With the many regulatory changes due to COVID-19, healthcare compliance consulting has become more relevant than ever. When the first case of COVID-19 was reported on December 31, 2019, no one knew that within a month, it would become a global health emergency and by March 2020, a pandemic. Now, as the world faces yet another wave – the Delta variant – it seems that the end we expected has been pushed back even farther.
The pandemic has changed nearly every industry. The healthcare industry is no different. Healthcare regulatory compliance consulting had to re-focus and modify its approach.
The industry has endured compliance challenges as a result. Thus, healthcare compliance consulting must adapt accordingly.
Healthcare compliance consulting and HIPAA
HIPAA privacy and security are vital for compliance with patient care. But under a disaster protocol, there are certain exceptions. The organization must have specific processes to meet the requirements of applying for a HIPAA penalty short-term waiver.
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There are strict rules for sharing protected health information that goes beyond the requirements of the HIPAA Privacy Rule. Any situation where this is allowed must meet certain conditions:
- Specific to areas that are within the public health emergency zone.
- Specific to hospitals that have actively enacted their disaster protocol.
- Restricted to a 72-hour period from the onset of the disaster protocol.
The waiver has certain conditions for hospitals, such as addressing the terms for written policies on patient visitation. The waiver only covers hospitals that have 51 or more confirmed COVID-19 cases. It also only applies to COVID-19 patients.
Hospitals that meet the criteria have more time to provide requested patient medical records.
Compliance and Telehealth
Telehealth became a new normal as people feared the risk of infection. They were less likely to leave their homes or meet with other people. However, telehealth comes with a few compliance concerns:
- Policies for disasters.
- Technology use.
- Communication plans.
- Technology security.
- Accountability of remote staff.
- Remote patient care and monitoring.
- Engagement from staff.
Geographic challenges have called for medical licenses that cross state borders. Fortunately, new laws make this possible. Health insurance coverage and payment for telehealth services have also posed problems. The industry has had to work them out.
Also, HIPAA does not have any demands that specifically relate to telehealth. This has ramped up the review process for HIPAA guidance for new technology.
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All of the issues that have arisen with telemedicine have done so within a year. This left little time to write and put in place policies as organizations rushed to work out ways to balance patient care and compliance while adapting to emergency protocol.
A reminder of some state and federal assistance programs
The federal government has funded many programs in response to the pandemic. For example:
- Medicare CAAP.
- FEMA assistance.
- Paycheck Protection Program (ended May 2021).
- CARES Act Provider Relief Fund.
- SBA COVID-19 relief programs.
States also have their own support programs for providers. State-funded and governed, each program has its own rules for eligibility, documentation, performance, and verification.
Those that apply for help must submit specific documents, which must be checked to confirm accuracy. They need to understand the conditions for use of any funds. They should also know there is a process to ensure compliance.
Moreover, all activity has to be tracked. They must submit reports to show compliance with all rules. Any queries must be responded to on time with correct information.
New policies and healthcare compliance consulting
New regulations in these areas and others all require staff training and updated policies to ensure full compliance. There is no room for error, and healthcare compliance consulting professionals must be nimble, flexible, and ready to take action as soon as new regulations are introduced.
The healthcare industry is changing rapidly, and it is not expected to slow down anytime soon. Even after the pandemic is under control and no longer a global threat, there will still be policies that remain in place. So, seeking the help of compliance experts will help you adapt to the changing industry while ensuring quality patient care.