusions to coverage, including for aircraft, defective work, products liability, property damage, vehicles, advertising injury, asbestos, and more.
4) Important definitions, conditions, and notices regarding the insured's duty of disclosure and privacy are also included.
The document is a legal opinion from the South Carolina Attorney General regarding whether the South Carolina Department of Social Services can enter into indemnification agreements as part of its contractual arrangements. The Attorney General concludes that DSS generally lacks authority to enter into indemnification agreements under state law because such agreements violate statutes requiring funding to be specifically appropriated and limiting the state's waiver of sovereign immunity. The Attorney General suggests alternative contract language or purchasing liability insurance instead of including indemnification clauses.
This document provides advice to protect one's identity and finances during and after a divorce. It recommends securing personal records and digital assets, monitoring credit, notifying credit bureaus of fraud alerts, protecting access to financial accounts/insurance policies, and using caution on social media regarding the divorce to avoid issues in court. Overall, the document stresses being prepared, securing important documents and accounts, and consulting legal advice when going through divorce proceedings.
This document summarizes the key details of a general liability and products insurance policy, including:
1) It is underwritten by certain underwriters at Lloyds and effected through Genesis Underwriting Pty Ltd.
2) It complies with the Insurance Code of Practice and outlines the complaint handling process, defining complaints and the steps to take to resolve disputes.
3) It provides information on privacy policies, duty of disclosure requirements, and how personal information is collected, used, and disclosed in accordance with privacy laws.
This document is a prenuptial agreement between two parties getting married. It outlines that each party's property and assets acquired before and during the marriage will remain separate. It details what constitutes separate vs. community property. It also establishes terms for contributing to shared living expenses during the marriage and divides responsibility for debts incurred before vs. during the marriage. The agreement states that in the event of a divorce, each party's proportionate interest in increases in home value will reflect their relative monetary and non-monetary contributions during the marriage.
This document outlines the pre-trial stipulation for a case between plaintiff Traian Bujduveanu and defendants Dismas Charities, Inc., Ana Gispert, Derek Thomas, and Adams Lashanda. It summarizes the facts of the case, including that the plaintiff was transferred to the Dismas facility to serve out his sentence before release, but was then returned to prison for violating rules. It lists the contested issues to be litigated including whether the defendants violated the plaintiff's constitutional rights and whether he sustained damages. It also lists the motions that have been filed, witnesses and exhibits to be presented at the estimated 4-5 day trial.
Oregon Health & Science University HIPAA Finesdata brackets
This resolution agreement is between the US Department of Health and Human Services (HHS) and Oregon Health & Science University (OHSU) to resolve HHS investigations of two data breaches at OHSU involving unsecured protected health information. OHSU agrees to pay HHS $2.7 million and comply with the terms of a corrective action plan, which requires OHSU to conduct a risk analysis, develop a risk management plan, implement encryption of mobile and network connected devices, and provide status updates to HHS. The agreement resolves alleged violations of HIPAA privacy and security rules related to the data breaches and ensures OHSU's ongoing compliance during a three year term.
Catholic Health Care Services Resolution Agreement and Corrective Action PlanAlex Slaney
Catholic Health Care Services of the Archdiocese of Philadelphia settlement, Resolution Agreement and Corrective Action Plan as a result of violating the HIPAA Security Rule for ePHI
The document outlines penalties for misusing consent forms and improperly disclosing or using private information collected by the U.S. Department of Housing and Urban Development (HUD) and property owners participating in HUD programs. It states that knowingly making false statements to the government or misusing social security numbers are felonies, and negligent disclosure of information can result in civil lawsuits. It also provides application instructions and requirements for prospective tenants, including submitting an application, background check fee, proof of identity documents, and policies regarding pets and smoking.
False claims policy fraud protocol state of georgiascreaminc
1) Acumen Fiscal Agent, LLC is committed to complying with federal and state false claims laws, which aim to prevent fraud and abuse in government healthcare programs.
2) These laws make it possible to recover damages and penalties from individuals who submit false claims to the government. They also allow whistleblowers to file lawsuits on behalf of the government.
