Managing Healthcare Compliance in Massachusetts

Nestled among Massachusetts’ historic landmarks and vibrant communities, lies a challenging yet critical aspect for healthcare professionals: navigating the intricate maze of healthcare compliance regulations. Each rule, like a Boston cobblestone, serves as part of the complex regulatory path organizations must follow to successfully manage healthcare compliance in Massachusetts.

In order to stay on track and avoid legal or financial consequences for non-compliance, efficient systems for effective compliance management must be established. Not only do healthcare leaders need to stay up to date with changing regulations, they need to know how they apply to their specific organization. This article reveals the must-knows for confidently achieving compliance in Massachusetts.

Massachusetts Healthcare Compliance Resources

Let’s start with the important state government agencies you’ll need to work with:

• The Massachusetts Department of Public Health (DPH) is a state government agency dedicated to ensuring the health and well-being of all Massachusetts residents through a variety of public health initiatives, programs, and regulatory oversight.
• The Massachusetts Health & Hospital Association (MHA) is a prominent organization representing hospitals and health systems across Massachusetts, advocating for policies and practices that support healthcare delivery and patient care.
• The Executive Office of Health and Human Services administers MassHealth, the state’s Medicaid and Children’s Health Insurance Program (CHIP), providing essential health coverage to low- and moderate-income residents, including families, children, seniors, and individuals with disabilities.
• The Board of Registration in Medicine (BORIM) for Massachusetts is the regulatory body responsible for licensing, monitoring, and disciplining physicians in the state to ensure the highest standards of medical practice and patient care.
• The Board of Registration of Allied Mental Health and Human Services Professions in Massachusetts oversees the licensure and regulation of mental health counselors, marriage and family therapists, educational psychologists, and rehabilitation counselors to maintain professional standards in mental health services.

These agencies help maintain the integrity and quality of healthcare services in Massachusetts, protecting the public and promoting patient safety. The resources provided by these Massachusetts state agencies are essential for promoting public health, ensuring access to healthcare, supporting healthcare professionals, and enhancing overall health outcomes for the residents of Massachusetts.

Regulations Unique to Massachusetts

To meet the standards of healthcare compliance in Massachusetts, there are a few additional regulations.

Access to Emergency Care Law

Effective January 1, 2024, all Massachusetts hospitals with emergency departments must comply with “Laura’s Law.” The law is a result of the 2016 tragic death of a patient who was unable to access her local hospital’s emergency room due to poor signage, locked doors, and lighting that was misleading. Hospital and compliance leaders can seek guidance from the Patient Access to Emergency Care (Laura’s Law) Workgroup, assembled by the Massachusetts Department of Public Health (DPH). Non-compliance with the law may result in legal and/or financial penalties. 

Patient Medical Records and Documentation

In Massachusetts, a regulation concerning concurrent surgeries aims to enhance transparency and patient safety in surgical procedures. This rule requires attending physicians to clearly document their absence from any procedure that requires a patient’s written consent. This requirement is part of the state’s effort to ensure that patients are fully informed about their surgical care and that accountability is maintained in the operating room. By mandating clear documentation of the surgeon’s presence or absence, Massachusetts seeks to uphold the highest standards of patient care and trust in medical procedures. It is imperative that organizations have policies in place to ensure adherence to this important regulation.

Tips To Manage Healthcare Compliance in Massachusetts

Effectively managing healthcare compliance in Massachusetts is a critical responsibility for healthcare organizations, as it ensures the delivery of high-quality care while adhering to legal and regulatory requirements. Here are some key strategies to help healthcare organizations manage compliance effectively:

• Conduct State-Specific Training: Provide ongoing training and education to staff that is customized to your state’s regulations as well as your facility. If using a learning management system, ensure the vendor offers Massachusetts-approved training.
• Organize Policies By Requirement: Including “MA” in every document that is required by the state will make it much easier for you to find these documents in an online system when a surveyor is onsite. It is also best practice to include the standard you are meeting for additional clarity.
• Establish a System for Monitoring Risk: Being able to identify compliance risks before they become incidents or violations can save the entire organization time and money. Identifying trends and consistently reviewing reports can signal issues, such as training not being completed or a large number of incidents in one location.
• Use Compliance Management Software: Accreditation surveyors say organizations that use compliance software are more prepared for onsite visits and surveys. The software helps to keep documents and policies organized, ensures training content is up to date, and makes reporting easy.

By implementing these strategies and fostering a culture of compliance within your healthcare organization, you can effectively manage healthcare compliance, reduce risks, and provide the best possible care to your patients while staying within legal boundaries.

Credentialing Compliance in Massachusetts

The Massachusetts Physician Credentialing Initiative is a unique aspect of medical credentialing in Massachusetts. Using a standardized process for physician credentialing by health plans and hospitals with a uniform application, 95% of initial applications must be processed by participating health plans within 30 days. Health plans are also required to maintain regular communication with physicians about the status of their applications. Once credentialed, physicians can treat plan enrollees and be reimbursed by the applicable health insurance plan for covered services starting from the plan’s credentialing date.

Meet Massachusetts Compliance Requirements With MedTrainer 

While the path may be complex, healthcare providers who prioritize compliance will not only avoid legal troubles but also enhance the quality of care they provide to their patients in Massachusetts. 

MedTrainer’s all-in-one compliance platform can streamline management of Massachusetts healthcare compliance. MedTrainer seamlessly consolidates your organization’s policies, incident reports, safety plans, HR documents, contracts, and more. This centralized repository ensures all employees have easy access to essential information. The course library is curated to align with regulatory and accreditation requirements, and courses are regularly added and updated to ensure the most current information. Learn more about MedTrainer today!