One of the most regulated industries in the USA is healthcare, making compliance crucial in the industry. It’s the reason why there are many compliance training courses related to healthcare and why companies hire compliance officers to ensure their organization and its employees follow the ever-changing rules and regulations mandated by law.

But compliance is more than just giving employees accounts to platforms like True Office Learning to learn compliance topics from. Here is a short guide to compliance in healthcare and its importance.

What is Healthcare Compliance?

Healthcare compliance refers to the process of following laws, rules, and regulations relating to healthcare practices. It would usually cover various practices, observing internal and external rules. The most crucial compliance issues will relate to patient safety, billing practices, and patient information privacy.

Importance of Healthcare Compliance

All healthcare organizations need to have some level of corporate compliance to operate efficiently. Compliance will keep the company’s operations running effectively, ensuring all employees will follow the proper procedures and understand standards and expectations.

Compliance in healthcare will come with higher stakes compared to other industries, as one’s health is involved. For example, if a doctor or nurse does not follow the proper procedure, it can result in injuring a patient or staff member.

Healthcare compliance is all about ensuring that an organization provides safe and high-quality patient care. By complying with industry regulations and standards, healthcare organizations can continue improving their quality of care.

If any laws are violated, it can result in lawsuits, loss of licenses, hefty fines, and damaged company reputation, which can ultimately lead to company closure.

What’s Needed for Healthcare Compliance

There are various aspects of healthcare compliance, all of which are governed by state and federal agencies. The ever-changing laws and regulations make it challenging for organizations to stay updated with compliance, especially with laws differing between local and state governments. However, it’s a must to take time and effort to examine all the laws applying to their organization, staying updated and implementing any changes right away.

Here are some of the federal regulations and governing bodies governing healthcare compliance:

  • Social Security Act – governs funding and requirements for Medicaid, Medicare, CHIP, among others.
  • HIPAA and HITECH Act – protects patient privacy and requires healthcare organizations to implement appropriate measures to ensure all patient records are secure.
  • False Claims Act – law making it illegal to file false claims for funds from federal programs.
  • Patient Protection and Affordable Care Act – implements requirements for Medicaid, insurance, etc.
  • Drug Enforcement Administration (DEA) and Food and Drug Administration (FDA) – regulates medications’ creation and distribution.
  • Department of Health and Human Services (DHHS) and Office of the Inspector General – helps protect organizations and patients from fraud.

Note that all healthcare organizations are subject to the same regulations applying to organizations in other industries, too.

Wrapping It Up

Healthcare compliance is a crucial part of protecting your organization and to provide exemplary patient care, so make sure your company and employees remain compliant with the proper practices.