3) Acumen's policy requires all employees and partners to be educated on these laws. It also mandates reporting potential fraud and prohibits retaliation against whistleblowers. Violators will face disciplinary action.
The document discusses insurance fraud, outlining what constitutes insurance fraud, penalties for committing insurance fraud, partners in fighting insurance fraud like the Division of Insurance Fraud and National Insurance Crime Bureau, and responsibilities of claims adjusters to be aware of fraud indicators and consult special investigation units if fraud is suspected. Insurance fraud is a serious crime that costs consumers an estimated $80 billion annually, so combating fraud protects consumers and helps control insurance costs.
How to screen your prospective tenants properly 2013cweinberg
The document provides guidance to landlords on screening rental applicants. It advises that the primary goal is to find stable tenants who are good credit risks and will not damage property. Landlords can consider an applicant's credit, employment, income, rental history and conduct risks. The document outlines steps landlords should take, including using a rental application to obtain information, verifying the information provided, and obtaining a credit report with the applicant's consent. Landlords must follow fair housing laws and the Fair Credit Reporting Act when screening applicants.
This document provides guidance on coordination of benefits and responding to claim denials related to other insurance being primary. It discusses determining primary vs secondary coverage between different types of insurance plans. It emphasizes the importance of accurately verifying a patient's insurance coverage at the time of registration to avoid denials and issues with coordination of benefits later. It also provides sample language to respond to payers demanding refunds due to other insurance not being billed first.
A slide show that I compiled for my post master's certificate program, through Northcentral University, in Business Administration, with a specialization on Advanced Accounting. This is assignment 5 Consumer Fraud Prevention.
This document provides guidance on defining, preventing, and reporting fraud involving federal education grant funds. It defines fraud and the two types - civil and criminal. It discusses who commits education fraud, examples of fraud, applicable laws like the False Claims Act, and vulnerabilities in grant administration that could enable fraud. Unallowable costs under federal cost principles are also outlined. The document aims to help grant recipients and administrators identify and report potential fraud.
The document summarizes your rights under the Fair Credit Reporting Act (FCRA). It outlines that you have the right to know what information is in your consumer file, to dispute inaccurate or incomplete information, and to seek damages from violators of FCRA. It also describes that you must be informed if adverse action is taken based on a credit report, and that you can limit prescreened credit offers. Consumer reporting agencies must investigate disputes and correct mistakes.
This document provides an overview of Medicare fraud, waste and abuse (FWA) training requirements. It defines FWA, outlines laws related to FWA, describes best practices for prevention, and notes individual responsibilities. Key points include annual FWA training is required for Medicare Part C organizations, defining fraud, waste and abuse, explaining false claims and anti-kickback statutes, and emphasizing individual responsibility to report suspected FWA.
The IRS annual “Dirty Dozen” list of tax scams 2013, the list includes the most common scams that taxpayers might encounter at anytime during the tax season. The list is advising taxpayers to be aware of identity theft, phishing scams and several other red flags that can cause financial mayhem.
This document discusses fraud and abuse in managed care from the perspective of a managed care organization. It defines fraud and abuse, provides examples of each, and outlines the roles and responsibilities of managed care organizations and providers in preventing, identifying, investigating and reporting potential fraud and abuse. Key responsibilities include managed care organizations developing compliance programs, investigating claims, recovering overpayments, and reporting issues to the proper authorities, while providers must properly document services, self-audit, and cooperate with investigations.
Identity theft involves criminals stealing personal information like Social Security numbers and using it to open accounts or apply for loans. Around 10 million Americans are victims of identity theft each year. People can reduce their risk by checking credit reports annually, guarding their Social Security number, and ignoring suspicious emails. If someone becomes a victim, they should contact credit reporting agencies, close fraudulent accounts, file a police report, and potentially file an identity theft insurance claim for assistance recovering. ERIE insurance offers an identity theft endorsement for $20 per year that provides up to $25,000 to help restore someone's identity if stolen.
