6 compliance trends likely to affect your practice in 2016

Why This Topic Matters

Understanding the likely enforcement environment helps practices prioritize compliance efforts, governance, documentation, and vendor oversight. The article is relevant to organizations trying to anticipate regulatory pressure across federal and state agencies and to prepare for heightened scrutiny of operational and privacy practices.

Article Sections

1. Prediction 1: Big data and data analytics will become more important

   Discusses the growing role of data analytics in evaluating provider performance and reimbursement. It also notes broader visibility into payment transparency data.

2. Prediction 2: Federal agencies besides OCR will get in on the privacy and security enforcement action

   Covers expected continued attention to privacy and security enforcement and the involvement of additional federal agencies beyond the main health care privacy regulator.

3. Prediction 3: False Claims Act, kickback and related compliance will remain a front-burner issue

   Summarizes anticipated focus on fraud and abuse enforcement, including related compliance areas and documentation oversight.

4. Prediction 4: DOJ and OCR will focus more on individual liability

   Addresses expected enforcement attention on personal accountability within organizations and heightened scrutiny of individual conduct under federal programs.

5. Prediction 5: OCR will examine business associate relationships

   Describes increased scrutiny of business associate relationships, audit activity, and associated contractual and oversight considerations.

6. Prediction 6: States will increase enforcement activity

   Covers expected growth in state-level enforcement efforts affecting providers, including actions by state authorities in areas where they have jurisdiction.