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BHA-FPX4006_Assessment 3-1.pptx

BHA-FPX4006_Assessment 3-1

pptx

School

Capella University *

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Course

4006

Subject

Health Science

Date

Jun 27, 2024

Type

pptx

Pages

19

Uploaded by PrivateSardine2365

VILA HEALTH Annual Healthcare Compliance Training Capella University BHA-FPX4006: Healthcare Regulation and Compliance PAGE 1

Training Outline PAGE 2 • Health Care Regulation, Accreditation, and Ethics Part One • Compliance Training Effectiveness Part Two

Part One PAGE 3  Regulations, Accreditations, and Ethics  Risks and Consequences of non-compliance  Analysis of Health Care Regulations  Ethical Considerations for Staff  Readiness for Compliance We will cover these topics:

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REGULATIONS  The Privacy Rule  Protects a patient’s personal health information submitted electronically  Applies to Healthcare Providers, Health Plans, and Clearinghouses  The Security Rule  Protects the confidentiality, integrity, and availability of ePHI  The HITECH Act  Requires covered entities and their business associates to report PHI breaches (III, G.B. M., 2013) PAGE 4

ACCREDITATIONS  The Joint Commission  Utilization Review Accreditation Commission  National Committee for Quality Assurance (Accreditation-Comparison-Tool.pdf) PAGE 5

ETHICAL CONSIDERATIONS  Respect for Autonomy  Beneficence  Nonmaleficence  Justice PAGE 6

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RISKS AND CONSEQUENCES OF NON-COMPLIANCE  Civil Monetary Penalties from DHHS and lawsuits from individuals involved in a PHI breach  Up to 5 years Imprisonment  Loss of licensing or certifications  Disciplinary action  Termination (III, G.B. M., 2013) PAGE 7

PRIVACY LAWS HIPAA was enacted in 1996, and its main goals are to  Ensure the portability of health insurance coverage  Combat healthcare fraud and abuse  Protect the privacy and security of health information PAGE 8

QUALITY STANDARDS  CMS establishes quality standards to ensure healthcare providers provide safe, efficient, and equitable care  Their standards aim to  Measure hospital performance  Incentivize physicians for accurate reporting PAGE 9

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PATIENT RIGHTS  To privacy and confidentiality  To receive information  To consent to or refuse treatment  To receive quality and respectful care (Department of Health and Human Services, 2022) PAGE 10

ETHICAL CONSIDERATIONS FOR STAFF  All employees must act with –  Integrity  Competence  Respect  Professionalism  Confidentiality (Hayes, 2023). PAGE 11

THE NEED FOR CONTINUOUS READINESS  Assists with:  Process Improvements  CMS/Medicare Requirements  Joint Commission Standards compliance and accountability measures (Joint Commission Resources, 2024) PAGE 12

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CONTINUOUS READINESS, cont’d  Reviewing policies and performing interventions  Audit Readiness  Accreditation, Patient Safety, Performance Improvements  Preparation for patients (Joint Commission Resources, 2024) PAGE 13

Part Two PAGE 14  Best Practices for Training  Motivation for Compliance We will cover the following topics:

BEST PRACTICES  Provide formal annual training and opportunities throughout the year  Include all employees of the organization  Be aware of literacy, cultural, and generational differences (OIG-HHS, May 5, 2024) PAGE 15

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BEST PRACTICES, CONT’D  Use engaging material with real scenarios  Minimize the length of the training  Evaluate the effectiveness of training (OIG-HHS, May 5, 2024) PAGE 16

PAGE 17

REFERENC ES PAGE 18 III, G.B. M. (2013). Managing Legal Compliance in the Health Care Industry. Jones & Bartlett Learning. https://capella.vitalsource.com/books/9781284075533 Department of Health and Human Services. (n.d.). Operating an effective compliance program. https://oig.hhs.gov/documents/provider-compliance training/944/OperatinganEffectiveComplianceProgramFinalBR508.pdf Continuous Service Readiness. Joint Commission Resources. (n.d.). https://www.jcrinc.com/products-and-services/advisory- services/accreditation-preparation/continuous-service-readiness/ Hayes, A. (2023, November 13). Code of ethics: Understanding its types, uses through examples. Investopedia. https://www.investopedia.com/terms/c/code- of-ethics.asp#toc-code-of- ethics-vs-code-of-conduct

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PAGE 19  Majumder, M. A., & Guerrini, C. J. (2016, March 1). Federal Privacy Protections: Ethical Foundations, sources of confusion in clinical medicine, and controversies in biomedical research . Journal of Ethics | American Medical Association. https://journalofethics.ama-assn.org/article/federal- privacy- protections-ethical-foundations-sources-confusion- clinical- medicine-and/2016-03  Department of Health and Human Services. (2022, January 19). Your rights under HIPAA . HHS.gov. https://www.hhs.gov/hipaa/for-individuals/guidancematerials-for- consumers/index.html REFERENCE S

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