Healthcare compliance in Georgia is a complex and ever-changing landscape, requiring medical providers to navigate numerous state-specific laws and regulations. Compass Healthcare Consulting has extensive expertise in addressing these challenges and others throughout the Peach State.
Whether you’re operating in Atlanta, Augusta, or Savannah it’s important to understand compliance requirements to ensure your practice’s success and regulatory adherence.
Unique Aspects of Healthcare Compliance in Georgia
For 2025, Georgia is launching a state-run health insurance marketplace, which could lead to a busy administrative year for practices as patients enroll or change coverage. It will support Georgia’s commitment to patient safety through specific regulations. For example, the state mandates strict requirements for automated external defibrillator (AED) use, including:
- Training
- Physician oversight
- Device registration
Additionally, all practitioners must register with and consult the GA Prescription Monitoring Program before prescribing controlled substances. Clear identification of healthcare providers is emphasized, with specific requirements for physician assistants and registered nurses to display their titles.
In the area of cosmetic procedures, Georgia enforces stringent laser device registration and licensing for laser practitioners. The state also requires detailed informed consent for laser procedures, ensuring patient awareness and safety.
These regulations demonstrate Georgia’s dedication to balancing patient protection and healthcare access, ensuring quality care.
State Agencies in Georgia
Georgia has several state agencies that oversee healthcare compliance and regulation. The Georgia Department of Community Health (DCH) is a key agency that administers Medicaid, PeachCare for Kids, and other health insurance programs. It also oversees healthcare facility licensing and regulation.
The Georgia Composite Medical Board is crucial for medical professionals, including dermatologists and pediatricians. It handles:
- Licensing
- Disciplinary actions
- Adherence to professional standards
For aesthetic practitioners, the Georgia Board of Cosmetology and Barbers regulates certain non-medical aesthetic procedures.
The Georgia Department of Public Health (DPH) plays a vital role in:
- Disease prevention
- Health promotion
- Emergency preparedness
It’s particularly relevant for pediatrics providers due to its focus on maternal and child health programs.
The Office of the Commissioner of Insurance and Safety Fire regulates health insurance plans, which impacts all healthcare providers. For practices dealing with controlled substances, the Georgia Drugs and Narcotics Agency enforces laws related to prescription drugs.
Lastly, the Healthcare Facility Regulation Division, under the DCH, inspects and licenses healthcare facilities, ensuring they meet state standards. This division is essential for any provider operating a medical office or clinic in Georgia.
How Compass Healthcare Consulting Can Help
Compass Healthcare Consulting offers specialized services to support healthcare compliance in Georgia and nationwide. Our expertise, combined with national reach:
- Enhances coding accuracy
- Reduces compliance risks
- Identifies growth opportunities
Medical billing and coding reviews
For medical billing and coding reviews, we conduct comprehensive chart audits for multi-site physician groups. This includes private-equity-sponsored and health-system-affiliated practices.
Our team provides detailed analysis and reporting on coding and billing practices. This helps organizations identify reimbursement-impacting trends, highlight high-risk areas for payor audits, and reduce claims denials.
Risk assessment and compliance support
Our risk assessment and compliance support help healthcare organizations navigate complex regulatory requirements. We conduct thorough, site-specific assessments to identify business and regulatory risks, particularly for multi-site practices.
Our deliverables include:
- Tailored findings
- Actionable recommendations
- Enterprise-level summaries
This helps to prioritize risk management and improve operational efficiency.
Mergers and acquisitions
For medical practice mergers and acquisitions, we provide comprehensive due diligence services. Our team performs thorough analyses of revenue integrity and evaluates technology and regulatory risks through site visits, delivering detailed reports with actionable insights throughout the M&A process.
Personalized approach
At Compass Healthcare Consulting, we emphasize personalized engagement across all services. We address specific challenges through:
- One-on-one consultations
- Regular communication
- Tailored solutions
This approach helps Georgia healthcare providers optimize operations, improve financial performance, and maintain compliance in a dynamic regulatory landscape.
Our expertise, combined with national reach, enhances coding accuracy, reduces compliance risks, and identifies strategic growth opportunities for healthcare practices.