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.

 


Drug Shortages

Drug shortages have become a major problem for providers across the country, posing serious consequences for

patient safety, quality of care, and access to essential medications. GNYHA advocates for policies aimed at addressing the drug shortage problem.

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Employee 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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Energy Efficiency and Cost-Saving Opportunities

GNYHA is committed to helping members reduce operating costs in a variety of areas (e.g., energy expenditures). GNYHA

provides resources and information about cost-saving opportunities.

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Group Purchasing Organizations (GPOs)

Hospital operations rely on all manner of medical/surgical supplies to function smoothly and deliver high-quality,

cost-effective care. GPOs such as GNYHA Services, Inc., ensure that hospitals have access to the best prices, technologies, medical supplies, and pharmaceuticals. GNYHA advocates for policies that ensure that health care providers can utilize GPOs to reduce their costs and increase efficiencies. 

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Health Information Technology (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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Hospital Accreditation Options

Voluntary accreditation is one way that hospitals demonstrate adherence to the Medicare conditions of participation,

the minimum standards that hospitals must meet to be a Medicare or Medicaid provider. The three approved voluntary accreditation options for hospitals are Det Norske Veritas Healthcare, Inc., the American Osteopathic Association’s Healthcare Facilities Accreditation Program, and The Joint Commission. 

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Planning/Certificate of Need

New York State’s Public Health Law requires the Commissioner of Health to grant certificates of need (CON) for certain types

of health care facility construction, renovations, and service changes. GNYHA has resources to help members navigate the CON process and advocates for reforms to streamline the process to reduce delays and costs while maintaining access to care. 

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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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Cardiac Initiatives

Providing hospitals with appropriate and timely information on cardiac care guidelines, recommendations, and reporting

mechanisms is a priority for GNYHA. Member letters and briefing materials focus on relevant cardiac issues, including guidelines and policies, Medicaid coverage limitations for certain procedures, and updates from New York State Department of Health’s Cardiac Advisory Committee Meetings.

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Clinical Laboratory Issues

GNYHA updates members on issues that impact hospital clinical laboratories, and laboratory issues related to hospital

clinical operations. GNYHA also invites hospitals and clinical laboratory staff to participate in forums and programs on current laboratory matters. 

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Conditions of Participation for Hospitals

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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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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Restraint and Seclusion

Federal and State agencies strictly regulate the use of restraints and seclusion in the inpatient and behavioral health settings.

GNYHA has prepared resources to help members understand and comply with the New York State Department of Health, Centers for Medicare & Medicaid Services, and The Joint Commission’s guidelines.

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Stroke Initiatives

GNYHA works closely with hospitals on their efforts to improve the quality of care for patients who have experienced a stroke.

This includes convening educational briefings, advocating on stroke-related issues, and coordinating with the New York State Department of Health on their stroke programs, namely the State’s stroke center designation, and the Centers for Disease Control and Prevention–funded Coverdell Program.

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Surrogate Decision-Making, Advance Directives and 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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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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Credentialing Issues

Clinicians in New York State must have the appropriate training and State-issued credentials to provide care. GNYHA maintains

resources to help hospitals understand their obligations for verifying credentials for various health professionals. 

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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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Physician Assistants

As the health care delivery system evolves, certain professions have been authorized to carry out additional responsibilities in

their work. For example, physician assistants have seen their scope of practice change to allow them to sign death certificates and prescribe certain controlled substances. GNYHA helps its members keep track of such changes.

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Practitioner Licensure, Certification, Training, & Discipline

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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Professional Misconduct

GNYHA has resources for hospitals about their obligations to report professional misconduct, as well as information

that will be helpful to physicians about reporting requirements and referrals to New York State’s Committee for Physician Health.

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