The healthcare sector has changed over the years due to the fast-evolving government regulations, the Covid-19 pandemic recovery, technological innovations, and patient expectations. On the other hand, these changes and improvements have affected compliance officers and healthcare executives in some way, as it has posed new compliance issues.

As we are all aware compliance issues are a major part of the healthcare industry. Every organization, including healthcare providers, is required to follow regulations laid out by different laws. Trends and regulations in the industry must be observed at all times in order to manage risks, protect patients, and ensure quality care for them. Compliance can be considered as a way of ensuring that patient safety standards are met and professional ethics are observed at all times.

It is everything when it comes to protecting practice and patients. Therefore, it is imperative for healthcare executives to recognize the cruciality of managing compliance risks or issues and safeguarding against legal violations in this fast-paced business environment. Leaders must exert strong leadership and take a proactive approach when dealing with compliance issues.

As we move forward into 2023, one of the actions that healthcare compliance officers or executives strongly recommend is to pay close attention to the status of regulatory issues in their industry and those that have the potential to negatively impact their business. Learn in this article the compliance issues that are coming down the pipeline in the year 2023 in order to mitigate and manage the potential impact on organization.

Healthcare Compliance Issues (by https://www.precheck.com/blog/top-3-compliance-issues-healthcare-2023-and-beyond)

1. Ransomware

Healthcare organizations rely on data and digital connectivity to operate. Malicious cyberattacks featuring ransomware — a software-based attack that locks access to a system or database until a ransom is paid — can put patient care at risk while compromising patient privacy.

According to The State of Ransomware in Healthcare 2022 survey from security firm Sophos,  66% of healthcare organizations were hit by ransomware in 2021, up from 34% in 2020. The report also found that the average cost for a healthcare organization to remediate the impact of a ransomware attack was $1.85 million in 2021, the second-highest average cost across all sectors.

Human error is one of the top risk factors for cybersecurity breaches. According to the 2022 Verizon Data Breach Investigations Report, 82% of cybersecurity breaches tracked over a 12-month period were due to human error, which itself is 2.5 times more likely than malicious behaviors.

It is important for compliance officers to ensure that they have clear cybersecurity policies, including for mitigation after an incident, and that employees have regular training regarding cyber threats. The Sophos report revealed that 52% of healthcare organizations with cyber insurance have increased staff training and education activities.

Compliance officers can also work with IT to create compliance programs that emphasize password management, sound decision-making, and how to report suspicious activity. This training should include real-life examples of risk factors.

2. Telemedicine

Telemedicine spiked in the early months of the COVID-19 pandemic and continues to be a viable, reliable alternative for many patients.

KFF-Epic Research analysis of March to August 2021 found that 8% of outpatient visits were conducted via telehealth. That is significant since, before COVID-19, telehealth outpatient visits as a percentage of outpatient visits were a rounding error.

When COVID-19 was declared a national health emergency in March 2020, the Centers for Medicare & Medicaid Services relaxed many compliance rules regarding telemedicine to improve access to rural healthcare facilities.

While the federal health emergency is expected to continue into the spring of 2023, it would be beneficial to compliance officers to prioritize incorporating telemedicine processes into their organization’s policies and procedures . These policies include telemedicine billing, licensing requirements, financial relationships between telemedicine providers and other medical providers, and documentation of medical necessities for telemedicine treatment.

3. Unsecured Data

More than 19 million records were compromised in healthcare data breaches during the first half of 2022, according to healthcare cybersecurity firm Fortified Health Security. Unauthorized access and disclosure accounted for 15% of those breaches.

While data compliance and data security are sometimes used interchangeably, they are not the same thing. A healthcare provider’s data system can be compliant without being secure, especially with the increase of hybrid and remote workers.

A compliant system keeps patient data private, and a secure system prevents data from being hacked. Compliance officers in conjunction with IT security officers can ensure that their organization’s data system has both qualities. Keep in mind that assessments of compliance and security must be done separately. 

Compliance officers are responsible for enforcing the Health Insurance Portability and Accountability Act (HIPAA), a federal regulation that protects sensitive patient health information from being released without the patient’s consent or knowledge.

Compliance officers can oversee HIPAA training for employees, with an emphasis on the risks of sharing unauthorized patient information through mobile devices and social media. HIPAA regulations exist to safeguard patient privacy, and the penalties for violations can be costly for employees and facilities.

What You Can Do (https://www.collaboratemd.com/blog/healthcare-compliance/)

Upgrade Your Tech

Upgrading your technology to something that offers top-of-the-line security and accessibility is key. The right vendor will off encrypted cloud-based software that is accessible by a mobile device. They will offer a solution that is safe and guaranteed to protect your organization from cybersecurity risks. The right software will make it so your team can always have peace of mind that they are remaining compliant with industry standards.

Form Quality Partnerships

Your organization needs to establish partnerships with trusted vendors. Experienced and trusted vendors of services like telehealth, RCM, CCM, and more can be extremely helpful in reducing your healthcare compliance risk. The right vendor is up to date and completely informed on all industry standards so that you never fall victim to compliance errors. Their top priority is not only removing some of the burdens off the shoulders of your organization but also helping you excel along the way. The right partnership can offer your team peace of mind while also enabling you to focus more heavily on the quality of patient care you are offering.

HWAA can help you!

HWA Alliance of CPA Firms understands what risks can do to an organization. We believe in the statement, “Safety is everybody’s business. Risk management is a more realistic term than safety.” As we dive into the topic of mitigating risks, it is essential to include risk management as a priority for your organization. Allow HWA to help you anticipate and avoid risks. We have a complete risk management approach in place that will safeguard your organization’s finances, decision-making, actions, and operations. We have significant experience in various business industries and the tools and methodologies to improve your risk management functions.

You are the key to your safety and success! Allow HWA Alliance to assist you!