Regulatory Compliance, Health Care Law, and Ethics

Regulatory Compliance, Health Care Law, and Ethics
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Regulatory Compliance, Health Care Law, and Ethics
1 Regulatory Compliance and Health Care Law
Trust Hospice Service offers hospice and palliative care and complies with regulatory and quality while updating current practice, regulations, and laws.  The hospice and palliative care industry is a complex and challenging regulatory environment. The organization complies with various federal and state regulations, many of which are subject to periodic updates, revisions, and additions. The health care model focuses on patient satisfaction and value received.
Medicare Part A covers hospice services for those aged 65 and above.
Hospice and palliative care help terminally ill patients and families. People who qualify for hospice and palliative care are eligible for Medicare Part A (Hospital Insurance) or Medicaid.  Doctors and hospice directors must also certify that an individual is terminally ill. Chapter 400 - 2018 Florida Statutes (400.609 - Hospice services.) covers hospice services requiring that hospices provide hospital services allowing patients and their families to get care services tailored to patient needs and preferences (Online Sunshine, 2021). Besides core services, hospices in Florida provide hospice home care, residential hospice care, hospice inpatient care, and bereavement counseling (Online Sunshine, 2021).
Federal, state, and local laws, regulations, and guidelines
Chapter 400, Part IV, Florida Statutes, Hospice and Chapter 408, Part II, Florida Statutes, Health Care Licensing are the main Florida statutes on hospices. Chapter 408, Part II, Florida Statutes, Health Care Licensing, highlights aspects of health care licensing procedures that apply for licenses from the Agency for Health Care Administration (AHCA, 2021). Certification is required for the Medicare or Medicaid service provider to require licensure or certification. 
The 42 Code of Federal Regulations (CFR) §418 Hospice Care highlights provisions, definitions, and statutory basis for services covered in hospice care, including limitations on coverage and payment of hospice care (eCFR, 2021). The U.S. Code of Federal Regulations (CFR) also details Medicare regulations, quality reporting requirements, and appeals. Compliance with conditions of participation is a top priority for the Medicare hospice program, and Florida's requirements are based on Medicare hospice rules and laws. Another federal regulation is the Health Insurance Portability and Accountability Act (HIPAA), highlighting privacy, breach notification, and security rules. The privacy rules emphasize protecting the privacy of protected health information.
The hospice must comply with the Medicare and Medicaid hospice eligibility rules, including submitting claims to Medicare. Additionally, Medicare reimbursement for hospice care must be accurate based on the care services rendered, and the facility must not engage in unlawful kickbacks. Following Medicare, reimbursement eligibility requires complying with the federal rules and considering the False Claims Act, which prevents fraudulent misuse of government funds. Medical charges are reimburse...