Academic journal article Frontiers of Health Services Management

Legal and Compliance Issues in the Dynamic Context of Healthcare Today

Academic journal article Frontiers of Health Services Management

Legal and Compliance Issues in the Dynamic Context of Healthcare Today

Article excerpt

As they work to stay on top of the myriad changes occurring in the healthcare environment, hospitals and health systems face unique legal and regulatory issues that affect their operations and financial position. Leaders must correctly interpret laws and regulations and be able to clearly communicate their importance to staff, physicians, board members, and consumers.

Providers want to use current technology to reach consumers and provide care where and when patients need it. Telehealth, e-consults, physician e-visits, patient engagement apps, direct care delivery apps, mobile devices, social media, and web portals can help meet those expectations, but these innovative approaches also increase the potential for breaches in data privacy and security. Safeguards must be in place to protect health information and data across the continuum of care because monetary penalties for failure can be substantial.

Fraud and abuse top the list of legal concerns for healthcare providers as they endeavor to improve operations and care delivery. Antitrust actions, financial relationships with physicians, accountable care incentives, kickback considerations, and new inducements in healthcare reform present possible financial pressures and exposure to enforcement penalties. It is imperative that healthcare organizations identify the laws, regulations, and trends that affect their industry and develop effective policies, procedures, and strategies to address them.

So how do healthcare organizations stay up to date with regulatory changes and minimize their risk? What are the most pressing regulatory and policy concerns? This issue of Frontiers of Health Services Management looks at those questions and provides a variety of informed perspectives from experienced healthcare leaders.

In his feature article, Joseph Baar Topinka, JD, FACHE, of Texas State University, reviews important legal and regulatory issues that can overwhelm healthcare organizations and lead to costly consequences for noncompliance. "Healthcare leaders do not want to be in violation or end up embroiled in a costly lawsuit; more important, they want to do the right thing," Topinka advises. "Staying aware of current issues and ready for potential future challenges can position leaders to do the right thing for their organizations and their communities. …

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