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What Healthcare Compliance Means for Healthcare Providers

Posted: May 10, 2018 at 3:19 pm   /   by   /   comments (0)

Through technology, organizations in the healthcare sector have achieved hands-on patient care with information being captured in real time and stored in existing IT systems. Even then, the information leaves organizations prone to privacy breaches as malicious people are always searching for such data to manipulate.  It’s through aligning your organization’s operational policies to healthcare compliance frameworks that you can safeguard patients’ data and your organization’s reputation.

Healthcare Compliance-An Overview

Healthcare compliance is a process of evaluating and aligning an organization’s policies to existing regulatory frameworks as spelled out by the government of the day. The regulations mainly revolve around protecting patients and staff from malicious characters, safeguarding personal and medical data as well as ensuring patient’s information is used in a standardized means.

As a compliance officer, you are charged with the responsibility of developing and overseeing compliance plans, correcting irregularities and training staff on the same.

The HIPAA and HITECH Compliance Frameworks

1.  Health Insurance Portability and Accountability Act

The HIPAA spells out the guidelines that healthcare providers should observe to secure user data and privacy.  With both users and healthcare providers embracing new technology in the form of electronic transactions, mobile health, use of patient portals and the definitive telehealth, the HIPAA lays out the regulatory guidelines that providers of health care services must implement. The regulations portray you, the medical service provider, as both a custodian of the stored information and as a security wall that feds off malicious characters.

2.    Health Information and Technology for Economic and Clinical Health Act

The HITECH Act adds weight to the HIPAA regulations as it stipulates punitive measures that an organization with multiple violations should be handed. The act was crafted with anticipation that there would be increased sharing of electronic, protected health information between medical professionals. According to the act, healthcare providers who demonstrate exceptional use of electronic health records qualify for monetary incentives as motivation.

The Key Variations Between HIPAA and HITECH

Both the HITECH and HIPAA frameworks were developed to curb possible fraud during storage and transmission of patient’s data such transactions during billing, medical records, prescriptions and personal details.

However, while the HIPAA framework focuses on regulations that players in the health sector should abide by, HITECH revolves on expanding notification and enforcing the rules set in the HIPAA framework. It is in the HITECH act where charges against fraudsters and organizations that fail to comply are spelled out.

How Healthcare Regulatory Compliance Benefits Healthcare Providers

Besides avoiding heavy penalties for non-compliance, health care providers who embrace the HIPAA and HITECH will enjoy an improved service delivery since these regulatory frameworks are designed based on the best clinical practices.

Having effective internal controls as envisioned by the HITECH regulations safeguards an organization from fraud. A solid reputation in the market equates to better business.

Another gain is that healthcare compliance boosts communication, collaboration, and communication between staff and even between providers in the healthcare industry.

Lastly, developing compliance plans means having a well thought out mitigation process which helps arrest staff concerns or acts of fraud before they can affect the core of an organization’s systems.

How HITECH’s Compliance Impacts HIPAA Business Associates

Business Associates play a key role in the supply chain. For this, any business associates working under the Medicaid umbrella are compelled to observe the Non-Emergency Medical Transportation regulations.

The regulations outline the way the business associates should handle any information they collect in the line of duty.  Specifically, the associates should ascribe to set HITECH and HIPAA regulations.  Your organization is also charged with ensuring that the business associates you are working with follow set rules and regulations to the later.

Empowering your Board of Directors on HITECH and HIPAA

The board of directors is an important organ of any organization and, as such, you should ensure that your company’s board members are appraised on compliance issues. The members should be trained on the different subsets of HIPAA and HITECH as well as the implications of being compliant or otherwise. Training should thus be extended to the board of directors so that members of the board can understand about the compliance and its implications.

Once trained on healthcare compliance, the board act as an independent arm that helps keep the organization on the right side of the law.

Healthcare compliance gives you freedom from fraudsters and law enforcement agencies. It also earns you trust and respect from patients that you have attended to and continue to serve in the field. This can only earn you more businesses thus ensuring your organization is on an upward growth trajectory.

Author Bio

Ken Lynch is an enterprise software startup veteran, who has always been fascinated about what drives workers to work and how to make work more engaging. Ken founded Reciprocity to pursue just that. He has propelled Reciprocity’s success with this mission-based goal of engaging employees with the governance, risk, and compliance goals of their company in order to create more socially minded corporate citizens. Ken earned his BS in Computer Science and Electrical Engineering from MIT.  Learn more at

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