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All You Need To Know About Healthcare Regulatory Compliance

Healthcare Business Review | Thursday, March 17, 2022
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Fremont, CA: Everyday healthcare providers are dealing with the nerve-racking task of complying with an increasing number of healthcare regulations. As per a recent report, the healthcare industry spends approximately $39 billion every year on the administrative tasks of regulatory compliance.


Today, healthcare organizations need to comply with over 600 regulatory requirements. The regulations concerning healthcare encompass various occupational sectors, including pharmacies, insurance companies, and cloud service providers. Below listed are three major laws that govern healthcare compliance in the United States.


Patient Safety and Quality Improvement Act (PSQIA)


The purpose of this law is to promote a safety culture by requiring peer evaluation of information about healthcare mishaps. To prevent the information from being utilized in lawsuits against the PSO, the statute created new patient safety organizations (PSOs).


The PSO is the primary vehicle for collecting data on adverse medical events and assisting providers in implementing strategies that reduce adverse events and foster safety cultures while improving care quality.


 


Health Insurance Portability and Accountability Act (HIPAA)


HIPAA compliance includes the rules on breach notification, privacy and security, and enforcement for the protection of healthcare system information.


The HIPAA privacy rules are applicable for all healthcare providers and involve all media: paper, electronic, and oral. It also gives patients the right to check their own protected health information (PHI) and needs disclosure of how it is utilized.


Healthcare facilities must also keep their security procedures up to date in order to keep medical records safe in an ever-changing environment. The Department of Health and Human Services (HHS) establishes limits on the distribution of health records and fines for infractions under HIPAA.


Anti-Kickback Statute and Stark Law


The Anti-Kickback Statute and the Stark Law are imposed to keep medical treatment decisions free from the chances of hidden financial arrangements between hospitals and healthcare workers. These laws are critical because improper financial incentives can result in improper medical decision-making as well as higher expenses for Medicare and Medicaid Services.


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