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By Adam Turteltaub
adam.turteltaub@corporatecompliance.org
It’s a busy time in the managed care industry, reports Carolyn Barton, the Vice President Compliance and Regional Compliance Officer for Kaiser Permanente Washington. There are new entrants, evolving models of care and more communication with patients than ever before. At the same time, she notes in this podcast, regulators are actively calling for more affordability, focusing on quality and service improvements and driving for more transparency and accountability.
But, focusing on these issues, as important as they are, is not enough, Carolyn points out. One other issue is as critical for managed care today as it is for many other industries: the #MeToo movement. Healthcare is not immune and has been dead center of some of the larger cases. Managed care entities need to focus on building or strengthening a speak-up culture, understand how their third parties are acting, educate themselves and address this issue.
At the same, they can’t lose sight of other risk areas. HIPAA is still a significant concern and requires strong data governance. To help stem the opioid crisis managed care compliance professionals need to both stay on top of fast-changing requirements, and help ensure that the clinical, leadership and operations teams are all working together to meet these new obligations.
Tune in to hear more.
Considering the very vital and delicate nature of the roles of health care compliance professionals in particular and the compliance profession in general , it’s important that regulatory mechanisms are strengthened to form a protective hedge around their activities against unscrupulous , desperate and opportunistic individuals or groups who might try to capitalize on any little chance or opportunity in the course of their activities to achieve their nefarious aims.. . In such cases even the least accidental, unintentional and coincidental acts on the part of the health care professionals could be so much magnified and faked into a norm or an acceptable practice, by such desperate individuals which in my opinion must not be tolerated at all in other words such groups or individuals must not be allowed to waste our time or drag our profession into disrepute. Personally I think only modern, and relevant healthcare practices must gain the necessary approvals from our regulatory authorities .
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