Be Aware of the Top Challenges of Healthcare Compliance

Valuation Considerations in the Era of the New Stark Law and AKS Final Rules
New Stark Law and AKS Final Rules -Valuation Considerations

Top Challenges Healthcare Compliance

One of the most crucial, yet complex, aspects of the healthcare sector is ensuring compliance. Every organization and individual offering healthcare or healthcare-related services needs to be aware of the regulations and laws and follow compliant practices. This is the only way to stay protected and achieve long-term success in the sector.

The government usually relies on a regulatory framework that serves as a model used to enact regulations developed with an end goal in mind, according to an article by Forbes. The COVID-19 crisis has created multiple challenges for hospitals and caregivers. This has made it difficult to ensure that your institution is updated on the latest regulations in an ever-shifting compliance landscape.

So, the healthcare compliance department of your organization needs to be prepared and well-resourced to tackle all issues. This will help reduce adverse impacts and maximize response. Here are a few challenges to look out for.

Changing Laws

Medical practices and health policies tend to change often. This is done to promote greater efficiency and accessibility. So, the legal team must be ready to update the existing rules to align with new needs. Consider working with compliance management software that can make this process easier.

Pick a cloud-based solution that includes risk assessment, document library, weekly e-mail reminders, real-time updates of incident reporting and data storage, according to experts at First Healthcare Compliance. These solutions are all you need to stay on track while ensuring your training needs are met.

Billing and Coding Updates

Every organization needs to ensure correct coding and billing practices to optimize appropriate reimbursement and adhere to payer and CMS guidelines. Whether the providers are responsible for coding or the organization employs coding professionals there are steps every organization should take to ensure correct processes. 2021 is a year of changes and it’s important to keep an eye on  the key areas of concern and provide realistic solutions to efficiently and effective validate current processes and identify areas of potential concern.

Data Breaches

Data breaches cost healthcare providers an average of $6.45 million a year. In fact, studies have found that 41% of Americans had their protected information exposed in the 3 years leading up to 2021. This mainly happens due to errors by employees, negligence and acts of malicious insiders, according to an article in the HIPAA Journal. But organizations are now getting better at detecting such breaches. This is much needed, since violation can have huge consequences.

The best compliance program can help healthcare executives manage regulatory changes. Physicians in private practice, hospital networks and health systems, billing companies and long-term care facilities can make the best use of the software to remain compliant. This can help everyone save a significant amount of time, money, and resources.

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