Medicare Compliance & Reimbursement

Tip: Check with your state's minimum wage standards to avoid reprisals.

It's no surprise that the importance of a practice's human resources departments coupled with a rise in policy standards has greatly influenced the subsequent increase in litigation in the United States. And healthcare providers more than most need to be fully aware of the repercussions of falling short on employee safety, welfare, and salary requirements.

At MGMA16, speaker Marcia Brauchler, MPH, FACMPE, CPC, COC, CPC-I, CPHQ gave attendees the lowdown on six important HR compliance areas that all medical practices should be paying attention to:

1. Non-Discrimination: The U.S. Equal Employment Opportunity Commission (EEOC) enforces the Civil Rights Act of 1964 (Title VII). The EEOC may file claims in federal court, which could result in your practice having to pay substantial civil damages and losing your good reputation, Brauchler points out.

Reference: Title VII of Civil Rights Act of 1964 https://www.eeoc.gov/laws/statutes/titlevii.cfm.

2. Sexual Harassment: "Sexual harassment is a form of sex discrimination that violates Title VII of the Civil Rights Act of 1964," Brauchler explains. Penalties that can result from litigation against your practice include lost wages, compensatory damages, and punitive damages.

Reference: https://www.gpo.gov/fdsys/pkg/CFR-2011-title29-vol4/xml/CFR-2011-title29-vol4-part1604.xml.

3. Family Medical Leave Act: If your practice has 50 or more employees, your employees are entitled to up to 12 weeks of "job-protected leave during any 12-month period for the birth of a child, care of immediate family member, employee's own serious health condition, or immediate family member is on active military duty," Brauchler says. The law was passed in 1993 and is enforced by the Department of Labor, Wage and Hour Division. Non-compliance can result in civil actions by employees.

Reference: https://www.dol.gov/whd/regs/statutes/fmla.htm.

Poster for Your Break Room Available at: https://www.dol.gov/whd/regs/compliance/posters/fmlaen.pdf.

4. Fair Labor Standards Act (FLSA): This statute governs minimum wage and overtime pay and is enforced by the DOL Wage and Hour Division. Non-compliance can result in lawsuits by employees to recover lost back pay and damages.

Reference: https://www.dol.gov/whd/flsa/.

5. Americans with Disabilities Act (ADA): If your practice has 15 or more employees, the ADA "prohibits discrimination in hiring, promotions, training, pay, social activities, and other employment privileges" based on disability, Brauchler reminds.

References: Statute: https://www.ada.gov/pubs/ada.htm.

Guidelines: https://www.ada.gov/cguide.htm.

Q&A: >https://www.ada.gov/archive/q&aeng02.htm.

6. Occupational Safety and Health Act of 1970 (OSHA): Enforced by the agency that bears the same name, these regulations apply to all workplaces. Penalties can be up to $63,000 per instance, Brauchler notes.

The good news: The guidelines available on OSHA's website are admirably clear and easy to follow, especially if you've become accustomed to sweating through confusing compliance guidance from CMS.

Tip: If you run across a compliance consultant who wants to sell you "an OSHA training program" for your practice, don't shell out any money until you check out what's available on OSHA's website for free. It's highly likely the site has all the resources and training materials you need, so save your outsourcing budget for other kinds of compliance help.

The OSHA standards most relevant to physician practices are:

• Bloodborne Pathogens
• Hazardous Chemicals
• Exit Routes
• Electrical
• Reporting occupational injuries and illness (state law)
• OSHA Poster
• Ionizing Radiation (if you have machines like X-ray)

Handy, Free OSHA References

Statute: https://www.osha.gov/law-regs.html

Compliance Assistance Quick Start for Health Care: https://www.osha.gov/dcsp/compliance_assistance/quickstarts/health_care/

OSHA Guidelines about standards most relevant to physician practices: https://www.osha.gov/Publications/osha3187.pdf.

Poster: https://www.osha.gov/Publications/poster.html.