Governmental Regulatory Agencies - Effect on the Health Care Industry
Health care is a very complex industry with high social and community visibility. Due to high importance, public risk, and complexity, the health care industry is heavily regulated by federal and state laws and regulation. In order for health care provider to remain complaint and reduce their risk, they must be knowledgeable of laws and regulation impacting their specific program or organization. Failure to do so could result in fines, penalties, prosecution, or even prison. Federal and state governments’ objective is to increase health care organization/provider accountability; therefore, the providers must hold themselves accountable. Discussed below are just a couple of laws/act and regulations that are impacting health care.
Laws versus Regulation – Health Care
In order to determine how laws and regulations impact health care, the definition of each need to be determined. Legislation (Law/ACT) is presenting a bill taken before the government legislature and having that bill passed and signed into law. Regulations are guidelines or instructions on how the laws/ACT should be enforced (Harris, 2008). Regulations are developed through federal and/or state agencies. The development of regulations/ guidelines also includes a public comment period process. This is a set period of time the public can comment on the proposed regulations. The purpose of health care laws and regulations is to maintain system integrity, develop a fair and consist process, and protect the public.
Fraud Enforcement and Recovery Act of 2009 and Title VI Transparency and Program Integrity Regulation The Fraud Enforcement and Recovery Act of 2009 (FERA) is a law/Act implemented to boost enforcement of not just health care fraud but also mortgage fraud, financial institution fraud, and other federal assistance program frauds. The act also included...
References: Harris, D. M. (2008). Contemporary Issues in Healthcare Law and Ethics (3rd ed.). Chicago, IL: Health Administration Press.
The False Claims Act: Recent Amendment and Their Implications. (2010, April). NACUA Notes, 8(8), Retrieved from http://www.princeton.edu/ogc/legal-guidance/compliance/Vol.-8-No.-8.pdf
Centers for Medicare and Medicaid Services. (2010). The Patient Protection and Affordable Care Act. Retrieved from http://www.cms.gov/Regulations-and-Guidance/Legislation/LegislativeUpdate/downloads/ppaca.pdf
Rosenbaum, S. (2011, January). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Report, 126(1), 130-135. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001814/
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