Provider Operations & Compliance

 

GNYHA provides significant advocacy services, support, and assistance to and on behalf of members with the goal of reducing operational costs, improving organizational compliance, and enhancing efficiencies.

 


Conditions of Participation

The Federal government develops minimum standards hospitals must meet to provide services to recipients of, and be

reimbursed by, Medicare or Medicaid, standards known as Conditions of Participation (CoPs). GNYHA provides hospital members with guidance and analysis of the CoP’s to help them remain in compliance.

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Consent to Treatment

Empowering patients and their loved ones to make decisions about care and interventions can help improve patient

satisfaction and care experience. GNYHA has a number of resources that describe legal and regulatory requirements on surrogate decision-making, advance directives, and consent to treatment.

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Event Reporting Requirements

GNYHA’s member hospitals are committed to learning from adverse events and, when appropriate, reporting them to Federal

and State agencies. In addition, voluntary reporting programs have been developed to capture data on errors that are detected or are corrected before reaching the patient (near miss events). GNYHA provides a number of resources to assist hospitals with the associated reporting processes, different tracking systems, and protocols.

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Other Regulatory Issues

Hospitals must comply with scores of local, State, and Federal regulations. GNYHA provides analysis and guidance on a wide array of complex regulations,

works to reduce regulatory burdens, and helps its members comply with regulations.

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Testing and Screening Requirements

GNYHA provides updates for hospitals on various conditions’ testing and screening requirements to help them remain in

compliance with State, Federal, and professional guidelines.

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Employee Health & Wellness

Comprehensive and sustained employee wellness programs are a key way to invest in staff health and well-being.

 GNYHA assists member hospitals in developing, maintaining, and evaluating comprehensive employee wellness programs. Through meetings and complementary activities, GNYHA focuses on functional aspects of employee wellness programs such as assessment, communications, and evaluation, as well as interventions in specific areas including tobacco cessation, and diabetes prevention and management. 

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Hospital Workforce

A strong workforce is the backbone of every hospital. GNYHA supports our member hospitals and their workers by ensuring that laws and regulations benefit employees and provide

a safe workplace, providing technical assistance and guidance on labor and employment issues, and through training and educational opportunities.

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Nursing Workforce

GNYHA is committed to advocating for and supporting the nursing workforce as they deliver high-quality health care

to patients in an increasingly complex care delivery system.

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Practitioner Licensure, Certification & Training

An appropriately licensed and certified workforce is essential to delivering high-quality care. Hospitals also need to be aware of

discipline requirements for health professions in the event they are needed. GNYHA has collected State resources pertaining to licensure and certification for clinical laboratory, social work, and other health professionals.

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Cybersecurity

Hospitals and health systems are deeply committed to protecting patient data and electronic health information from damaging cyberattacks.

GNYHA supports our members through programming, resources, and guidance on best practices.

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Electronic Health Records

Hospitals and health systems continue to build on their electronic health records to meet “meaningful use” requirements

and more easily share information between providers and patients. GNYHA provides technical assistance and guidance, and serves as a liaison between members and State and Federal agencies on regulatory and policy issues.

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ePrescribing

In 2015, New York became the first state to require providers to transmit all prescriptions electronically to pharmacies. GNYHA helps our members

understand myriad requirements and ensure compliance.

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Other HIT

GNYHA provides practical assistance to hospitals for the efficient adoption and implementation of HIT systems. GNYHA

also provides support for members to meet the Federal criteria for “meaningful use” of electronic health record technology, which in turn will determine hospital and physician eligibility for Federal funding. Through ongoing advocacy at both the Federal and State level, GNYHA continues to strive to ensure that requirements and incentive payment eligibility criteria are flexible and realistic.

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Telehealth

Telehealth is an umbrella term encompassing the use of various health technologies to treat patients that are not

in the same physical location as their provider. Because of recent changes in state and federal law and regulation, opportunities for providing telehealth in the region have expanded and will continue to increase. 

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