PriceWaterhouseCoopers Release Report in Relation to HIPAA Compliance

The state of healthcare compliance in the US has been reviewed by PriceWaterhouseCoopers, following a survey carried out this summer. A report on the survey findings has now been released with the results showing that compliance is often not being given the importance it should be.

Healthcare Chief Compliance Officers are often part time roles while 43% of respondents claimed they “are responsible for other functions and those other duties and responsibilities generally took precedence over compliance.” There was also the impression that more could be done to improve compliance and to raise its perception and profile within groups.

Compliance clearly is not forefront in the minds of all senior management and board members when decisions are made relating to day to day running or even for strategic future planning. Since compliance is not a profit making function, it is essential for
CCOs to convince board members of the value to be had from introducing and maintaining a compliance program.

One problem found was the fact that budgetary constraints are hampering compliance efforts. Ten percent of the survey respondents said that reductions in budgets from the previous year were an issue.

The financial restrictions in health care organizations often sees funding allocated to other areas that have an impact on treatment outcomes in order to stay competitive rather than the investment being made to ensure compliance is being maintained. The survey data portrayed that the allocation of resources to compliance issues is often problematic, with half of the participants in the survey reporting a number of less than five FTE’s working on areas of compliance.

Financial sanctions can seriously hurt organizations, as can damage to reputation from security breaches. HIPAA privacy and security measures are a vital area of concern for CCOs, especially with HHS Office for Civil Rights privacy audits soon to begin.

The survey also emphasized the main dangers CCOs perceive as being a threat to the business:

• Privacy and confidentiality
• Industry-specific regulations
• Security and safety
• Fraud
• Conflicts of interest in a company

Compliance committees are still being formed and are now being adopted by 88% of respondents, a 3% increase on last year’s figures. Departments serving on the boards include compliance, finance, HR, Ops, IT and business, internal audit and legal departments. However, more recently data analysts have been asked to participate and advice and assistance is being sought from experts with business and clinical management know how to ensure compliance becomes an integral part of every decision taken.

The outlook seems good and CCOs think that they can be successful and ensure compliance is given the focus it demands, although it is clear that there is still some progress to be made.