Corporate Compliance Program in Healthcare: A Primer

Corporate Compliance Program in Healthcare: A Primer

Corporate compliance in healthcare: a failsafe against misconduct

What is a Healthcare Compliance Program?

Healthcare compliance is the adherence of an organization or individual to any established policies, rules and regulations, and operating laws that govern the practice area in question. To maintain a corporate compliance program in healthcare is to safeguard not only your operations but also the well-being of employees, patients, and visitors alike with standardized processes. Setting up the right processes and precautionary measures – a combination of software, risk assessments, planning and training – constitutes what is known as a healthcare compliance program.

Why Compliance Programs for Healthcare Providers Matter

What is a corporate compliance program in healthcare needed for? For starters, it means maintaining a valid license and minimizing the risk of malpractice, misconduct, mishandling of sensitive data, and other issues. These would otherwise jeopardize security and compliance with the regulations that govern the practice. In essence, compliance programs equate to setting rules and best practices for staff through specific internal processes that fully respect these laws, as well as to appropriately address any violations.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is one such governing law that a healthcare provider must be fully compliant with. Otherwise, should they be found in violation of the Act through an audit or the revelations of an internal whistleblower, they may be subject to severe legal and financial punishment. The U.S. Department of Health and Human Services (HHS) and, subsequently, the Office of Inspector General (OIG), are other examples.

Are Compliance Programs for Healthcare Providers Mandatory?

With the introduction of the Patient Protection and Affordable Care Act (PPACA), it is now mandatory for healthcare providers of any size – from individual practitioners to sprawling, multi-unit facilities – to have an effective compliance program in place and adhered to. Mandatory compliance in healthcare translates to enforcing appropriate disciplinary responses in the event of violating either an internal policy, federal law, or other requirements.

HHS Compliance Program Guidance

The HHS-OIG has available online a wide array of essential compliance resources. These include a compliance roadmap for new physicians, corporate integrity agreement details, advisory opinions, and more to help inform a healthcare provider’s corporate program development. Combined with solutions like our own HIPAA compliance and ethics hotline, a provider can benefit from real-time, robust reporting and highly informative analytics in addition to completely safe anonymous misconduct reporting, among other benefits.

Enable the Ability to Speak Up

Regardless of the specific department or operational process that is the source of the risk in question, you and your team must be able to not only report on it safely but also take appropriate actions to mitigate it. Therefore, promoting a speak-up culture is crucial, and a good compliance program in a healthcare setting includes this as a solid foundation. Software, in particular, can provide a comprehensive audit trail that leaves nothing to chance in terms of actions taken, provides deep customization to meet specific needs of processes relevant to your particular operations, and attentive support capabilities when you need them most urgently.

Conclusion

All in all, a corporate compliance program in healthcare acts as a failsafe, keeping you in good standing with any laws and regulations that your employees must adhere to. It also promotes an open-door culture that does not tolerate misconduct in any form, plus it enables you to take informed and appropriate action to resolve any issues that do occur.

To learn more about dedicated HIPAA compliance software, reach out to us today. We’re happy to help you maintain full compliance and peace of mind, assisting in optimizing your internal policies and processes in a proactive manner.

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photo Amanda Nieweler

Amanda Nieweler

Amanda writes for WhistleBlower Security about ethics, compliance, workplace culture, and whistleblower hotlines. Amanda brings her nearly two decades of risk and compliance experience to the WBS blog where she is dedicated to helping people and companies promote speak-up cultures.