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According to some research, 70% of healthcare companies are not currently HIPAA compliant. This could be detrimental to your business, so if you’re not focusing on healthcare compliance, now is the perfect time to start.
But why is compliance in healthcare so important?
It can ensure that your patients are safe and that you’re legally running a business. Keep reading to learn about why it’s important and what compliance solutions for healthcare are out there.
What Is Healthcare Compliance?
Healthcare compliance means that you’re following professional, legal, and ethical standards in healthcare. You’ll need to follow the rules, and there are many of them to follow.
These rules are very difficult and often complex, and they can change constantly. You’ll likely need to make changes to your business, constantly learn, run audits, and do IT compliance updates.
Healthcare compliance is important for any type of healthcare organization, whether it’s small or large. It’s part of an approach to managing risk in healthcare to provide a high-performing and reliable environment.
There are many different rules and regulations that you’ll need to follow. But the Social Security Act controls the requirements and funding for Medicare and Medicaid.
The Health Insurance Portability and Accountability Act (HIPAA) is the most prevalent law. It started in 1996. This law protects patient privacy and focuses on making sure that organizations keep medical records safe and secure.
The Health Information Technology for Economic and Clinical Health (HITECH) expanded HIPAA in 2009. It provides certain standards for IT compliance to make sure that all of the electronic health records are secure.
Who Is Responsible for It?
Every healthcare organization is in charge of ensuring that its own business is compliant. However, there are many governing bodies that will make sure that they ensure that each organization is compliant.
You may even want to develop an internal administration to implement different compliance programs. They’ll also control a compliance budget to make sure that they stay compliant.
This internal organization can also make sure that they train each individual employee on the latest standards in compliance. While having policies and programs in place are important, it also comes down to each employee.
If one individual fails at healthcare compliance, then the entire organization can fail. Even sanctions against one individual can affect even the smallest healthcare organization.
Who Regulates It?
The regulatory body will depend on what type of healthcare business you’re running. If you’re a pharmacy or drug manufacturer, then the Drug Enforcement Administration or the Food and Drug Administration will monitor you.
If you’re running a healthcare organization, you’ll likely be audited by the Office of the Inspector General and the Department of Health and Human Services. They will ensure that you’re not committing fraud, and they will audit your organization.
The Joint Commission also can offer certifications and accreditations for certain hospitals and organizations that meet their compliance standards. The National Association of Healthcare Quality is also similar to this organization, but they focus on health plans and credential verification.
You may also encounter the Agency for Healthcare Research and Quality. They focus on auditing organizations to ensure that they provide high-quality and safe care to patients.
Why Is It Important?
Healthcare compliance is so important because if there isn’t compliance, then you could have your business shut down. However, it can also affect patient safety.
Depending on your healthcare organization, having bad compliance could mean the difference between life or death. Even if you make a small mistake, this can result in a bad patient outcome. You could ruin the care coordination or the safety of the patient.
When you have compliance throughout your organization, you’re more likely to offer high-quality patient care.
You’ll also make sure that you’re complying with federal and state law. You’ll also be able to work with all private healthcare insurance. For example, the Affordable Care Act says that medical practices need to show that they are compliant in order for them to enroll in the Medicare program.
Now, many commercial carriers are now going to require the same compliance.
How to Implement a Compliance Program?
To start out with, ensure that you have all of your licenses, like for MedPro Systems®.
Implement any written policies, standards of conduct, and procedures. To help you, you’ll also want to set up an officer or a committee for compliance. This committee can focus on compliance in your company.
You’ll also want to make sure that everyone in the company has training. Since each individual is in charge of being compliant, everyone needs to know about the best practices.
Having open lines of communication is also crucial. This will encourage anyone to ask questions if they’re not sure of something. You’ll also be able to communicate these changes easily.
Conduct regular audits and monitor areas for compliance. It’s far better to audit your own company and catch any mistakes rather than having the government find them.
If you do catch any mistakes, make sure that you report them and fix them as soon as possible so that you remain compliant.
Discover More About Healthcare Compliance
These are only a few things to remember about healthcare compliance, but there are many other factors to consider.
We know that healthcare compliance can be challenging even for a small business, but we’re here to help you out.
If you’re interested in more healthcare content, explore our website to find even more great content just like this!