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PriceWaterhouseCoopers Report on HIPAA Compliance

The state of healthcare compliance in the US has been assessed by PriceWaterhouseCoopers, following a survey conducted this summer. A report on the survey findings has now been issued with the results indicating that compliance is often not being given the importance it requires.

Healthcare Chief Compliance Officers are often part time positions 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 a feeling that more could be done to improve compliance and to raise its perception and profile within organizations.

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

One problem raised was the fact that budgetary constraints are hampering compliance efforts. Ten percent of the survey respondents claimed that reductions in budgets from the previous year were a problem.

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The financial pressures on 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. The survey data showed that allocation of resources to compliance issues is often problematic, with half of the participants in the survey reporting less than five FTE’s working on areas of compliance.

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

The survey also highlighted the main risks CCOs perceive as being a threat to the business:

• Privacy and confidentiality
• Industry-specific regulations
• Security
• Fraud
• Conflicts of interest

Compliance committees are still being used and are now being adopted by 88% of respondents, up 3% 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 invited to participate and advice and assistance is being sought from experts with business and clinical management experience to ensure compliance becomes an integral part of every decision made.

The outlook looks good and CCOs believe they can be successful and ensure compliance is given the importance it demands, although it is clear that there is still some way to go.

Author: Steve Alder is the editor-in-chief of HIPAA Journal. Steve is responsible for editorial policy regarding the topics covered on HIPAA Journal. He is a specialist on healthcare industry legal and regulatory affairs, and has several years of experience writing about HIPAA and other related legal topics. Steve has developed a deep understanding of regulatory issues surrounding the use of information technology in the healthcare industry and has written hundreds of articles on HIPAA-related topics.