Story after story is grabbing the public’s attention and shining a light on the difficulties hospital and private practice administrations face when trying to navigate regulatory compliance. The public is currently paying attention to COVID-19 vaccination guidelines, which is arguably most difficult to navigate here in Texas where it seems that President Biden’s guidelines are in conflict with Governor Abbott’s. In this current landscape, the government has left hospitals, ambulatory surgical centers, private practices, and similar facilities in a difficult situation. Either they enforce the vaccine mandate and take the risk of loosing staff or they choose not to enforce the vaccination requirements and face the risk of getting their claims for payment to Medicare and Medicaid denied.
Although a difficult situation, this is just one of the many examples of regulatory compliance issues that businesses who operate in the healthcare sector must address. Staying in compliance with federal, state, and local ordinances is not an easy task — especially in a world that is often changing these rules seemingly overnight. Even a simple billing mistake can result in allegations of a violation and lead to a denied request for payment, additional financial penalties and even the inability to make claims for payment in the future.
Because of the complicated nature of compliance, it is important to take proactive steps to better ensure your group or facility is following applicable regulations. An internal audit can help your group gather the information it needs to find any potential issues and make needed changes before the matter becomes a much bigger problem. This is an area where the old adage holds true — an ounce of prevention is truly worth a pound of cure.