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2004's top compliance focus areas

Case Management Weekly, February 11, 2004

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As you prioritize your compliance plan for 2004, consider where other professionals will devote their time and resources.

1. Quality of care
Quality of care is an underlying aspect of the Office of Inspector General's (OIG) 2004 Work Plan and the agency included it in most of its hospital audits and investigations. For example, billing for services not rendered and providing medically unnecessary services will become part of a larger quality of care issue.

2. Auditing and monitoring
Focus your monitoring efforts on coding, medical record documentation, and HIM compliance policies and procedures. These areas continue to show up on the government's radar.

3. Pharmaceutical compliance
Ensure your organization has definitive policies and procedures for interacting with drug and device sales reps.

4. HIPAA security
Make compliance with the HIPAA security rule a top priority this year. Now that your organization has successfully implemented the privacy rule, focus on electronic and physical security.

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