Everything that I am reading is telling me to prepare and prepare more for increased regulatory audits, investigations, surveys, inquiries and inspections. Here is a short list of regulatory bodies that could come knocking on our doors any day.
DOH (Department of Health)
JCAHO (The Joint Commission Accreditation for Healthcare Organizations)
OCR (Office of Civil Rights) aka the HIPAA police
CMS (Center for Medicare and Medicaid Services)
OIG (Office of the Inspector General)
RAC (Recovery Audit Contractors)
It seems logical for this to follow the billions of dollars that have been invested by the government to incentivize providers to adopt electronic medical records systems. This was all done with the idea of increasing quality and lowering costs. I think we have seen some of the former but not much on the latter, save for some ACO's (Accountable Care Organizations) maybe. Regardless, there is so much information that is now available, in discrete data format and fully accessible to the government, payors, providers and patients alike, that someone is going to notice if they are getting value or not. Everyone is going to try to use this data to their advantage, i.e. to pay less and demand more. Furthermore, patient privacy and security, or lack there of, has been at the forefront of the issue and is the driving force behind much of the scrutiny, especially by the OCR whose job it is to enforce the HIPAA provisions.
Yes, this is the year of compliance, I just hope that everyone is in compliance.
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