In case you missed it, we held our first (virtual) Client Summit last Wednesday, June 23, during which we covered important compliance and regulatory updates, provided a glimpse into our newest product innovations and roadmap, offered learnings from our partners and peers, and highlighted data and monitoring trends and insights. If you weren’t able to make it, we’ve got you covered – read on for Part 1 of the summary of the event and keep an eye out for Part 2, coming soon.
Compliance & Regulatory Updates: What You Need to Know
OIG Priorities for 2021
One of the most recent announcements from the Office of the Inspector General (OIG) came during the HCCA Annual Compliance Institute in April. During their keynote session, they shared their top 10 compliance priorities for 2021. At our Client Summit, Donna noted that seven out of the ten compliance priorities are on our radars every day at ProviderTrust, including protecting COVID-19 relief and response from fraud; stomping out potential fraud amid the telehealth boom; advancing equity in healthcare services; prioritizing cybersecurity; and modernizing program integrity and compliance resources.
During the HCCA event, the OIG stated that they will be seeking feedback in the near future from healthcare industry stakeholders on how to modernize the format and delivery of various published guidance and resources. For the OIG’s List of Excluded Individuals/Entities (LEIE), which gets 26 million visits annually, the OIG is considering how to adopt modern data sharing practices, including APIs, to ensure easier access. Ultimately, the OIG’s efforts to modernize center around making the data and information they provide more readily accessible and usable to the healthcare industry.
Updates to SAM.gov
Several clients reached out to us, noting that the SAM.gov website had a different look due to a recent overhaul of the site. Although the recent updates were made to help increase efficiency, many of our clients were having trouble navigating the changes without some help. Luckily, our Data and Monitoring Team was already on it, so they put together a one-pager with some helpful tips and tricks when utilizing the new site.
State Exclusion Lists Update
ProviderTrust is constantly monitoring which states have active exclusion lists, as it’s always subject to change. Most recently, as Donna noted, Arizona made the decision not to publish its exclusion list any longer with the last exclusion being released publicly on January 11, 2021. All of the historical information from Arizona’s exclusion list still resides in our dataset and if the list goes public again, it will be on our radar.
Changing Licensing Requirements During the Pandemic
Our team was extremely agile early on in the pandemic and adapted our license monitoring process to make sure that nothing was missed and that our clients could focus on what really mattered: keeping patients safe. Due to the public health emergency declaration, which is still ongoing, many state license boards made rapid changes regarding provider eligibility. Boards extended license expiration dates, allowed providers to work across states, and generally reduced the administrative barriers to providing care. We ensured that as these expiration dates were extended, our platform was updated with the applicable screenshots.
Additionally, historically, our normal license verification cadence was quarterly, however, we recently increased our monitoring capabilities to allow for up to daily license verification depending on the license and depending on the board. Donna noted that, “A lot of our clients are starting to realize that an increased verification schedule reduces the risk and makes sure that in an ever-changing healthcare environment, nothing is missed.” We strongly encourage every client to consider making this change to reduce their risk of missing important licensure changes.
HITRUST Certification Efforts
ProviderTrust also recently made the decision to pursue our HITRUST certification, an arduous process that we just initiated. We currently are SOC2 Type 2 certified and we will continue to participate in the applicable audits until we are HITRUST certified. We anticipate being completely HITRUST certified within the next two years and we will keep all of our clients apprised of the progress along the way.
Innovations & the Product Roadmap
Dash Module Updates
With the Dash application, we are constantly working to meet our payer clients where they are so they can get the business insights where they need them most: in their current workflows and systems.
- Instant to Ongoing Monitoring: Within our Dash application, you can now instantly screen new providers for exclusions when they enter your workflow and then add them to ongoing exclusion monitoring. Using NPI for exclusions, and NPPES, Medicare Opt Out, and SSN for SSDMF, we can return instant results to our clients.
- Term Limits: Instead of editing and reviewing your files, you can now proactively manage your populations and set term dates in Dash related to the last interaction date with a provider. This capability complements the instant-to-ongoing population monitoring strategy.
Passport Module Updates
As our most mature application, we are constantly looking for ways to improve efficiency and increase functionality as audit needs and our clients’ needs change and evolve.
- Simplifying File Mapping & Uploads: In Passport, we recently enhanced credential file imports to increase upload speed by up to 75%. Additionally, we added more free text fields which means fewer file failures, while still maintaining the high level of data integrity on imports and uploads.
- License Verification History Reporting: You can now view license verification history within the verification notes in Passport. We know that auditors routinely ask for evidence of license verification for a variety of timeframes so Passport also now captures screenshots of these historical verifications from the board that include the expiration date and status. This can be especially beneficial when you have providers who hold multiple licenses, like RNs.
VendorProof Module Updates
Our recent focus has been on vendor enrollment from day 1 and ensuring we are monitoring them using the most accurate data. Our ultimate goal is to create a vendor compliance portal that you can use to interact with your vendors on an ongoing basis.
- Vendor Compliance from Day 1: VendorProof now allows for a streamlined vendor onboarding to ensure rapid compliance, so you can save time and money and collect critical business information from day 1.
- Vendor Employee Monitoring: After receiving feedback from the market, we have enabled vendors and subcontractors to monitor their own employees for exclusions, which will help you meet contractual obligations.
Keep an eye out for Part 2 of the recap of our first Client Summit, coming soon, during which we will cover learnings from our partners and peers as well as data and monitoring trends and insights!