Health_Care_Laws_and_Regulations

Health Law and Regulations Paper Tim Anderson HCS/545 October 28, 2013 Shawna Butler Health Law and Regulations Paper Federal regulation is one of the basic tools government uses to carry out public policy, agencies create regulations when Congress provides the authority to do so (Department of Health and Human Services, 2013). Regulation is a crucial part of the healthcare industry and healthcare insurance coverage. Health care regulations are carried out by state. Local, and federal governments. State regulators govern day-to-day activities. When such things involving defense, foreign relations and interstate commerce take place the federal, regulators step in (Field, 2008). Oversight of participants in the healthcare system, such as physicians, hospitals, and insurance companies are done at the state level. Federal authorities coordinate all the programs. Public health, which includes sanitation, restaurant inspections, and epidemic investigations are the responsibility of state and local regulators, but the Centers for Disease Control and Prevention (CDC) is the resource on the federal level (Field, 2008). The American Medical Association is a private regulator that has helped create organizations that are essential in the oversight of the medical profession, such as those who accredit medical schools, administer licensures, and certify specialists. These organizations enhance the work of government regulators (Field, 2008). Nonetheless, it is important to understand the role of each agency and its effect on the healthcare industry. Role of Federal Regulatory Agencies Operating divisions are made up of sub-divisions making the health care system complex. Main operating agencies are: Administration for Children and Families (ACF) This agency promotes economic and social well-being of families, children, individuals, and communities. Services are provided by state, county and local agencies (Department of Health and Human Services, 2013). Administration on Children, Youth, and Families (ACYF) The Administration on Children, Youth, and Families oversees federal programs to support social services that encourage growth and development of children, youth, and families. They also oversee protective services for at-risk children and adoption of special needs children. States, community-based organizations, and academic institutions receive financial assistance from this agency to conduct research, provide training, and technical assistance (Department of Health and Human Services, 2013). Administration for Community Living (ACL) The Administration for Community Living combines the endeavor and achievements of the Administration on Aging, the Administration on Intellectual and Developmental Disabilities, and the HHS Office on Disability as the federal agency for increased community support for the needs of older Americans and those with disabilities (Department of Health and Human Services, 2013). Agency for Healthcare Research and Quality (AHRQ) The AHRQ supports research to improve the quality of health care. The AHRQ uses a system of indicators to set standards for quality care. The indicators are broken into four categories to be monitored. These categories are prevention, in-patient, patient safety, and pediatric (Department of Health and Human Services, 2013). Centers for Disease Control and Prevention (CDC) CDC`s Center, Institute, and Offices (CIO) implements CDC`s response in their areas of expertise, while providing intra-agency support and sharing resources. The CDC examines public health and monitors health threats from infectious diseases. The CDC also monitors emergency preparedness, birth defects, vaccines, and public safety (Department of Health and Human Services, 2013). Centers for Medicare and Medicaid Services (CMS) CMS covers 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the new Health Insurance Marketplace. CMS oversees many of the regulations directed to health care delivery and introduces health care cost control measures (Department of Health and Human Services, 2013). Food and Drug Administration (FDA) FDA is responsible for protection of public health, by overseeing the effectiveness and security of human and vetinary drugs, biological products, medical devices, food supply, cosmetics, and products that give off radiation (Department of Health and Human Services, 2013). Health Resources and Services Administration (HRSA) HRSA is the Federal agency who primarily is responsible for improving access to health care services for the uninsured, isolated, or medical vulnerable. This agency also oversees organ, bone marrow and cord blood donation. HRSA is responsible for compensating persons harmed by vaccinations. They maintaining databases that protect against healthcare malpractice, waste, fraud and abuse (Department of Health and Human Services, 2013). Indian Health Services (IHS) IHS is responsible for federal health services to American Indians and Alaska Natives. IHS provides all-inclusive health service delivery system for all American Indians and Alaska Natives who are members of 566 recognized Tribes in the United States. National Institute of Health (NIH) NIH is made up of 27 different components