CORPORATE GOVERNANCE IN THE HEALTHCARE INDUSTRY:

Introduction:

Regulatory compliance in healthcare industries

What does it mean?

So to understand, we analyze the key terms.

Key Terms :

• Regulatory Compliance.

• Healthcare Industries.

Regulatory Compliance:

It means to comply with or follow regulations framed by the governing authority in this respect.

Healthcare Industries:

It refers to that sector of the industry that relates to Healthcare. In other words, the primary operation of that industry is focused on the health aspects. Health is key to success in the achievement of all goals. A healthy person and a healthy mind effectively contribute to the economy's growth and the country's development.

So, it can be said that compliance plays a vital role in a highly regulated, high-risk industry like Healthcare.

Healthcare compliance is the process of complying with rules and regulations and laws that are being framed by governing authorities for healthcare industries. For example, in the case of the COVID-19 crisis, there were norms framed by governing bodies like wearing a mask, maintaining social distance, and various other norms which were to be compulsorily followed by all.

It covers a wide range of practices comprising internal as well as external rules. But mainly, it covers patient safety, information related to the patient to be private, and billing procedures.

Compliance in Healthcare, Why So Important?

Compliance is important in all sectors, but in Healthcare, it's crucial. If a doctor or supporting staff does not comply with practices and procedures, it may lead to an adverse effect on the health of the patient, and it may also result in the patient's death.

So these procedures and practices are focused on the best quality patient care, and by complying with industry standards, healthcare organizations can improve the quality level of patient care.

Suppose the organization fails to comply with these practices being framed by the central and state governments. In that case, it may also lead to the cancellation of the registration certificate of that organization and also various civil as well as penal consequences.

Requirements for Healthcare Compliance

Both central and state-level governments frame rules and regulations for healthcare compliance. So, every organization should be updated with all these rules and put the amendments into effect.

A list of a few governing bodies and federal regulations that govern healthcare compliance are as follows:

• The Social Security Act is being framed to deal with aspects regarding funding and requirements for Medicare, Medicaid, CHIP, and more.

• HIPAA and the HITECH Act regulates aspect that deals with confidentiality of patient data and policies to be followed for maintenance of such confidentiality.

• The Patient Protection and Affordable Care Act was designed to deal with aspects related to insurance and other related aspects.

• The Drug Enforcement Administration and the Food and Drug Administration deal with e creation and distribution of medication.

A compliance officer is appointed, or a department is established for compliance.

It's not limited to only this; all levels of management have a role in this compliance as compliance can be effective only when all levels of management comply with these policies and procedures. Accountability, transparency, and ethical norms should be practised for effective compliance.

Patient Data Confidentiality

It is of utmost importance in the health care industry. Many laws are enforced to maintain doctor-patient confidentiality. Though there are also standards where patient information may be disclosed, such as HIPAA.

Privacy and information security play a vital role as they correlate with the quality of care level. Also, if this information is disclosed, it may lead to financial and other losses to the patient.

As it is the era of the digital world, laws have also been framed, like Information Technology Act, 2000, as amended from time to time. All data is collected and recorded on mobile and various other recording systems.

Scheduling Healthcare Compliance Events

The Office of the Inspector General deals with healthcare compliance. He has been authorized to provide material concerning compliance and to provide guidelines for healthcare compliance. Few of them are below mentioned :

1. Plan, distribute and implement written policies, procedures, and standards of conduct.

2. The OIG suggests that policies and procedures include coding, overpayment, conflict of interest, privacy, non-retaliation, and policies that address regulatory requirements.

3. Moreover, employees must have access to all the above.

4. A policy management software must be developed to create and distribute policies and procedures and update them as per changes in governing rules and regulations.

5. An effective training program must be conducted from time to time so that employees may feel easy to comply with these regulations.

6. A training management software must be there for online training, at it can be made more effective by organizing quizzes, etc.

7. Employees must also be well updated on the consequences of these rules and regulations violations.

8. Various audit programs must be scheduled for monitoring compliance, and questionnaires must be set up so that employees share their difficulties, if any, concerning compliance.

9. Corrective action must be implemented as soon as possible if compliance is not proper to avoid various legal and other consequences.

Conclusion:

So, in a nutshell, it may be concluded that healthcare compliance plays an important role; it has to comply effectively with the combined effects of all levels of management and governing bodies.

References:

• Definition of compliance in healthcare (2020). PowerDMS. (n.d.). Retrieved July 26, 2022, from https://www.powerdms.com/policy-learning-center/definition-of-compliance-in-healthcare

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