Top Healthcare Compliance Issues for 2013

Summary:  Linkedin poll results – what do you see as the top healthcare compliance issues for 2013? The answers may surprise you.

Have you ever participated in the “answers” portion of Linkedin? It is a wonderful, interactive forum in which you can pose questions, categorize your question, and receive fantastic answers very quickly. For example, we posed a question in regard to web conferencing hosting options. We wanted to determine if there was one option that stood out from the crowd, one that was working very well. We received a variety of different answers which provided a great starting point for our research. The polls also allow you to deem which answer you feel is the “best” answer and the ability to let that person know that you thought their answer was best. The answers are a great place to network and find new connections. Start a question of your own and join in the discussions already in progress.

One of our latest questions was “What do you see as the top healthcare compliance issues looming for 2013? We received a broad range of answers which provided terrific insight as to what the burning issues are in terms of healthcare.

1. Changes in laws and regulations – This response refers to putting the cart before the horse. Laws are put into place before all of the steps are carefully planned. The examples cited refer to different laws which require specific reporting mechanisms. The laws were put into place before all of the reporting details were worked out, leaving individuals confused as to how to comply. Some of the examples given were:

• Patient Safety, Patient Handling requires a change in the reporting process but no formal system has been established.
• QI survey data for these laws requires periodic participation, online system not in place.
• Whistleblower in place for years, OSHA Alternative Dispute Resolution Pilot, not fully operational.
• Disclosure of governance responsibility for nursing homes, reporting not in place

1. Inconsistency from state to state – Organizations whose boundaries span several states find it difficult to comply with each state’s regulations and can cause issues with cost effectiveness.
2. Privacy Protection of Health Information – 2013 will have a focus on privacy protection especially when dealing with tele-medicine and/or mobile health. HIPAA compliance will be on the forefront of the radar, including HIPAA 5010 as we transition to ICD-10.
3. Transparency so people can go and see the “audit trail” in individual cases and user-friendliness so that the end-users aren’t discourage from seeking the care and coverage they need.
4. Healthcare IT is going to be of great importance, compliance will be key.
5. Lack of compliance due to the allocation of scarce resources. With the scarce resources, people have to do more with less and spend less time to complete the same tasks. This hurried mentality may cause things to slip through the cracks in terms of compliance.
6. Surviving in an increasingly divisive and frequently combative regulatory environment, especially the 26 plans with low star ratings for an extended period of time.  Plans will need to invest in mock audits in advance of CMS arrival and will need to continue with internal audits in order to meet federal expectations. Budgets for this as well as continuous training programs will impact the bottom lines.
7. Privacy and breach investigations will require greater adherence and reporting.
8. Insurance and the accessibility thereof.
9. Understanding the ins and outs of Healthcare Reform.

Healthcare is certainly an important topic for 2013 and going forward into 2013. We just survived the fiscal cliff which was an indication that there are so many laws out there and there doesn’t seem to be a gatekeeper monitoring effective and expiration dates. 2014 is the big year in terms of Healthcare Reform. I wouldn’t be surprised if we are facing yet another fiscal cliff at the end of 2013. Compliance with these regulations is costly especially in terms of Healthcare IT. The other side of the coin is non-compliance is even more costly. Can you afford to be non-compliant?

As part of the healthcare IT initiatives, electronic medical records will continue to become essential. As a token of our appreciation, we invite you to download our free presentation on electronic medical records. Please click HERE.