Regulatory Compliance.

Regulatory compliance is central to health care business operations. State and federal governments develop and enforce regulations. To comply with these regulations, it is incumbent upon health care entities to create and implement effective compliance programs and plans. Regulatory compliance in health care typically focuses on safety, patient privacy, and billing practices. G2Z Law Group, PLLC is ready to ensure that your health care practice is in compliance with governmental rules and regulations.

Examples of government agencies regulate health care businesses.

The U.S. Department of Health and Human Services (HHS) houses several health care agencies, including the Office of Civil Rights (OCR), Office of the Inspector General (OIG) and Center for Medicare and Medicaid Services (CMS). Health care businesses and practitioners interact with these federal agencies and offices depending on an applicable regulation. For example, OCR is responsible for enforcing Health Insurance Portability and Accountability Act (HIPAA) compliance and breaches of unsecured Personal Health Information, OIG investigates fraud and abuse under antikickback statutes and CMS enforces physician self-referral regulations (Stark Law) and oversees government-subsidized medical plans, including Medicare (elderly and persons with disabilities) and Medicaid (assistance based on income). CMS is also responsible for overseeing each state’s Children’s Health Insurance Program (CHIP).

Other federal agencies that fall under the HHS include:

• The Centers for Disease Control (CDC) (infectious disease prevention and response),

• The Food and Drug Administration (FDA) (safety of food and drugs),

• The National Institutes of Health (NIH) (research institute for health and science); and

• The Agency for Healthcare Research and Quality (AHRQ) (research for improved quality of health care).

This list is not exhaustive. The U.S. Department of Labor (DOL) also governs health care agencies through the Occupational safety and Health Administration (OSHA) and the Environmental Protection Agency (EPA). Many non-profit and non-governmental agencies provide important oversight functions in health care standards and guidance.

At the state level, state departments of health, licensing agencies and the states Attorney General Office can oversee and enforce healthcare regulations. Other state agencies may also implement regulations relating to different aspects of the healthcare practice. For example, the Colorado Department of Public Health and Environment provides state-specific regulation.

The number of regulations that apply to health care businesses can be overwhelming. Keeping track of which agency implements which rules can also be confusing, but G2Z Law Group has the knowledge and experience to help you sort through all the red tape.

What are the major areas of concern for health care regulation?

Many health care professionals develop compliance programs to ensure regulatory compliance with the following areas:

• Health care standards of care and implementation best practices,

• Medicare and Medicaid reimbursement and certifications,

• Anti-trust regulations that govern competition rules,

• Fraud and abuse standards regarding billing and organizational behavior,

• Health care technology including security and privacy of health information; and

• Health care provider regulation at the federal, state, and institutional levels.

What can G2Z Law Group do for my health care business?

Complying with the vast number of governmental and non-governmental agencies at the federal and state level is burdensome. Although a challenging task, the professionals at G2Z Law Group will provide your health care team expert guidance and advice to maintain compliance and reduce the risk of future litigation and enforcement costs. With our firm’s help, your business can avoid the pitfalls of regulatory compliance.