HIPAA and Compliance

HIPAA and Compliance are now more important than ever ...

For many years, the federal government encouraged healthcare organizations to implement voluntary HIPAA and compliance plans.  The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) issued guidance to several types of healthcare providers, including:

  • hospitals
  • clinical laboratories
  • home health agencies
  • DME suppliers
  • third party billing companies
  • hospices
  • Medicare Advantage plans
  • nursing homes
  • physicians

Do you know what to do if you're facing a medical documentation and coding audit?

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Clinician Concerned with HIPAA and Compliance

Patient Protection and Affordable Care Act

Now, with the passage of the recent Patient Protection and Affordable Care Act (PPACA) in 2010, there has become a new urgency for healthcare organizations to develop and implement HIPAA and general regulatory compliance program policies and procedures.  PPACA will require healthcare providers applying to enroll as Medicare providers to have a full compliance program in place.

Beyond this requirement are the on-going efforts of federal and state governments to decrease the fraud and abuse that plagues government-sponsored healthcare programs.  An effective overall healthcare compliance program, one that includes HIPAA compliance as well, can help an organization spot errors in its processes, and prevent small problems before they become large ones, especially in the area of billing to government healthcare programs and adhering to HIPAA Privacy and Security Rules.

There are many dimensions of "compliance" for healthcare organizations, including:

  • compliance with medical documentation
  • compliance with billing and coding practices
  • compliance with health and safety laws and regulations
  • compliance with environmental laws and regulations
  • compliance with human resources laws and regulations
  • compliance with HIPAA laws and regulations
  • ... and more.

Health Insurance Portability and Accountability Act

HIPAA and Compliance Consulting

HIPAA, the Health Insurance Portability and Accountability Act of 1996, requires healthcare organizations to comply with a host of regulations covering the privacy of personal health information (PHI).  These requirements have increased with adoption of the HITECH Act provisions of the American Reinvestment and Recovery Act (ARRA) early in 2009.

HIPAA and Compliance Consulting Services

The Fox Group's HIPAA and compliance consultants offer a wide range of services, from helping clients to develop and implement compliance program policies and procedures to conducting coding and documentation audits, to completing operational assessments designed to identify high risk areas.  You can learn more about them by visiting the following pages:

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