Your Social Insurance Number (SIN) should be kept confidential to prevent identity theft and fraud. Providing your SIN when it is not legally required can put you at risk. If you suspect someone is using your SIN fraudulently, you should immediately file a police report, contact credit bureaus, review financial statements for suspicious activity, and visit a Service Canada center to report the issue and potentially receive a new SIN. Protecting your SIN is important to safeguard your identity and finances.
Company names mentioned herein are the property of, and may be trademarks of, their respective owners and are for educational purposes only.
17 U.S. Code § 107 - Limitations on exclusive rights: Fair use
Notwithstanding the provisions of sections 106 and 106A, the fair use of a copyrighted work, including such use by reproduction in copies or phonorecords or by any other means specified by that section, for purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, is not an infringement of copyright.
Labor and Employment Roundtable Privacy Rights and Other Onboarding IssuesPolsinelli PC
Hire The Best Without Making A Mess! Application forms, background checks, the interview process, immigration status, and even actions during the onboarding process are fraught with legal landmines these days. There are more privacy protections, employment laws, immigration requirements and lawsuits (including class action lawsuits) filed today than ever before based on the hiring and onboarding process. It is critical that all employers know which policies, procedures, and questions are required and safe when hiring and onboarding employees, and which are not.
This roundtable discussion is intended to be an interactive discussion focused on various "do" and "don't" tips related to privacy rights during the hiring process, criminal convictions, immigration, medical examinations, drug tests and background checks.
OUR PANEL:
• Jeffrey S. Bell, Shareholder
• Denise K. Drake, Shareholder
• Erin D. Schilling, Shareholder
• Emma R. Schuering, Associate
All product and company names mentioned herein are for identification and educational purposes only and are the property of, and may be trademarks of, their respective owners.
This document provides information about potential pathways to legal status in the United States. It discusses family petitions, Violence Against Women Act petitions, and U Visas for victims of crimes. Requirements are outlined for each potential pathway, including the need to demonstrate a qualifying family relationship, evidence of abuse, cooperation with law enforcement, and other eligibility criteria. Benefits of these options like the ability to apply for work authorization and a path to citizenship are also summarized.
Do I Have a Path to Legal Status in the United States?
Dental claim form
1. Dental Benefits – Claim Instructions
5B
Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any materially false
information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil
penalties.
Attention Arkansas, District of Columbia, Louisiana, Rhode Island and West Virginia Residents: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or
knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Attention California Residents: For your protection
California law requires notice of the following to appear on this form: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject
to fines and confinement in state prison. Attention Colorado Residents: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose
of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who
knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a
settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurance within the department of regulatory agencies. Attention Florida Residents: Any person
who knowingly and with intent to injure, defraud, or deceive any insurer, files a statement of claim or an application containing any false, incomplete or misleading information is guilty of a felony of the
third degree. Attention Kansas Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person submits an enrollment form for insurance or
statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto may have violated state law. Attention
Kentucky Residents: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially
false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and may subject such person to criminal
and civil penalties. Attention Maine and Tennessee Residents: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding
the company. Penalties may include imprisonment, fines, or denial of insurance benefits. Attention Maryland Residents: Any person who knowingly and willfully presents a false or fraudulent claim for
payment of a loss or benefit or who knowingly and willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. Attention
New Jersey Residents: Any person who includes any false or misleading information on an application for an insurance policy or knowingly files a statement of claim containing any false or misleading
information is subject to criminal and civil penalties. Attention New York Residents: Any person who knowingly and with intent to defraud any insurance company or other person files an application for
insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act,
which is a crime, and shall be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each violation. Attention North Carolina Residents: Any person who
knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any materially false information or
conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which may be a crime and subjects such person to criminal and civil
penalties. Attention Ohio Residents: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing
any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto is guilty of insurance fraud. Attention Oklahoma Residents: WARNING:
Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is
guilty of a felony. Attention Oregon Residents: Any person who with intent to injure, defraud, or deceive any insurance company or other person submits an enrollment form for insurance or statement
of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto may have violated state law. Attention Pennsylvania
Residents: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false
information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil
penalties. Attention Puerto Rico Residents: Any person who knowingly and with the intention to defraud includes false information in an application for insurance or file, assist or abet in the filing of a
fraudulent claim to obtain payment of a loss or other benefit, or files more than one claim for the same loss or damage, commits a felony and if found guilty shall be punished for each violation with a fine
of no less than five thousand dollars ($5,000), not to exceed ten thousand dollars ($10,000); or imprisoned for a fixed term of three (3) years, or both. If aggravating circumstances exist, the fixed jail term
may be increased to a maximum of five (5) years; and if mitigating circumstances are present, the jail term may be reduced to a minimum of two (2) years. Attention Texas Residents: Any person who
knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any intentional misrepresentation of
material fact or conceals, for the purpose of misleading, information concerning any fact material thereto may commit a fraudulent insurance act, which may be a crime and may subject such person to
criminal and civil penalties. Attention Vermont Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for
insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act,
which may be a crime and may subject such person to criminal and civil penalties. Attention Virginia Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurance
company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact
material thereto commits a fraudulent act, which is a crime and subjects such person to criminal and civil penalties. Attention Washington Residents: It is a crime to knowingly provide false,
incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines, and denial of insurance benefits.
