During this unique time in public health history, as a society we have adapted — in many ways for the better. This includes the growth of telehealth as a delivery model of services traditionally provided within physician offices and medical centers. However, this rapid adaption of telehealth brought with it unforeseen — maybe even initially ignored for the sake of innovation — consequences, including a spike in fraud, waste, abuse, and other core healthcare compliance principles.
The federal government at the onset of the COVID-19 crisis waived many healthcare compliance rules in order to ensure individuals were able to maintain relationships with their providers. These adjustments included HIPAA security and privacy requirements, co-payments, and co-insurance rules.
However, many other federal and state compliance rules that dictate the delivery of healthcare are still as relevant as ever. If they are not followed, an organization or healthcare provider will stand to lose big — not just in monetary figures, but also damage to the brand and the provider’s ability to serve as healthcare professional in the future.
Then there’s the issue of individuals getting involved in setting up the organizations. Yes, partnerships in the healthcare and tech arenas can develop into tremendous advancements. But it’s important for those without an understanding of the healthcare regulatory environment to receive counsel on the laws and regulations that dictate how they and their companies can provide services to patients — whether those are covered by government insurance, commercial payors, or private pay.
Telehealth corporate operations that do not implement a compliance structure for the healthcare regulatory environment — which controls everything from hiring to reimbursement — is a major red flag for investors and anyone who works for the organization.