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Medicare and Medicaid compliance

On Behalf of | Mar 30, 2023 | Medicare & Medicaid Fraud

Medicare and Medicaid regulations provide rules that most Texas providers receiving funds through these programs must follow. These regulations cover many topics vital to people receiving care paid for by the government.

Patient rights

Medical providers accepting state and federal funding must inform patients of their privacy rights and encourage them to make informed decisions about their medical care. Furthermore, residents in long-term care facilities must be informed of their right to have at least two visitors. They must be given the number to ombudsmen to help them advocate for their care if requested.

Quality of care

The federal code establishes a minimum standard of care. It also requires providers to bundle some services together and offer a discount when providers routinely do those procedures simultaneously. Furthermore, each provider must use a mandated checklist to constantly strive to meet state and federal standards established by industry leaders.

Infection control

Through the Centers for Medicare and Medicaid Services, policies are established to control viruses within facilities. Then, providers must follow through by practicing these guidelines. State and federal inspectors routinely inspect facilities to ensure rules are followed.

Medical staff qualifications

Medicare and Medicaid law establishes minimum staff qualifications for each level of nursing care. It also provides guidance on how many staff must be present for different scenarios.

Medical record documentation

Medicare and Medicaid also outline standards different types of providers must keep to prove they provided medical care. Furthermore, they establish how long various medical records must be retained.

Medicare and Medicaid regulations govern many facets of medical care affecting all patients.