The Significance of Healthcare Compliance

The US healthcare industry is governed by a different set of regulations for private and public companies, and federal agencies. However, in general all healthcare entities have to comply with constantly changing regulations. HIPAA or Health Insurance Portability and Accountability Act is the primary regulation that is applicable to all healthcare providers, employers, authorities responsible for public health, health insurers, clearing houses, billing agencies, health plans, vendors, information systems, hospitals and service organizations, as well as universities.

Failure to comply with HIPAA attracts civil and criminal penalties with fines up to $25,000 for recurring violation of the same standard in one calendar year and fines up to $250,000 along with a 10 year imprisonment for tampering and misuse of an individual’s identifiable health information. All healthcare organizations have to disclose the use of protected health information and show documented evidence with physical, administrative and technical safety metrics.

While the role of IT is unmistakably one of great relevance in regulatory compliance, customer satisfaction and cost control, the increasing demand to share and handle information diligently without increasing costs is an immense challenge for organizations. Moreover, since customers prefer the convenience of accessing information through the Internet the healthcare industry needs automated web-based solutions that can fulfill these needs, improve the efficiency of operations with tactful management of information, both internally as well as externally without affecting their costs.

According to the Patient Protection and Affordable Care Act enforced by President Obama on March 23^rd, 2010, there are several regulations to check fraud and abuse and to ensure provider compliance. As per this act all providers must be aware and adhere to the new regulation changes. In such a precarious environment it is advisable to invest in a robust compliance program that can execute the best operational practices, maintain and monitor optimum records management for the safety of individuals.

The program provides quality solutions for healthcare regulatory compliance and fosters data control, compliance enforcement, regularized auditing schedules, recording and reporting analysis and remediation measures. With a standardized process in force healthcare organizations can be in sync with the changing regulations and maintain a high standard of compliance.

With the introduction of automated systems, healthcare organizations are in complete control of their processes. Accessibility to personal health information is restrained without ambiguity, thus providing security to individuals, and making IT healthcare compliance a truly competent and effective approach.