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Ensuring HIPAA, CMS, and Joint Commission compliance by embedding governance structures, auditing mechanisms, and cross-disciplinary accountability systems
Center for Community Balance Inc. – Baltimore, MD, United States.
Review
International Journal of Science and Research Archive, 2023, 10(02), 1492–1508.
Article DOI: 10.30574/ijsra.2023.10.2.0952
Publication history:
Received on 01 October 2023; revised on 19 December 2023; accepted on 28 December 2023
Abstract:
Healthcare organizations operate in increasingly complex regulatory environments where compliance is both a legal mandate and a strategic necessity. Effective compliance extends beyond avoiding penalties; it fosters patient trust, ensures operational integrity, and sustains institutional credibility. Broadly, compliance encompasses adherence to privacy, safety, and quality frameworks that collectively safeguard patients and align healthcare delivery with evolving societal expectations. Among the most critical standards are the Health Insurance Portability and Accountability Act (HIPAA), the Centers for Medicare and Medicaid Services (CMS) regulations, and the Joint Commission accreditation requirements. Each framework targets distinct but interrelated domains: HIPAA enforces data privacy and security, CMS governs reimbursement and care quality, and the Joint Commission establishes safety and performance benchmarks. To achieve comprehensive alignment, healthcare organizations must embed compliance into governance structures rather than treating it as a periodic audit exercise. This involves integrating compliance checkpoints into project lifecycles, developing auditing mechanisms that operate continuously, and leveraging real-time data to monitor adherence. Governance frameworks should be supported by cross-disciplinary accountability systems, ensuring collaboration between clinicians, administrators, compliance officers, and IT professionals. Such alignment not only addresses regulatory requirements but also builds organizational resilience by reducing risk exposure and strengthening quality improvement. In practice, embedding compliance across all levels of healthcare delivery provides a sustainable pathway for meeting regulatory obligations while advancing patient-centered outcomes. By harmonizing governance, auditing, and accountability, organizations can transform compliance from a reactive burden into a proactive driver of safety, trust, and long-term sustainability.
Keywords:
Compliance; HIPAA; CMS; Joint Commission; Governance; Accountability
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Copyright © 2022 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0
