In thinking through the top health care compliance issues for 2020, we thought through our recent experiences and what government agencies have been discussing: Show
Telemedicine entities engaging in and/or embarking on multi-state delivery models must be cognizant of, and compliant with, applicable state foreign entity qualification requirements and corporate practice prohibitions, and must ensure that their clinical services providers are duly licensed (or registered) and compliant with clinical practice requirements in the states in which they seek to treat patients.
In the coming year, we expect to see an increased number of cases focused on Medicare Advantage (MA) and skilled nursing facilities (SNFs). The focus of the MA cases will arise out of plans’ failure to inform the government of mistaken diagnoses that are not current because MA plans are paid based on those diagnosis codes. Further, we have been told that those Medicare Advantage cases could pull in healthcare providers and suppliers, so although diagnosis codes have been reviewed in compliance audits in the past, the scrutiny on the accuracy of those diagnosis codes, the electronic health records’ issues with pulling past diagnosis codes forward and the correction of such diagnosis codes must be a focus. We also understand that the DOJ is focusing on SNFs because of continuing issues related to substandard care, neglect and improper prescribing of drugs to patients, so the DOJ’s Elder Justice Initiative is likely to involve a more thorough investigation into these kinds of cases in the near future. These ten issues reflect the current focus on compliance within the industry, as well as what we expect going forward in 2020. If you would like to discuss any of these issues in more detail, please reach out. Which regulatory standards affect most health care organizations?The Joint Commission on Accreditation of Health Care Organizations (JCAHO) works to ensure that health Care organizations provide quality care. JCAHO employs a system in which health care organizations are examined and then given a score of 1-100, with higher scores being better.
What are examples of regulatory issues?Here are the top 10 regulatory issues identified by Paychex for 2022:. No. 1 —Workplace Safety. ... . No. 2 — Cybersecurity. ... . No. 3 — Paid Leave. ... . No. 4 — Retirement. ... . No. 5 — Tax Changes. ... . No. 6 — Healthcare Reform. ... . No. 7 — Pay Equity. ... . No. 8 — Worker Classification.. What are the problems within the healthcare industry?Major Challenges Facing the Healthcare Industry Today. Cybersecurity Threats.. Telehealth Implementation.. Invoicing and Payments.. Price Transparency Mandate.. IT Healthcare Investments.. Patient Experience.. Effective Payment Models.. Healthcare Staffing Shortages.. What are regulatory compliance issues?Regulatory compliance is an organization's adherence to laws, regulations, guidelines and specifications relevant to its business processes. Violations of regulatory compliance often result in legal punishment, including federal fines.
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