To alleviate some of the challenges and administrative burdens of COVID-19, Congress and federal agencies have relaxed certain regulatory requirements and compliance standards. However, since this more flexible regulatory environment is likely to be temporary, healthcare providers must develop controls to respond and monitor in the short term, and retrospectively review processes once the COVID-19 outbreak subsides.
This issue brief – Compliance Can’t Wait – provides a comprehensive overview of the risk and compliance actions triggered by new regulatory guidelines. For example:
- Temporary billing privileges for non-certified Part B providers and out-of-state providers require developing, documenting, and/or assessing internal controls for provider enrollment.
- More generous Medicare payment models require reconciliations of claims to assess expected vs. actual reimbursements.
- Looser virtual care restrictions require claims audits to identify accuracy, completeness, and appropriateness of virtual services offered.
For more information on how to balance compliance and regulatory oversight obligations during the COVID-19 outbreak, please click here.