Healthcare Compliance Challenges – The Office for Civil Rights of the United States Department of Health and Human Services reports that over five million people have been harmed by the five hundred+ healthcare cybersecurity breaches revealed over the past year.
Many of these lapses have arisen because of the pandemic itself, as hospitals and clinics have had to find various other ways of connecting with and seeing patients in light of the restrictions placed on them by the COVID-19 rules. Because of this, several institutions have been forced to trust unprotected web servers with highly confidential data.
While businesses make efforts to remain in compliance, individuals charged with enforcing the relevant legislation face an air of ambiguity that won’t be lifted until at least year. Furthermore, compliance officers in the healthcare industry will be confronted with these three major obstacles.
Table of Contents
1. Performing Ethical and Legal Background Checks
In order to work for a healthcare provider, potential employees are required to undergo a thorough background check. Although the epidemic has resulted in manpower shortages and new regulations, there is a need for a more streamlined approach to carrying out these inspections.
According to Darrell Contreras, Chief Compliance Officer at Millennium Health, an accredited specialty laboratory in San Diego, “comprehensive background checks should be undertaken for those individuals who will have any economic oversight responsibility or high-level leaders within the organization.”
While it’s true that healthcare compliance solutions should do background checks, it takes a more comprehensive and strategic approach in today’s competitive labor market if they hope to attract and retain top employees. Having a background check company that specializes in healthcare or online mental health services might be of great assistance.
2. Strengthening Cybersecurity At All Organizational Levels
The US Government plans to invest up to $125 billion in healthcare cybersecurity over the next five years to help modernize insecure systems and safeguard sensitive patient data. In order to ensure that their procedures are effective in preventing anomalies, compliance officers must verify that they are being followed. There must be a detailed system in place to audit claims and check for any billing discrepancies, adds Contreras.
As a corollary, compliance officers should open up direct lines of contact with doctors and other employees to make sure everyone is on the same page about the risks involved. To quote, Furniss believes, “Administrators need to hire people with a broader skill set and the capacity to actually communicate well.” Organizations in the healthcare industry, for instance, should hold regular cybersecurity training and meeting sessions for their staff. Most essential, the compliance officer must show that cybersecurity is a priority in all they do.
The healthcare compliance industry is facing difficult issues as a direct result of the system shock caused by the epidemic. By making better use of technology and taking a more holistic approach, compliance officers can adapt to the new requirements and help their firms recover from the epidemic.
3. Ensuring Telemedicine’s Safety and Compliance
Increased competition between providers across state lines is achieved through the use of telemedicine, which benefits patients by expanding their access to healthcare options. However, the doctors’ capacity to deliver these services in other jurisdictions is constrained by rules, regulations, and licensing requirements.
Private equity firm GTC Group’s CEO and author of The 60% Solution: Rethinking Healthcare, Todd Furniss, notes that the healthcare industry’s obligations are “still predicated on an agrarian paradigm.” They very from state to state, but you already know that biology and chemistry don’t alter when you travel from one to the other. The high risk of data breaches and inadequate practice in telehealth means that it is still extensively regulated, despite the fact that many health facilities have welcomed in-person appointments across state lines.
It has been a major issue for compliance officers to determine how to regulate telehealth. The HIPAA Security Rule has made cybersecurity a top responsibility, and keeping up with the ever-increasing volume of data has become yet another formidable challenge. Compliance in a remote workplace is significantly more difficult to ensure due to cyber security concerns. According to Contreras, “COVID-19 testing is being very thoroughly monitored for fraud.” Providers should only do tests that the patient has specifically requested, ordered, and reasonably anticipated.
Additional Healthcare Compliance Challenges:
1. Mental health & wellness of employees
Many workers have experienced rough patches recently. Some of them have a considerably hard time dealing with the rising cost of living, unpredictability, overwork, and stressful situations at home, especially if they have to commute long distances, live in cramped quarters, and/or juggle work with home-schooling or caring obligations. There has been a rise in the number of reports of fatigue and burnout amongst workers.
Businesses should think about adopting a more holistic approach to employee wellness, one that includes mental health and focuses on minimizing stress, burnout, and conflict rather than only the typical physical wellbeing model that emphasizes injury and accident avoidance.
The concept of “psychological safety” is gaining traction as well; this refers to the establishment of an environment where individuals feel comfortable and familiar enough to speak up about their own faults without fear of retaliation.
Developing a positive company culture has several positive effects, including raising morale, decreasing turnover, and increasing productivity.
2. Loyalty penalties rules
Businesses sometimes engage in “price walking,” a marketing strategy whereby they initially provide low pricing in order to entice new clients but then raise those prices annually when their contracts are up for renewal.
That means consumers have to be proactive and switch providers annually to avoid getting penalized for sticking with one company. The least intelligent customers, such as the elderly or the handicapped, are punished as a result of this distortion of market competitiveness.
The FCA has implemented a whole package of remedies in the financial services sector to end the practice of penalizing customers who remain loyal. One such remedy mandates that homeowners’ and drivers’ insurance providers provide renewal quotes that are no more expensive than those provided to new customers. Over a ten-year period, the FCA predicts that these reforms will save British consumers £4.2bn.
Healthcare compliance is harder than ever, but businesses can still take precautions to avoid penalties. One of the best methods for a company to stay in compliance is to provide its staff with regular updates on the latest information security threats to patient data.