called Institutes and Centers. Each Institute and Center responsible for specific research and each one receiving funding directly from Congress (Department of Health and Human Services, 2013). National Cancer Institute (NCI) NCI is part of the National Institutes of Health. NCI conducts and supports research, training, health information circulation and other programs that support the cause, diagnosis, prevention, and treatment of cancer (Department of Health and Human Services, 2013). Substance Abuse and Mental Health Services Administration (SAMHSA) SAMHSA is leading the public health effort to advance the behavior health of the nation. SAMHSA Strategic Initiatives help people with mental and substance use disorders, helps their families, builds strong and supportive communities, prevents expensive behavioral health problems, and promote better health (Department of Health and Human Services, 2013). Analysis of Two Current Health Care Regulations The Health Insurance Portability and Accountability Act (HIPAA) have a consequential effect on hospitals. HIPAA regulations block health care organizations from sharing PHI without consent of the patient. HIPAA regulations authorize providers to protect private health information in drafted and digital formats. To protect patients’ identity, providers do not display patient names or diagnosis on the chart Displaying a patients name outside of a hospital room or any other area outside the room may put the patients identity in peril(O`Herrin, Fost, & Kudsk, 2004). Keeping computer terminals, fax machines, and medication carts in a secure area accessible to authorized personnel. Health Information Medical Services (medical records) feels the effects of HIPPA regulations. HIMS must follow the guidelines of releasing any information from a medical record such as a valid authorization must be in place before releasing any PHI. Authorization for this information must include how long the authorization is good for, the purpose, and a description of the information being released. Because of the strict regulations there can be delays in delivering timely patient care (O`Herrin, Fost, & Kudsk, 2004). One of the protections under HIPAA is patients with preexisting condition cannot be denied coverage by an employer’s insurance if there was no treatment, diagnosis, or medical advice 6 months before enrollment (Department of Labor, 2013). The second health care regulation is The Patient Protection and Affordable Care Act. This became law on March 23, 2010. Full utilization occurs in 2014. The Act creates the basic protections that have been missing such as guaranteed access to affordable health insurance coverage from birth to retirement (Rosenbaum, 2011). The health care system normally pays doctors and hospitals according to the total visits, procedures and medical devices they supply in lieu of the quality of care. The Affordable Care Act is prepared to better coordinate care, reduce preventable complications during hospital stays, and advocate the choice of improved health information technology (Farwell, 2013). The Affordable Care Act advances insurance to almost everyone. To pay for care, insurers need healthy consumers to buy policies. The directive was chosen to avoid a situation in which only sick people signed up and push up the price of premiums (Farwell, 2013). Conclusion Federal regulations oversee health care in the United States from state, local, and community level. The Department of Health and Human Services and the federal agencies that oversee the more than 300 programs is spread thin. Out of date Medicare procedures are in place costing taxpayers billions of dollars every year. As an example, Medicare requires a hospital stay of three days before moving to a skilled nursing facility. Patients could be ready on day two, but to meet Medicare guidelines patients must stay a third day. The United States spends the highest per person on health care and still has the highest uninsured population. Regulatory agencies are the authority as well as the enforcer of laws from the government. There are many examples of laws and regulations that are currently being phased in health care such as The Affordable Care Act with Medicaid increases. Health care is an ever-changing market but one thing that is certain are that there will always be a demand: people will always need health care and a way to pay for it. References Department of Health and Human Services. (2013). Retrieved from http://www.hhs.gov/open/contracts/index.html Department of Labor. (2013). Faq`s about portability of health coverage and HIPAA. Retrieved from http://www.dol.gov/ebsa/faqs_consumer_HIPAA.html Field, R. I. (2008, October). Why is health care regulation so complex' Pharmacy and Therapeutics, 33(10), 607-608. Retrieved from http://www.ncbi.nim.nlm.gov O`Herrin, J., Fost, N., & Kudsk, K. (2004, June). Health Insurance Portability and Accountability Act: regulations effect on medical research. Annals of Surgery, 239(6), 772-778. Rosenbaum, S. (2011, Jan-Feb). The Patient Protection and Affordable Care Act: implications for public health policy and practice. Public Health Report, 126(1), 130-135. Retrieved from http://ncbi.nlm.nih.gov/pmc/articles