Compendious Med Works Blogs

Important regulations in United States health care

Important regulations in United States health care. The United States health agencies have developed laws designed to protect public well-being with Congressional oversight. The health issues and concerns of all American citizens are overseen by the Department of Health and Human Services (HHS). It also spearheads initiatives that further medical research and improve public health. The mission of the HHS in 2016; entailed the reduction of medical costs and improvement of patient outcomes. Throughout time, by supporting various new laws, the HHS has worked towards such goals. These are known as the United States medical device regulations. Consequently, health in America has been significantly impacted by the following 8 acts of legislation–

  1. Healthcare Quality Improvement Act of 1986 (HCQIA): The Healthcare Quality Improvement Act provides immunity for medical institutions and medical professionals during conduct assessments. The origin of the law partially owes itself to a Supreme Court ruling that involved abuse of the physician peer review system. To date, as the act arises in courtrooms and justices deliver new rulings, HCQIA continues to evolve. The legislators enacted the law to encourage physicians to file official complaints after encountering dangerous and unprofessional peer conduct and protect medical professionals from peer review-related lawsuits. These are the regulations in the healthcare industry.

  2. Medicare: Almost 50 million American citizens are provided insurance coverage by the Medicare program. In 1945, the Congress was rallied for funding by President Harry Truman to insure all United States citizens. President Kennedy eventually succeeded in providing coverage for the senior citizens of the country. Thanks to sweeping spending reforms, today, the Congressional Budget Office forecasts that the program will survive indefinitely.

  3. Medicaid: A provision to provide for low-income individuals was also included in President Johnson’s 1965 legislation. Medicaid provides insurance coverage for over 70 million American citizens today. The program reimbursed hospitals for almost 50% of all medical expenses in 2014. Medicaid covers a wide range of recipients such as temporarily unemployed workers, uninsured expectant mothers, and disabled individuals. New legislation has recently lowered the nation’s uninsured rate to fewer than 9%, representing the highest coverage rate in the States’ history.

  4. Children’s Health Insurance Program (CHIP): The Children’s Health Insurance Program and Medicaid have created a strong foundation for delivering health coverage to children living in low-income households. The program originated simultaneously with the Children’s Health Insurance Authorization Act 2009 and has efficiently provided services to many previously disqualified clients. The program receives funding from respective states and federal government and has an extensive history of providing insurance to underprivileged children. This service has been made accessible to the largest number of low-income children in the nation’s history through the Affordable Care Act (ACA).

  5. Hospital Readmissions Reduction Program (HRRP): An Affordable Care Act (ACA) initiative, Hospital Readmissions Reduction Program (HRRP) requires the Centers for Medicare and Medicaid Services (CMS) to reduce payouts to care facilities that experience excessive patient readmissions. This program – launched in late 2012 – defines readmissions as “repeat patient admissions among participating CMS hospitals in 30 days; allowing exceptions for a few heart conditions, such as heart failure and pneumonia, as well as factors such as poor health and multiple illnesses.” These are the government regulations in healthcare.

  6. Health Insurance Portability and Accountability Act (HIPAA): The Health Insurance Portability and Accountability Act (HIPAA), 1996 protects American workers by allowing them to port their health insurance policies from job to job. The program also permits workers to adjust for family changes such as births, marriages, and adoptions; and apply to a select group of health insurance plans to replace lost coverage. This act prevents insurers from discriminating against policy applicants due to health problems. In some instances, an individual may apply for coverage outside of the normal enrollment period if an insurance company denies a worker’s application. The act additionally preserves state laws that protect the insurance rights of workers.

  7. Patient Safety and Quality Improvement Act (PSQIA): This act of 2005 protects health care workers reporting unsafe conditions. While maintaining patients’ confidentiality rights, legislators created the law to encourage the reporting of medical errors. The HHS levies a fine for confidentiality breaches to ensure patient privacy. The law also authorizes (AHRQ) Agency for Healthcare Research and Quality to publish a list of Patient Safety Organizations that analyze and record patient safety data. The law among national healthcare facilities is enforced by the Office for Civil Rights (OCR). These are some of the most vital regulations in United States healthcare.

  8. Affordable Care Act, 2010: President Obama sanctioned the Affordable Care Act (ACA) – a modified version of the all-inclusive coverage imagined by presidents since the early 1990s – in March 2010. The act levies a penalty on individuals who fail to secure insurance but makes exceptions for a few protected groups; and requires most U.S citizens to apply for health insurance coverage. Enterprises that employ more than 200 workers must provide health insurance coverage under the law. The American Health Benefits Exchange was established by the act, where citizens could compare and review insurance plans. Health professionals are offered the opportunity to shape the delivery of patient services by the Affordable Care Act. While also reducing care expenses, the medical field can benefit from the input that helps deliver better services to the growing patient populace. As future or current decision-maker in healthcare, care providers should reflect on how to create these results at their respective workplaces. These are some of the strictest regulations in the healthcare industry.

Leave a Reply