Compliance Analytics: There’s Gold in the Data
Compliance can become a financial asset. For example, data mining provides opportunities to improve vague or incomplete clinical documentation, weak internal communication, overly conservative or inconsistent coding, and physician education, all of which improve the bottom line and reduce risk.
Hospital Requirement to Provide Auxiliary Communication Aids Continues
An appellate court ruled hospitals must continue to provide appropriate auxiliary aids to help hearing impaired patients exchange medical and financial information with hospital staff.
Auditing for Stark Law Compliance
Compliance with the Stark Law requires involving legal, compliance, and other expertise on the front end of the process rather than auditing for problems later.
DOJ Guidance on Compliance Effectiveness
New guidance highlights common questions that prosecutors ask when judging compliance program effectiveness.
Managing the ACA’s Nondiscrimination Provisions
The ACA prohibits discrimination in health programs or activities that receive federal financial assistance. Healthcare providers face the challenges of preventing language barriers that may impact certain patients based on race, as well as current litigation on gender identify.
Legal Concerns in Telemedicine
Although telemedicine provides numerous benefits, it also presents some legal and regulatory challenges. Legal and regulatory concerns can be grouped under three main categories: Licensure laws; privileges and credentials; and confidentiality, privacy, and security.
MOON Form Approved
The MOON notice related to observation status was recently approved.
Over the MOON about the NOTICE Act
Although many healthcare leaders applaud the fact that there is plenty of time to prepare for MOON requirements, there are lingering concerns, including limited patient education in the form and requirements for translating the form into other languages.
Addressing Challenges Presented by Financial Assistance Rules
Although the vast majority of hospitals have been working to implement IRS regulations for patient financial assistance, healthcare leaders should focus on potential problem areas because compliance with all the requirements is necessary to qualify for tax-exempt status.
High Court Decides False Claims Act Case
The Supreme Court ruled that “in some circumstances” hospitals’ implied certification of compliance with payment requirements may make them liable under the False Claims Act, but the decision’s reach is not as expansive as proposed by plaintiffs and the federal government.