Starting a medical staffing agency is a significant undertaking that requires not only finding qualified candidates and planning for growth but also staying current with the complex and ever-changing legal and compliance landscape. Navigating this landscape can be overwhelming, especially for new agency owners. However, with the right approach and knowledge, it is possible to ensure your agency complies with all state and federal regulations while also protecting your business and your clients. In this article, we will provide valuable insights and tips on how best to navigate the legal and compliance landscape for medical staffing agencies. From understanding the importance of proper licensing and insurance to staying current with industry standards, this guide will help you to establish a solid foundation for your agency and avoid potential legal challenges.
Become Familiar with Federal and State Regulations.
Every medical staffing agency needs to be well-versed in applicable federal, state, and local regulations. You must also fully understand the labor laws and industry regulations that pertain to your particular area of operation. Federal law, such as the Fair Labor Standards Act (FLSA), establishes overtime pay requirements and payment restrictions on certain short shifts. Meanwhile, states tend to have their worker classification systems with corresponding implications for tax withholding. In addition, you’ll need to stay apprised of administrative changes related to health care, immigration, and employment law which will influence the way you conduct business.
Ensure You Stay Compliant with Health Insurance Portability and Accountability Act (HIPAA).
To protect patient privacy and sensitive medical records, all medical staffing agencies must comply with regulations set forth by the Health Insurance Portability and Accountability Act (HIPAA). All employees should be trained to understand what is expected of them in terms of managing protected health information for clients. Make sure your policies are updated as applicable HIPAA laws change to ensure compliance at all times. Additionally, you may need to invest in a training program or an electronic system that tracks employee compliance.
Research Customer Licensing Requirements and Expected Credentials.
A key compliance issue is making sure that the agency meets all customer licensing requirements and other appropriate credentialing standards. This includes not only verifying each employee’s proficiency in their respective field but also making sure that any medical licenses or other qualifications are up-to-date and sound. To avoid any potential legal trouble, it’s often best to use a licensing service to investigate a given provider’s credentials. It can also be useful for an agency to purchase its background check system to regularly double-check the reliability of each medical worker.
Structure Your Claims Processing to Maximize Reimbursement.
As with any business, medical staffing agencies require proper billing and reimbursement systems to stay afloat. To make sure that your agency is properly reimbursed—and not vulnerable to fraudulent claims—it’s important to map out a reimbursement system that takes into account the various payers of services, such as Medicare and private insurers. At the same time, you must create an internal audit system to identify any potential errors or duplicates. This can also be beneficial for evaluating new billing technologies and making sure your procedures remain up-to-date.
Participate in Meaningful Use Programs Where Available.
Many government payment programs give help to medical staffing agencies. One such program is the Centers for Medicare & Medicaid Services (CMS) Meaningful Use Incentive Program. This program rewards healthcare providers with EHR technology implementation and provides them with financial incentives for using digital records in a meaningful way. To qualify, your agency must install specific types of digital records software. Participating in these kinds of programs can make your billing process easier and more efficient, not to mention having strong benefits from a financial standpoint.
