Following the end of the COVID-19 Public Health Emergency (PHE) on May 11, hospitals and healthcare providers are faced with rolling back PHE-related policies and procedures. In an article published by the Association of Healthcare Internal Auditors (AHIA), PYA’s Tynan Kugler, Principal, and Susan Thomas, Consulting Manager, discuss post-pandemic compliance challenges, explain expired Medicare and Medicaid regulatory waivers, and provide an inventory of areas for audit and remediation.
In the article, the authors advise hospitals, health systems, physicians, and other healthcare leaders to conduct audits of their compliance programs related to pandemic waivers as the healthcare environment returns to a pre-pandemic status. They identify unique challenges hospitals and physicians face and provide helpful recommendations to bring operations back into compliance.
In the article, the authors state:
“One of the biggest ongoing changes is the end of Medicaid’s continuous enrollment requirement, which prevented states from terminating an individual’s Medicaid coverage. As a result of the change, a significant number of beneficiaries who gained coverage during the PHE now are at risk of losing it. During 2024, states must complete a redetermination process that terminates coverage for any person who no longer qualifies for Medicaid or who fails to submit information required for such redetermination.”
The full article was published in the Vol. 42, No. 5 issue of the AHIA New Perspectives journal, where it is available to AHIA members and subscribers. View a PDF of the AHIA article.
AHIA is “the only professional, specialized association for healthcare internal auditors,” according to its website. The international association helps the auditing community assess and evaluate risk, manage healthcare governance, and direct internal controls through knowledge- and resource-sharing for professionals in a variety of disciplines.
PYA is proud to be an AHIA Supporting Partner.
If you would like help with healthcare compliance or any other matter related to healthcare strategies and management, one of our executive contacts would be happy to assist. You may contact them at the email addresses below or by calling (800) 270-9629.
Resources
Identify compliance considerations with PYA’s End-of-the-PHE Compliance Checklist.
Learn about PYA’s comprehensive risk management program, Overwatch.
Generate appropriate documentation with PYA’s Stark Law Blanket Waiver Documentation Checklist.
