Ensuring compliance with new healthcare legislation

Published: November 23, 2010 by bkrenek

Legislation has been introduced in Congress to crack down on Medicare and Medicaid fraud. This legislation comes at a time when incidents of medical fraud are on the rise and the Obama Administration is poised to role out sweeping healthcare reform.  Medical fraud is estimated to cost the U.S. health care system $100 billion a year.

The new rules will give federal health officials key powers to detect fraud early and prevent improper payments from being made.  For example, medical provider employees will be subject to fingerprinting, payments will be suspended to health organizations that are under investigation and medical programs will be required to stop using providers kicked out of Medicare or Medicaid programs.

These rules have serious implications for the health care industry that must also comply with stringent new HITECH rules. As I mentioned in a previous blog entry, some professionals feel the best way to comply with the new requirements is to be proactive.  For example, providers should consider actively working with their vendors to ensure all parties comply with the new standards.

Another recommendation is to conduct an internal risk assessment. A thorough assessment can identify where a business is not complying with the HITECH Act or HIPAA standards and provide an opportunity to make the right adjustments. Non-compliance can result in up to $1.5 million in fines or even civil action from a State Attorney General.

Learn more about risk assessments and act now before it’s too late.