Maintaining compliance is a critical factor for healthcare companies and those who work in the healthcare industry. Many federal laws and statutes not only define what it means to be out of compliance but also what the penalties are for violation of compliance standards.
When regulatory standards are not maintained, healthcare professionals may face legal charges and also be ordered to pay heavy fines and potentially lose their ability to practice their profession in the medical industry.
What Is Healthcare Compliance?
Healthcare compliance in the medical and dental industry is defined by maintaining federal regulations with a focus on high ethical standards in patient care.
On a day-to-day basis, this can look like continually assessing and updating processes in order to prevent fraud, patient abuse, and waste across departments.
Some of the laws that govern healthcare compliance include the following:
- Health Insurance Portability and Accountability Act of 1996(HIPAA): HIPAA dictates how healthcare organizations may store, share, and use private patient medical information and defines the fines and penalties imposed for violations.
- Health Information Technology for Economic and Clinical Health Act (HITECH): HITECH ensures that healthcare providers comply with HIPAA mandates and maintain security protocols in order to protect patients. Penalties are set for violations as well.
- Anti-Kickback Statute(AKBS): This federal law prevents anyone from giving or receiving anything of value, including money, in exchange for facilitating the sale of healthcare services or treatment, especially when federal healthcare dollars are covering the cost of that treatment. Violations are criminal in nature.
- Stark Law: Similar to AKBS, the Stark Law forbids doctors from referring patients to other physicians or service providers with whom they have a financial relationship, especially if the services are paid for by Medicare. Penalties are outlined for violations.
- Patient Safety and Quality Improvement Act of 2005 (PSQIA): The PSQIA protects employees in healthcare settings who report medical care violations in the workplace that put patient safety at risk.
- Emergency Medical Treatment and Labor Act(EMTALA): Specific to hospitals, this law requires that stabilizing treatment be provided to all who enter in need of treatment regardless of their ability to pay for medical services.
There are also laws that pertain to specific jobs and address issues of patient understanding of care and options, ending a medical relationship with a patient, and provision of care.
To ensure that your organization is in full compliance with all federal regulatory laws and standards, it is a good idea to meet with a legal team who is up to date on current regulations.
How to Maintain Regulatory Healthcare Compliance
If you would like to learn more about how to maintain regulatory healthcare compliance or improve compliance standards within the company, contact Florida Healthcare Law Firm today. We can help you ensure the following:
- Current policies and procedures are up to date
- Education and training are available to employees to ensure continued compliance
- Reporting, monitoring, and auditing are consistent and thorough
- Enforcement measures are in place
Call Florida Healthcare Law Firm today to set up your initial consultation.