Federal regulation agencies function as an extension of the executive branch in government that generate and enforce legislation. Regulation and regulatory agencies play an important role in the health care arena. The array of regulations that govern healthcare are overwhelming, however, each individual regulatory agency has a specific scope that focuses on protecting and maintaining quality care, and work to improve access and affordability for Americans.
Healthcare professional who are knowingly submitting false claims or conspiring with others to submit false claims are with violation of the FCA. Whistleblowers are protected under FCA Under PPACA (Patient Protection and Affordable Care Act), whistleblowers may initiate false claims actions based on information publicly disclosed through federal criminal, civil and administrative proceedings in which the government or its agent is a party, as well as federal reports, hearings, audits or investigations (beckershospitalreview.com).
Whistleblowers are protected regardless if a lawsuit is filed and protect them from retaliation from their employers. Over the course of 2010, many hospitals, health systems and pharmaceutical companies were targeted by the federal government for their roles in submitting false claims. (beckershospitalreview.com).
The second example of a regulation currently faced by the health care industry is the HIPAA regulation. The Health Insurance Portability and Accountability Act. HIPAA was signed on August 21,1996 by U.S. President Bill Clinton and was made compliant by the health care industry by April 2003.
HIPAA has two primary components to which hospitals and healthcare providers must conform Administrative Simplification, which calls for the use of the same computer language industry-wide Privacy protection which requires healthcare providers to take reasonable measures to protect patients written, oral, and electronic information. The HIPAA law is a multi-step approach in that it is geared to improve the health insurance system.
The approach of the HIPAA regulations is to protect privacy and confidentiality by enforcing a standard for the privacy of individually identifiable health information and govern its disclosure. Analysis of the Impact of Laws on the Provider, or Hospital One out of every seven dollars spent in the United States is spent for healthcare services. This is a greater percentage than in any other industrialized country. (Statistical Abstract of the U.S. 2001).
As we continue to study the topic of health care and the direct effects of regulatory agencies, we can apply this concept to the current healthcare reforms implemented by Obama care.
The demand for healthcare can follow a downward-slope curve for services just as there is for other goods and services.
There are moments when the demand curve for healthcare occurs because consumers respond to changes in the price of healthcare making it more available. When analyzing the demand curve for healthcare you must also analyze the forces that may sway the curve upward or downward.
Hospitals might also see an increase in unintentional efforts, even within states where hospitals have conventionally stay union-free. Whereas unionization works for many services and offer a meaning of security to staff, it can also offer complexity for hospital administration. For instance, unionized environment, if an employee has a concern, he or she must go through a unionrepresentative and consult the union agreement rather than verbal communicating directly with a manager.
More than a few hospitals and health systems have been hindered by employee strikes in current months. (Shi Singh, 2012). As I live in Massachusetts, where in 2006 the landmark legislation passed a law ensuring near-universal health insurance coverage to residents of the state through a combination of mechanisms. By 2008, only 2.6 percent of Massachusetts residents were uninsured, considerably below the national average of 15 percent. (Rand Health, 2009).
Massachusetts is continually trying to find ways to reduce spending on healthcare as a major focus for private and public policymakers in the state. Conclusion Health laws and regulations in the health care industry are extremely stringent. They are implemented to help protect patient and providers from repercussions and legality issues. There is an array of regulations and agencies who guideline and monitor compliance.
For example, as stated in this paper, HIPPA is one of the regulations healthcare professionals must observe. Hefty monetary fines maybe enforced if a HIPPA violation is determined after the investigatory procedures of yet another regulatory agency. The Department of Civil Rights. Regulations are in place to improve the quality of service, protect the public, and ensure healthcare professionals abide by a set standard. Virtually no aspect of the healthcare industry escapes regulatory oversight.
Each individual segment from pharmaceutical, acute care hospitals, medical professional, reimbursement, and patient protection have regulatory agencies that oversee and govern their operations and standard of conduct to maintain the integrity of the healthcare industry. References Field, R. (2008).
Why is Health Care So Complex Pharmacy and Therapeutics. 33(10). 607-608. Morrison. E.E. (2011). Ethics in Health Administration A Practical Approach for Decision Makers. (2nd ed.). Sudbury. Ma Jones and Barlett. Rand Publications (2009). Retrieved from www.rand.org/pubs/research_briefs/RB9464-1/Indexl.htmlanalysi softheproviderinmassachusetts. SHI, L., Singh, D.A. (2012).
Essentials of the US Healthcare system. Jones Bartlett Publishers. Statistical Abstract of the United States. (2001). Retrieved from http//www.census. Gov/prob/www/statistical-abstract-us.html. Table 119, p. 91. Thirteen Legal issues for Hospitals and Health Systems. (2001). Retrieved from http//www.beckerhospitalreview.com/hospital-management-administration/13-
legal-issues-for-hospitals-and-health-systems.html. What is HIPPA (2008). Retrieved from April
28, 2008. httpwww.tech-faq. Com/hippa.shtml. PAGE PAGE 8 Y, i-qN3 (f4Av2l_j-OQ PL521w/AXE6NGUOsVBLy_xPiBIO1k9IcLHYv7aEh,8q4WqnogA8f2)QHxK
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