Compliance

Every healthcare professional knows about the consequences of compliance issues in healthcare. The role of healthcare compliance officers is to ensure internal policies and external laws and regulations are met by all personnel. These leaders create programs for training employees, reinforce a culture of compliance and stay alert to new trends and regulations.

Explore three key issues healthcare compliance officers should be monitoring in the coming calendar year.

With the growing prevalence of telemedicine comes a growing risk of fraud.

Over the past few years, 27 states have participated in the National Background Check Program to develop screening programs for long-term-care facilities. The Office of Inspector General (OIG) recently completed its fifth in a series of six reports on the program. This report focused on Idaho and Mississippi, the two states continuing the program. Twenty-seven states have completed their participation in the program.

Different types of bias, whether intentional or unintentional, have been a concern among HR departments for decades. In fact, psychologists have defined more than 180 human biases.

Artificial intelligence (AI) and machine learning (ML) programs have been promoted as a more objective, less biased way to screen, hire, and train job candidates. Unfortunately, humans may program biased information into algorithms, skewing results. AI programs also may exhibit bias when they lack sufficient, representative data.

More than 500 healthcare cybersecurity breaches were reported in the past year and have affected more than 5 million patients, according to the U.S. Department of Health and Human Services Office for Civil Rights.

HR leaders are very familiar with company audits, risk assessments, and gap analyses for skills, talent, and hiring needs. However, you don’t always take the time to audit your own department, identify potential risks and opportunities to strengthen resources, and ensure compliance best practices.

The areas within HR that create the greatest risk are likely the same areas on which you and your team expend the greatest amount of time and energy, such as: 

A year after the pandemic, the 25th Health Care Compliance Association (HCCA) Compliance Institute took place virtually this past week. As the healthcare industry adapts to the new normal, HCCA’s conference provides an opportunity for compliance professionals to learn about the latest developments and priorities from regulators.

As I compile PreCheck’s annual list of most popular blog posts this year, I am reminded of everything that we faced in 2020. In a year that transformed the world via the ongoing COVID-19 pandemic, PreCheck and our parent company Cisive focused on providing resources for employers and clients to overcome the challenges presented by the coronavirus.

The COVID-19 pandemic has vividly illustrated the high-stakes complexity of healthcare ethics and compliance. In the face of supply shortages, healthcare organizations have been forced to make life-and-death decisions regarding who can receive complete care and who can’t. But when confronted with these incredibly difficult decisions, a strong culture of ethics and compliance provides guidance.

Individuals who engage in fraud or abuse in the healthcare industry can put patients and taxpayers at risk of physical or financial harm. For this reason, the U.S. Office of the Inspector General (OIG) can exclude certain people or organizations from providing services under federally funded healthcare programs.