Many of you will start the new year making resolutions. The same should be true for your practice.
Just like making a personal resolution, practice resolutions should be made after reflecting on concerns or issues that may have occurred throughout the year and how improvements can be made moving forward. Having worked with professional practices for many years, I’ve found the following to be good starting points for thinking about meaningful resolutions as we head into 2022.
1. Review corporate contracts.
Many practices continue to operate off old documents that are sorely outdated. The parties actually may be applying compensation or other formulas that do not match the written agreements, which could result in an unexpected wage claim or other legal dispute for not following the documents.
Similarly, a retiring owner of a practice may be on the receiving end of an overly rich severance formula or buy-out computation that harms a practice because of documents that were written when the practice was more financially successful. Most importantly for healthcare practices, it is essential to review all corporate documents regularly to assure ongoing compliance with state and federal healthcare laws. This coming year, every practice should make it a project to work with healthcare counsel to review their documents and revise and update as needed.
2. Review HIPAA policies and training.
When HIPAA was first released, professional practices brought in consultants, purchased educational programs, and had personalized HIPAA manuals created. Many organizations have become lax about HIPAA training and fail to educate or enforce the law, which puts them at risk for substantial liability and fines for noncompliance.
In 2022, every practice should confirm that it has a Business Associate Agreement with third parties that might access any practice records or patient information and arrange for updated training for staff. It may also be time to dust off old HIPAA policies and work with legal counsel to make sure they are still meaningful and reflect the practice’s operations. HIPAA has changed over the years, so it is essential to make sure your policies and procedures reflect current HIPAA requirements.
3. Make sure the practice’s operations are compliant with state and federal health laws (ie, Stark and Anti-Kickback).
Almost every possible arrangement that includes a healthcare provider implicates some state and federal laws. If there is any third party to which the practice refers/receives referrals and/or has any financial arrangement, these relationships should be reviewed for compliance regularly.
Practices should work with knowledgeable healthcare counsel to review all contractual arrangements that may implicate healthcare laws, including management agreements, leases, marketing agreements, contractor agreements, and many others. These documents may need to be amended to reflect the actual arrangement of the parties or terminated if the arrangement is no longer in place. Oral arrangements may also need to be documented.
4. Review the practice’s policy manual and update as needed.
In addition to updating a manual to reflect the practice’s current policies, practices should review their manual to assure compliance with state and local laws, which may affect issues like disability leave, sick days, and maternity leave. Practices need to be sure that any new or modified policies from 2021 (ie, vaccination requirements) are addressed in the policy manual and are shared with all parties.
5. Do a financial audit.
Practices benefit tremendously when they spend time with their accountant/financial advisors reviewing the practice’s financial performance.
Are there costs that were too high? How are each of the providers performing? What additional lines of business or products should the practice explore to increase its revenue? Can it afford to bring on a new provider? Like any business, a practice needs to be savvy about reviewing its books and planning strategically for growth and profitability.
It’s also important to consider an audit of the practice’s billing by an outside auditor on an annual basis as part of an ongoing effort to ensure compliance with the law and to allow for education and correct any incorrect billing practices. Practices that have not done annual audits should resolve to start in 2022.
It’s easier to make resolutions than to stick with them. Practices should focus on developing a meaningful list of goals that are reasonably achievable, with special attention on areas where they perceive the greatest risk.
Spending a little time planning will make for a smoother and more successful 2022!
About Ericka Adler
Ericka L. Adler, JD, is a shareholder and health law practice group manager for Chicago-based law firm
Roetzel. She has nearly 25 years representing individual providers, physician groups, and other healthcare entities, focusing on regulatory and transactional healthcare law. Adler is also skilled in compliance counseling, handling mergers, sales and acquisitions of healthcare entities, and has deep experience with Stark, Anti-Kickback Statute, and other challenges facing healthcare professionals.
She also works with providers in HIPAA, fraud and abuse, billing audits, government investigations, and contract disputes.