The emerging enforcement of quality of care poses challenges and opportunities for hospitals and health care providers. Foley Partner Janice A. Anderson and Associate Nathaniel M. Lacktman explained the government’s three-pronged approach:
- Incentivizing quality of care through payment reform
- Driving quality of care through public reporting
- Enforcing quality of care through the False Claims Act
Many health care organizations are hampered in providing consistent quality of care and are simply unaware of their compliance vulnerabilities. Organizations scrutinize compliance concerns such as billing and claims submission or physician financial relationships, but overlook their quality of care processes. Moreover, a hospital’s compliance program traditionally is separate and distinct from its quality improvement and peer review programs. That type of traditional structure does not permit the information exchange necessary to recognize and address the compliance risks that can arise from poor quality of care.
Hospitals, physician groups, health care executives, and in-house counsel can benefit from this presentation and its accompanying materials.
