Health Care Enforcement and Compliance Matters Prevention, Compliance, Advocacy

12 Enforcement and Compliance Predictions for 2012

By Frank Sheeder on Posted in Culture, DOJ, Enforcement, Government Initiatives, ICD, Implantable Cardiac Devices, Long Term Care, Medicaid, Medicare, OIG, Reform, Settlements

This has been an interesting year for the health care industry, and I believe the coming year will be even more exhilarating.  Here are my 12 enforcement and compliance predictions for 2012.  Please comment with yours.  We’ll see how we do. . . .

 

  1. Regardless of what happens with the health care reform law, the current market forces toward collaboration, integration, efficiency and quality will continue.
  2. At the same time, there will be much more Stark and Anti-kickback enforcement as the government steps up its scrutiny of hospital-physician relationships.
  3. Medicaid enforcement will increase dramatically as the federal government pressures the states and the states endeavor to deal with funding pressures.
  4. HIPAA enforcement will increase, and there will be more unfortunate and costly breaches as we implement more electronic records.
  5. The DOJ/HHS HEAT initiative will ensnare some mainstream, institutional providers.
  6. The HHS-OIG will more aggressively target hospitals through its current intensive hospital audits.
  7. Many of the Implantable Cardioverter Defibrillator (ICD) investigations of hospitals across the country will be resolved.
  8. The government and whistleblowers will increasingly target long term care, home health and community care.
  9. While there will be large hospital settlements, device and pharmaceutical companies will write the biggest checks.
  10. The HHS-OIG will seek to exclude more individuals who are associated with organizations that had compliance lapses.
  11. The Health Care Compliance Association (HCCA) will continue to grow steadily and to serve its members’ needs assiduously.
  12. There will be increased demand for strong compliance professionals as smart leaders continue to recognize their value.

What are your predictions?