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Key Compliance Concerns for Healthcare Practices


About this program


Compliance remains a critical aspect of the highly regulated healthcare industry. Providers and their staffs must adhere to laws, regulations, and ethical standards while delivering quality care to patients. In this lunch and learn session, PMI instructor, Jan Hailey, will review key risk areas where compliance issues may arise in the practice and identify preventive and corrective measures. Attend this program and learn how to implement effective compliance strategies to guide your team in the proper direction.

Protecting sensitive information has become a significant challenge. Privacy breaches and data security incidents are in the news cycle too often. Compliance with HIPAA is critical and failure to protect patient data results in fines and sometimes, legal consequences, not to mention the impact to business operations and your professional reputation. Billing and coding errors can lead to fraudulent billing, leaving the practice vulnerable to monetary penalties, payer audits, and potentially, to criminal charges under the False Claims Act. Detecting and preventing fraud and abuse requires effective internal controls, a comprehensive compliance program, and routine self-audits.

Employment contracts or physician service agreements must comply with applicable laws and regulations to avoid potential violations related to fair market value compensation or improper inducements for referrals. Non-compliance with the Anti-Kickback statute or Stark law can result in penalties plus exclusion from federal reimbursement programs.

Healthcare providers and practice leaders must be proactive in protecting the organization. It can be challenging to keep up with ever-changing state and federal standards and guidelines. However, lack of knowledge is not a valid defense when facing a non-compliance charge. Identifying risk areas and proactively addressing them will help you cultivate a culture of compliance that minimizes the risks of non-compliance and preserves quality of care and ethical business conduct in your healthcare practice.

Highlights

  • Mobile Device security
  • How to properly dispose of PHI and ePHI
  • Coding and documentation accuracy
  • What to do when an auditor contacts your office