PYA Principal Barry Mathis and Consulting Principal Martie Ross contributed to the Jan. 15, 2024, issue of the Report on Medicare Compliance. The national publication is produced by the Health Care Compliance Association (HCCA) to provide updates on compliance strategies specifically pertaining to Medicare.
Mathis and Ross provided expertise for the article, “Outlook 2024: AI Risks Start to Come Into Focus; Eyes Are on MA Rule, Telehealth Audits,” which takes a look at top-of-mind issues for 2024 and what they could mean for compliance officers.
One issue is related to artificial intelligence (AI) and the impact it is expected to have on cybersecurity. In the article, Mathis comments on the use of AI—particularly generative AI—by “threat actors” to thwart healthcare organizations’ cyber defenses. Weakening the security of data further are the requirement for interoperability and the use of the cloud to transmit medical records. “2024 will be the year of ‘don’t trust anything and verify it twice’,” Mathis says.
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The topics of Medicare Advantage (MA), telehealth and split/shared services, and hospital price transparency will continue to be in focus in 2024, according to the article. Ross predicts heightened scrutiny of MA in reaction to the Centers for Medicare & Medicaid Services (CMS) rule requiring MA to be no more restrictive than traditional Medicare.
Another challenge comes from the complexity add-on code (G2211) for split/shared services. “[The code] is a compliance officer’s nightmare because CMS has not provided definitive guidance on the proper use of the code,” Ross says.
SEE ALSO:
- Let’s Talk Compliance: Medicare Advantage: Compliance Issues and Enforcement
- Webinar: Healthcare Regulatory Roundup: Billing Medicare for G2211
- Webinar: CY24 Final Rules
In the article, Ross also predicts Acute Care Hospital at Home telehealth services will be extended into 2025 and comments on the competitive value of the revised hospital price transparency rule.
Read the full article about 2024 topics on HCCA’s online platform, COSMOS, or access a PDF of the article.
If you have questions about cybersecurity, information systems and infrastructure, regulatory impacts, physician compensation, or any other matter related to compliance or strategy and transactions, our executives are happy to help. Contact them by email or at (800) 270-9629.
