Foley's Top 10 Hospital Compliance Challenges for 2008

Foley’s Health Care Industry Team is frequently asked to assist clients in identifying key compliance risks on an industry-wide basis. Foley Partners Maria E. Gonzalez Knavel and Lawrence W. Vernaglia presented our best estimates for the “top 10” compliance risks for hospitals and health systems in 2008. Of course, every hospital has its own unique set of challenges, and the list below is not meant to be exhaustive nor to exclude other issues from compliance review.

• Medicaid — Deficit Reduction Act (DRA) and False Claims Act


• Board of directors involvement — structural issues


• Centers for Medicare & Medicaid Services (CMS) data mining implications


• Recovery audit contractor (RAC) audits and other new predators


• Research, clinical trials billing, time, and effort reporting


• Medicare severity diagnosis related groups


• Present On Admission and Hospital Acquired Conditions


• “Supplemental” and certification/status payments


• Stark Phase III — physician-hospital relations


• Quality