Answers to the Most Common Compliance FAQs

Sarah Jones
Medical staff looking at a computer and learning together

Adhering to regulatory guidelines and ethical standards is of the utmost importance in every healthcare setting. Yet, navigating the intricacies of healthcare compliance can be daunting. It’s why we’ve compiled a series of the most common healthcare compliance FAQs and their answers.

Any healthcare professional curious about compliance practices will find these answers helpful, insightful, and empowering. More importantly, understanding them will help you make informed decisions and maintain the highest standards of integrity in practice. 

Let’s delve into the world of compliance with answers to the most common compliance FAQs.

What Is Healthcare Compliance?

Healthcare compliance refers to the process of adhering to the laws, regulations, and ethical standards that govern the healthcare industry. It ensures that healthcare organizations and professionals follow guidelines to protect patient safety, maintain data privacy, and uphold the integrity of medical practices.

Why Is Compliance Important?

Compliance is crucial in healthcare to safeguard patients’ well-being, maintain trust in the industry, and avoid legal and financial repercussions. It also helps prevent fraud, abuse, and errors, ensuring the delivery of high-quality care and ethical decision-making. Compliance needs to be a top priority at every facility and across every healthcare organization. 

What Are Some Common Healthcare Compliance Regulations?

Some common healthcare compliance regulations include the Health Insurance Portability and Accountability Act (HIPAA) for patient privacy, Stark Law for physician referrals, Anti-Kickback Statute for healthcare fraud and abuse, and the Affordable Care Act (ACA) for various provisions related to healthcare organizations and insurance providers.

What Is HIPAA and How Does It Impact Healthcare Compliance?

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law in the United States that protects patients’ health information, and ensures its confidentiality and availability. It impacts healthcare compliance by requiring organizations to establish safeguards, privacy practices, and policies to protect patient data and maintain compliance with HIPAA regulations.

What Are the Consequences of Non-Compliance?

Non-compliance can lead to severe consequences, such as legal penalties, fines, exclusion from government programs, loss of licenses, and even criminal charges for individuals knowingly involved in violations. Non-compliance also affects the reputation of the provider or organization, and can lead to rippling effects that have financial consequences. 

What Is a Compliance Officer?

A Compliance Officer is an individual responsible for overseeing and implementing compliance programs within a healthcare organization. Their role involves developing policies, conducting audits, training staff, and ensuring the organization operates within the bounds of applicable laws and regulations.


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How Often Should Compliance Training Be Conducted?

Compliance training should be conducted regularly and consistently across any healthcare organization. Annual healthcare compliance training is a common practice, but some organizations may choose to provide more frequent training, especially when there are significant regulatory changes or updates.

How Can Technology Assist With Compliance?

Technology can play a vital role in healthcare compliance by automating processes, enhancing data security, and streamlining auditing and reporting procedures. Software solutions can help centralize critical compliance documentation, track training completion, identify potential compliance gaps, expedite provider credentialing, and more.

Are There Specific Compliance Requirements for Electronic Health Records (EHR)?

Yes, there are specific compliance requirements for Electronic Health Records (EHR). Healthcare organizations must adhere to the Health Information Technology for Economic and Clinical Health (HITECH) Act, which outlines guidelines for the secure use and exchange of electronic health information. Compliance includes data encryption, access controls, audit trails, and safeguards against data breaches.

How Can Healthcare Organizations Stay Updated With Changing Compliance Regulations?

Organizations can stay up to date with evolving regulations by actively monitoring updates from regulatory agencies, participating in industry conferences and webinars, engaging with professional associations, and utilizing compliance consulting services. Regularly reviewing official websites and publications from regulatory authorities is also essential.

Are Safety Data Sheets (SDSs) Required in a Healthcare Environment for OSHA Compliance?

Yes, Safety Data Sheets (SDSs) are required for Occupational Safety and Health Administration (OSHA) compliance. An SDS provides detailed information about hazardous chemicals and substances used in the workplace related to a specific product, ensuring healthcare staff have access to essential safety information. Compliance software can be particularly useful for cataloging and storing the appropriate SDSs for a facility or particular healthcare setting. 

What Are Exclusion Checks and Are They Necessary?

Exclusion checks refer to the process of screening individuals and entities against government exclusion lists, such as the Office of Inspector General – List of Excluded Individuals/Entities (OIG-LEIE). Exclusions checks are necessary for healthcare compliance to ensure that no excluded individuals or entities receive federal healthcare program reimbursements or employment in federally funded healthcare programs.

What Is Included in Primary Source Verifications?

Primary source verifications in healthcare compliance involve directly verifying credentials, qualifications, and other relevant information from the original source. This process typically includes confirming educational degrees, licenses, certifications, work history, and references. It’s a prerequisite for any newly hired provider before they can begin to treat patients at an accredited healthcare facility. 

What Is an Assessment of Risk and Do I Need One?

An Assessment of Risk — also known as a Risk Assessment — is a systematic evaluation of potential risks and vulnerabilities within a healthcare organization. It helps identify and prioritize areas of non-compliance or security weaknesses. Conducting a Compliance Risk Assessment is crucial for healthcare organizations to proactively address compliance gaps and mitigate potential risks.

What Is a Security Risk Analysis (SRA)?

A Security Risk Analysis (SRA) is a mandatory requirement under the HIPAA Security Rule. It involves assessing and identifying potential risks to the confidentiality, integrity, and availability of electronic protected health information (ePHI). The SRA helps healthcare organizations implement appropriate safeguards and security measures to protect patient data and comply with HIPAA regulations.

MedTrainer Helps Raise the Bar for Compliance

Hopefully, the above answers to common compliance FAQs are helpful to you! If you’re looking to move from information to action and set a higher standard of compliance for your facility, reach out to MedTrainer.

MedTrainer Compliance digitizes healthcare compliance with a robust document center that pulls all your organization’s policies, incident reports, safety plans, HR documents, contracts, and more in one place where all employees can access. It’s the all-in-one software tool you need to prioritize compliance across every facility, person, and process. Contact us today to schedule a free demo.