Increased Scrutiny on the Horizon for Healthcare Industry in 2024

The healthcare industry is bracing for a wave of new regulations and heightened enforcement in 2024. The U.S. Department of Health and Human Services (HHS) is leading the charge, with backing from other agencies like the Department of Justice (DOJ) and the Federal Trade Commission (FTC). These new measures target a wide range of areas, including anticompetitive practices, private equity ownership in healthcare, the use of artificial intelligence (AI), and cybersecurity measures protecting patient data.

A key focus area is anticompetitive practices within healthcare. The government is concerned about mergers and acquisitions, particularly those involving private equity firms and health insurers, potentially creating monopolies and harming patients. These “roll-up” deals will face intense scrutiny by a newly formed task force composed of the DOJ, FTC, and HHS. This collaboration will involve increased data-sharing between agencies to identify and address potential antitrust violations before they occur.

Private equity firms investing in healthcare, especially nursing homes, will face new transparency requirements regarding ownership structures. New regulations from the Centers for Medicare & Medicaid Services (CMS) require detailed disclosures about governing bodies, officers, and any additional parties with a financial stake in these facilities. This information will be used by CMS to monitor the quality of care provided and hold owners accountable for any shortcomings.

The rapid adoption of AI in healthcare has prompted concerns about responsible implementation. To address these concerns, the HHS established an AI Task Force in January 2024. This task force is tasked with developing a plan that focuses on crucial areas such as ensuring proper human oversight of AI systems and long-term safety monitoring of AI technology in real-world healthcare settings. Mitigating bias within AI algorithms is another critical focus, and the plan will establish data privacy and security standards to protect sensitive patient information used by AI systems.

Healthcare organizations are expected to significantly strengthen their cybersecurity measures to safeguard patient data. The potential for increased penalties for violations of the Health Insurance Portability and Accountability Act (HIPAA) is a strong motivator for improved data security practices. Furthermore, the Cybersecurity and Infrastructure Security Agency (CISA) will play a more prominent role in ensuring robust cybersecurity practices are implemented throughout the healthcare industry.

Healthcare organizations across the board are advised to take proactive steps to comply with these new regulations and enforcement initiatives. Staying informed about guidance documents issued by regulatory agencies will be crucial for navigating this evolving landscape. Chief compliance officers and risk management professionals should conduct a thorough review of existing practices and make adjustments to ensure alignment with the new regulatory environment.

This increased scrutiny signifies the government’s commitment to fostering fair competition within the healthcare industry, prioritizing quality care, and ultimately ensuring patient safety. The year 2024 promises to be a period of significant change for the healthcare industry, and how these regulations are implemented will have a lasting impact on patients, providers, and healthcare delivery as a whole.

Sources:

https://www.navex.com/blog/article/healthcare-organizations-are-facing-increased-scrutiny-heres-what-you-need-to-know/

 

 


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