[BreachExchange] Give EMS compliance training the respect it deserves

[Audrey McNeil]

https://www.ems1.com/paramedic-chief/articles/285485048-Give-EMS-compliance-
training-the-respect-it-deserves/

It seems like you can’t go a day lately without seeing a report or article
related to compliance issues in healthcare. The statutes, guidelines,
regulations and laws governing the industry are complex and seem endless.
There are rules for privacy, signatures, legibility, localities, physician
certification statements, coding, billing – the list goes on and on.

While ambulance services represent just a very small segment of a much
larger industry, we are not immune from vigilant governmental monitoring
and – with a growing frequency – persecution.

Among others, CMS, HHS, the OIG, FBI, and the DOJ are keeping a watchful
eye on almost everything we do. It’s a virtual alphabet soup of compliance
cops! If you haven’t heard about someone who has had a compliance
violation, or perhaps even experienced one in your own service, you have
probably been out of the country for at least the past decade.

While it’s easy to see these folks targeting the big agencies, it has
become common knowledge that no one, from the smallest ambulance services
to the biggest metropolitan EMS agencies, gets a free pass. I’m reminded of
a song by legendary country singer Waylon Jennings, and to paraphrase it,
“Don’t you think this compliance bit’s done got outta hand?”

It is certainly not a stretch to find something to gripe, moan and complain
about with all these rules and regulations we are required to keep abreast
of. In addition to adhering to regulations, we are required to monitor a
wide variety of documentation, regularly check and update policies and
procedures, and provide training for our staff.

Everyone knows that compliance training day is a much-anticipated event in
every EMS organization – I wish I had a nickel for every snide remark or
eye-roll when the topic of compliance training comes up. Even supervisors,
directors, chiefs, CEOs and boards of directors often question the need for
it – but I can assure you they’re wrong.

As an industry, we have become well accustomed to annual clinical training.
We are required to attend regular educational sessions and skill labs to
demonstrate proficiency, and maintain certifications and licenses. It’s not
even a stretch to say that some people actually, believe it or not, look
forward to honing their talents or learning something new. And why not?

It’s easy to see the value of learning a new clinical therapy or procedure,
or practicing one you infrequently perform. The connection between this
training and safe treatment and transport of patients is clear to see.

Compliance training, on the other hand, just doesn’t get the same respect.
Some agencies have gotten smart about tucking required HIPAA training into
other regular meetings. It’s like hiding peas in a chicken pot pie. Maybe
they won’t notice if we put good stuff all around it.

COMPLIANCE TRAINING ROI

At the end of the day, it’s all about return on investment. Time and money
are required to attend compliance training and employees or managers want
to know what they get out of it. Will it help patients? Will it save money?
Will it increase revenue?

The answer to each of these questions is, yes. Far too often, educators
introduce compliance training by saying, “I don’t like it any better than
you, but it is something we have to do.” If they don’t actually speak those
words, they make it clear with their body language or by trying to rush
through the training as quickly as possible to check the box.

That is the wrong attitude. Compliance training is required because it
protects our patients, our services and ourselves. But only if we take it
seriously.

High-quality documentation that is honest, accurate and complete can help
inform other healthcare providers so the patient receives the right ongoing
treatment after the transport is complete.

Compliant patient care reports also ensure proper billing for services,
which benefits both the patient and the agency. Billing errors stemming
from non-compliant practices, even when unintentional, result in millions
of Medicare and Medicaid dollars being processed inappropriately – which is
fraud. Compliance training helps prevent mistakes that can result in
monetary penalties and other unpleasant events, including prepayment review
or exclusion from federal healthcare programs.

Finally, it can help protect the caregiver’s license. Regulators have
increased reprimands, personal fines, suspensions and revocations of
individuals’ licenses in response to violations.

NO TOLERANCE FOR IGNORING EMS RULES AND REGULATIONS

EMS is a proud and noble profession. A commitment to delivering frequent
and relevant clinical training is common in most ambulance services.
Tolerance for caregivers with poor clinical skills who deliver subpar
patient care is low – the same should be true for non-compliance with any
of the rules and regulations governing any aspect of treatment, transport,
documentation and billing.

No one mocks or pokes fun at the need for ongoing clinical training, and it
is time for compliance training to get the same level of respect. The EMS
profession should approach compliance training with the same level of
intensity that has been given to that of clinical education. It is doubtful
there will ever be three cheers for compliance training, but maybe a small
round of applause is due for the hard work of staying on the right track.
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