NOTE: INCOMPLETE CLAIM FORMS WILL BE RETURNED TO YOU FOR MISSING INFORMATION. THIS WILL DELAY THE PROCESSING OF THE CLAIM. FOR
FASTER, EASIER SUBMISSION OF CLAIMS, THE PROVIDER MAY CONTACT THE AETNA CLAIM PROCESSING CENTER FOR INFORMATION
REGARDING ELECTRONIC CLAIM SUBMISSIONS.
TO THE EMPLOYEE – USE BLACK INK ONLY
3B
1. Complete blocks 1–22 in full.
2. Complete blocks 23–27 only if other dental coverage exists.
3. Be certain to sign the authorization to release information in block 28.
4. If you wish to have your benefits for this claim paid directly to your dentist, sign block 29.
If total charges for the planned course of treatment are expected to exceed the minimum Predetermination dollar amount stated in your dental plan booklet, it is suggested
you file for Predetermination of Benefits. Aetna Dental will notify your dentist of the benefits payable.
NOTE: YOUR DENTAL COVERAGE IS SUBJECT TO SPECIFIC LIMITATIONS AND EXCLUSIONS. PLEASE REFER TO YOUR DENTAL BOOKLET FOR
DESCRIPTION OF COVERED EXPENSES, DEDUCTIBLE AND COPAYMENT INFORMATION, AND LIMITATIONS AND EXCLUSIONS.
TO THE DENTIST – USE BLACK INK ONLY
0B
1. COMPLETED SERVICES ⎯ Check the box noted "STATEMENT OF SERVICES RENDERED" and complete blocks 30-48. When entering the treatment plan on the form,
please indicate a separate fee for each individual service rendered.
2. PREDETERMINATION OF BENEFITS ⎯ If total charges for this claim are to exceed the minimum Predetermination dollar amount indicated in the employee's Dental Plan
Booklet (and treatment is not emergency in nature), Predetermination of Benefits is suggested. Check the box marked "PRE-TREATMENT ESTIMATE", and complete
blocks 30-48.
NOTE: PREDETERMINATION OF BENEFITS IS ONLY INTENDED TO AVOID MISUNDERSTANDINGS BETWEEN THE EMPLOYEE, DENTIST AND INSURANCE
COMPANY CONCERNING BENEFITS PAYABLE. YOU AND YOUR PATIENT ARE, OF COURSE, FREE TO PURSUE ANY TREATMENT PLAN YOU THINK BEST.
3. If the employee indicates that benefits should be paid directly to the dentist, these benefits will be sent directly to you with a copy of the transaction to the employee.
X-rays taken for metal restorations and crowns should be submitted with treatment plan. They may also be requested for other services. X-rays will be reviewed by
practicing Dentists and returned promptly.
