By Apollo Fuhriman, Region 10 Advocate
While many federal regulations start out with the best intentions, every additional layer creates not only additional work but frequently contradictory requirements. Where larger businesses have the personnel to overcome these challenges, small businesses – in particular small health clinics-do not.
Recently, several members of the medical staff at B3 Medical in Lutz, FL, met with representatives of the Office of Advocacy to discuss ways to overcome federal regulatory and paperwork challenges.
The overall message of this day was simply: if the goal of federal intervention in healthcare is to force all of the small, independent medical clinics to join a mega-medical provider, the government is succeeding. This goal may not help the patients or the small health care businesses that serve them. As a remedy, federal agencies need to take a holistic approach to healthcare by helping the patient adopt and maintain a healthy lifestyle, not merely recover from illness.
B3 employs more people in billing, collections and compliance than they do in their actual medical treatment department. The goal of the ACA was to increase access, decrease costs and improve outcomes, perhaps by increasing the number of medical clinicians in medical clinics. Advocacy was told what has increased is the number of attorneys and accountants. Because of increased overhead costs, there has been a decrease in the number of small clinics, especially in small towns. In some cases this has eliminated patient access in rural areas to the only clinic where people receive the most personal care.
Among B3’s many concerns were the overly burdensome requirements of HIPPA. It is understood that privacy is a great concern, but the rigid regulations surrounding this law are overbearing and in many cases hinder the goal of providing adequate care to patients.
Another concern voiced to Advocacy in Lutz, and other areas of the U.S., is that government entities do not audit with the intent to find and correct errors, or to educate about changes in the law. Instead, auditors seem to be looking for violations with the intent of imposing fines. If a business is doing everything possible to try to follow all regulations, a warning should be offered for a first offense.
In general, federal regulatory agencies need to be more sensitive to obstacles small businesses face when complying with regulations, especially during the rulemaking process.
Advocacy was in Florida for Regional Regulatory Reform Roundtables June 5-7th.
Apollo Fuhriman is the Region 10 Advocate and covers Alaska, Washington, Oregon and Idaho and his email is apollof@sba.gov