Deciding value-based compensation arrangements for physicians is complicated. To streamline this process, healthcare providers need to prepare value-based reimbursement inventories and understand what the result to incentivize will be.
FREMONT, CA: The healthcare industry has been facing a lot of challenges regarding regulatory compliance, and one such example is, at the end of 2019, the Office of Civil Rights (OCR) entered into the first enforcement actions related to the U.S. Department of Health and Human Services’ (DHHS) Patient Right to Access Initiative, as a reminder for covered institutions to respond to patient requests to access their medical records in time, in the format asked by the patient and not charge more than the nominal based fee.
Here are five healthcare compliance issues for 2020:
Telemedicine Provider Qualification, Licensing, and Operations Compliance
Telemedicine firms engaging in or embark on multi-state delivery models need to be aware of and compliant with applicable state foreign entity qualification needs and corporate practice restrictions. They need to ensure that their clinical services providers are properly licensed and compliant with clinical practice needs in the states where they seek to treat patients.
Government Overpayments
There is no minimum amount that is ignored for government payments. Healthcare providers need to expect their decision of whether to carry out relevant claims interference to be examined closely.
Value-based Compensation Arrangements
Deciding value-based compensation arrangements for physicians is complicated. To streamline this process, healthcare providers need to prepare value-based reimbursement inventories and understand what the result to incentivize will be. Additionally, they should not depend entirely on benchmark data.
Ransomware
Ransomware is a common threat to patient health information. Previously, there were only two types of ransomware, which were lock and crypto. But now there is a third type known as Datakeeper, which is franchised and increasing rapidly. Healthcare providers and associated institutions need to be alert to this privacy and security threat.
Compliance Due Diligence
Compliance due diligence processes needs to incorporate annual risk assessment to create up-to-date compliance work plans, exclusion checks, and conflict of interest reviews after initiating employment or contract, management and monitoring of revenue cycle functions, and vendor contractual arrangements.
