Healthcare Regulatory Compliance

Healthcare regulatory compliance is a fast-growing field of law that shows no signs of slowing down. And COVID-19 has complicated and accelerated that process even further. Patient privacy laws and regulations, Medicaid and Medicare reimbursement, STARK and AKS compliance, and EMR compliance are just the tip of the iceberg. 

Let the attorneys at Gill Ragon Owen keep up with healthcare compliance laws and regulations so you can focus on what’s important –  your practice and your patients. 

Healthcare Regulatory Compliance Practice Areas

There are so many rules and regulations governing your relationship with your patients, your internal policies and procedures, how you access and store patient information, and how you report on a state and federal level.

We know that you became a healthcare professional to practice medicine – not fill out paperwork. We hear the same story from all our clients. But to avoid legal repercussions for yourself and your practice, it’s important that you maintain regulatory compliance. 

That’s where the attorneys at GRO come in. Our healthcare compliance services encompass:

  • HIPAA compliance
  • Medicare and Medicaid reimbursement policies
  • Assisting with preparation for accreditation and surveys
  • Reviewing and Drafting agreements to ensure STARK and AKS compliance
  • Assistance with state licensure and responses to audit/survey issues
  • Assist healthcare providers and long-term care facilities with Change of Ownership documentation and affiliated filings with state and federal regulatory bodies
  • Health and insurance law updates
  • Assist healthcare providers with corporate practice of medicine issues

Let our dedicated attorneys perform an audit of your practice’s policies and procedures to ensure that you are fulfilling your legal obligations. Think of this process as preventative care for your practice. 

Remember, it’s much less expensive, time-consuming, frustrating to ensure compliance than it is to deal with the financial and legal consequences that come with charges of non-compliance. 

Examples of Potential Healthcare Compliance Issues

There are thousands of scenarios that could result in regulatory non-compliance. These are a few common examples:

  • Providing protected health information to individuals in violation of applicable state and federal laws 
  • Entering into referral or contractual arrangements that violate STARK and the Anti-Kickback Statute
  • Engaging in the inappropriate corporate practice of medicine
  • Lack of suitable professional liability insurance
  • Incorrectly following a patient’s advanced directive or living will
  • Mishandling the mandatory-reporting laws that affect your practice (i.e. those involving child or elder abuse)

What is a “Compliance Program”?

A compliance program is a documented plan to identify, assess, address, and reduce the appreciable risks within your healthcare organization or long-term care facility. 

A good compliance program involves developing and documenting practical policies and procedures as well as continuing education. Your practice’s plan should address billing, documentation, and related requirements for Medicare and other third-party payors. 

The OIG has provided a framework for compliance plans that includes:

  • Internal auditing and monitoring
  • The designation of a compliance officer and/or compliance committee
  • Appropriate training and education
  • An appropriate response to detected offenses and improving corrective procedure
  • Open lines of communication
  • Well-publicized guidelines on the enforcement of disciplinary standards 
  • Compliance and practice standards (i.e., policies)

While compliance programs are currently considered to be “voluntary”, in issues of non-compliance, the Federal Sentencing guidelines favor practices with an effective compliance program in place. 

The GRO attorneys will help you assess the risk to your practice and develop internal documentation and procedures designed to keep you in compliance – and out of the courtroom!

For more information, contact Gill Ragon Owen, P.A. to schedule a consultation with one of our dedicated healthcare regulatory compliance attorneys.

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