TO THE EMPLOYEE & DENTIST
Send the completed benefits request and the bills to: Aetna Dental
PO Box 14094
Lexington, KY 40512-4094
GC-8-13 (3-10) H R-POD
2. Dental Benefits Request
4B
Mail to: Aetna Dental
PO Box 14094
Lexington, KY 40512-4094
TO BE COMPLETED BY EMPLOYEE – USE BLACK INK ONLY
1B
1. Employer's Name 2. Policy/Group Number
3. Employee's Aetna ID Number 4. Employee's Name 5. Employee's Birthdate (MM/DD/YYYY)
6. Active Retired 7. Employee's Address (include ZIP Code) Address is new 8. Employee's Daytime Telephone
Date of Retirement Number
( )
9. Patient's Name 10. Patient's Aetna ID Number 11. Patient's Birthdate (MM/DD/YYYY) 12. Patient's Relationship to Employee
Self Spouse Child Other
13. Patient's Address (if different from employee) 14. Patient's Gender 15. Full Time Student 16. Patient's Expected Graduation Date 17. Name of School and City
Male Female No Yes
18. Patient's Marital Status 19. Is patient employed? 20. Name and Address of Employer
Married Single No Yes
21. Is claim related to an accident? 22. Is claim related to employment?
No Yes If Yes, date U time
U U am U pm No Yes
23. Are any family members’ expenses covered by another group health plan, group pre-payment plan 24. If Yes, list policy or contract holder, policy or contract number(s) and name/address
(Blue Cross- Blue Shield, etc.), no fault auto insurance, Medicare or any federal, state or local of insurance company or administrator:
government plan? No Yes
25. Member’s ID Number 26. Member’s Name 27. Member’s Birthdate (MM/DD/YYYY)
28. To all providers of dental care:
You are authorized to provide Aetna Life Insurance Company or one of its affiliated companies (“Aetna”), and any independent claim administrators and consulting dental professionals
and utilization review organizations with whom Aetna has contracted, information concerning dental care, advice, treatment or supplies provided the patient. This information will be used
to evaluate claims for dental benefits. Aetna may provide the employer named above with any benefit calculation used in payment of this claim for the purpose of reviewing the
experience and operation of the policy or contract. This authorization is valid for the term of the policy or contract under which a claim has been submitted. I know that I have a right to
receive a copy of this authorization upon request and agree that a photographic copy of this authorization is as valid as the original.
Patient's or Authorized Person's Signature Date U
29. I authorize payment of dental benefits to the dentist or supplier of service.
Patient's or Authorized Person's Signature Date U
TO BE COMPLETED BY DENTIST – USE BLACK INK ONLY
2B
30. This is a request for:
Pre-Treatment Estimate Predetermination/Preauthorization Number Statement of Services Rendered
31. Dentist's Name & Address (include ZIP Code) 32. National Provider Identifier 33. Dentist License No. 34. Telephone Number
( )
35. Enter the taxpayer identifying number to be used for 1099 reporting purposes. You are required under authority of
law to furnish your taxpayer identifying number.
36. First Visit Date Current Series 37. Place of Treatment 38. Radiographs or models enclosed?
Office Hosp. No Yes
ECF Other How many?
Is treatment result of: No Yes If Yes, enter brief description and dates.
39. occupational illness or injury?
40. auto accident?
41. other accident?
42. Are any services covered by another plan?
43. If prosthesis, is this initial placement? If No, date of prior placement and reason for replacement.
44. Is treatment for orthodontics? Date appliance placed: Initial Appliance Fee:
No. of months of treatment: Monthly Fee:
Mos. of treatment remaining: Total Case Fee:
45. To expedite claim handling, identify 46. Examination and treatment plan. List in order from tooth no. 1 through tooth no. 32. Use charting system shown.
all missing teeth with "X" If Previously Date Service
Tooth # Extracted, Description of Service (x-rays, prophylaxis, Performed Procedure
or Letter Give Date Surface materials used, etc.) MM DD YYYY Number Fee
47. I hereby certify that the procedures as indicated by date have been completed and that the fees submitted are the actual fees I 48. National Provider Identification Total charge $
have charged this patient and intend to accept for those procedures. Amount paid $
Dentist's Signature Date
Balance due $
GC-8-13 (3-10) H