Facing an uncertain healthcare environment one thing is for sure, providers are confronted with regulation and oversight. The following list is a guide for issues any governmental funded clinic should be concerned with:
• False Claim Act allegations – Recent investigations have focused as much on minor kick backs (gift cards, free transportation, etc) to Medicare/Medicaid patients as they have to organizations who do not report and return overpayments.
• Wage and Hour claims – Plaintiff attorneys are filing suits alleging systematic unpaid overtime, employee misclassification, and failure to pay minimum wage. These have been especially prevalent in the healthcare industry where missed breaks and unexpected overtime are common.
• RAC Audits – The third party investigators have mainly focused on the largest and most profitable organizations but anyone accepting Medicare/Medicaid is at risk of fines.
• Anti-Trust – Mergers and Acquisitions are the main driver of Anti-Trust actions in healthcare. Reform is encouraging providers to combine to obtain economies of scale and a broader range of services, at the same time the FTC is strongly fighting many proposed non-profit tie ups.
• HIPAA/Hi-Tech compliance – Recent changes in laws are upping responsibilities and penalties for health care providers who lose patient information.
• Discrimination charges – Not a new issue but settlements and verdicts are on the rise once again.
• Wrongful Termination allegations – An uncertain economy and trouble in the job market is causing many dismissed employees to seek monetary relief wherever possible.
• Employee Theft – The complex contracting of health care not-for-profits is fertile ground for fraud and abuse of accounting controls.
Contact us today with any questions concerning these issues or to better protect your organization.