...Health Law and Regulations Governmental Regulatory Agencies HCS/545 December 16, 2013 Governmental Regulatory Agencies A regulatory agency is a government body formed or mandated under the term of a legislative act to ensure compliance with the provisions of the act, and in carrying out its purpose. “The role of government regulator agencies in health care is to monitor health care practitioners and facilities, provide information about industry changes, promote safety and ensure a legal compliance and quality services” (2013). Health care industry rules and regulations are determined by regulatory agencies, local, federal and state with mandatory oversight. Accreditation agencies require participation that is voluntary because certification of quality provides important ranking. Large private organization and the government help develop and enforce health care regulations. Role Governmental regulatory agencies in health care are the “Food and Drug Administration (FDA), The Agency for Healthcare Research & Quality (AHRQ), The Centers for Medicare & Medicaid Services (CMS), The Centers for Disease Control and Prevention (CDC), and The...
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...Health Law and Regulations Federal regulations play a major role in the health care industry. Federal laws and regulations protect the American public from a number of health risks and administer programs for public welfare. Federal regulations also regulate the health insurance industry by implementing cost-containment measures. Through various regulatory bodies, Department of Health and Human Services (HHS) protects and regulates public health at every level. HHS is the United States principal federal agency for protecting the health of Americans and providing essential human services. HHS administers more grant dollars than all other federal agencies combined. Medicare program administered by HHS is nation’s largest health care insurance. HHS governs more than 300 programs administered by its 11 operating divisions (Department of Health & Human Services, 2011). In addition, Office of the Inspector General (OIG) is also part of the HHS. Description of each 300 programs is beyond the scope of this paper. However, it is imperative to understand the role of each operating agency and how it affects the health care industry. Role of Federal Regulatory Agencies Each operating division consists of sub-divisions making health care system a complex maze. Main 11 operating agencies are: Administration for Children and Families (ACF) The ACF provides funding for family assistance, child support, and childcare. The state, county, and city governments provide these services (Department...
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...Health Law and Regulations Sara Collins HCS/545 August 17, 2015 Nathanial Elam Health Law and Regulations Over the years, health care has emerged into a well-defined complex entity. It’s very unique comparable to the healthcare in other nations. As American healthcare continued to grow and expand, so did the growth of insurance, the involvement of governmental ties, dependency of advancing technology, and the expenditures of what healthcare would bring upon the American people. This brought about the greater need for accountability for services rendered at that healthcare institution (Morrison, 2011). Healthcare regulatory agencies have also had to keep up with the evolving healthcare fields. American College of Surgeons started a standardization of practices in the healthcare fields. This later developed with various other adjoining forces into what we know today as the Joint Commission on the Accreditation of Hospitals. In 1987, this evolved into the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This accrediting agency had influences among the ambulatory care, assisted living, home health, behavioral, health, laboratories, long term care, and office based surgeries (Morrison, 2011). JCAHO was developed to set a standard of care that held these services accountable for. This helped to have hospitals provide the same level of quality care to the people they served from the community. This in turn provided safe care...
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...Health Law and Regulations Crystal Sullivan HCS/545 October 6, 2014 Terry Matherne Health Law and Regulations According to "About Hhs" (2014), the purpose of governmental regulatory agencies in healthcare is “for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves” (para. 1). Governmental regulatory agencies have taken on the problems of both consumers and health care providers in an attempt to find solutions that will meet everyone’s needs. They take their ideas and the ideas of the public, and create rules and regulations for the healthcare industry. Regulation plays a critical part in the healthcare industry. The U.S. HHS (the Department of Health and Human Services) has developed several public health regulations to protect the citizens of the United States. The job of the HHS to determine which laws and regulations will be in the best interest of the public. “Through various regulatory bodies, the Department of Health and Human Services (HHS) protects the public from a number of health risks and provides programs for public health and welfare. Together, these regulatory agencies protect and regulate public health at every level” ("Healthcare Regulation", 2014). The government uses federal regulations to implement public policies. The federal government healthcare agencies are allowed to issue rules during the rulemaking process with the approval of congress. There are several...
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...Health Law and Regulation-Medicaid and Medicare Mathew V Kurian HCS/545 November 5 2012 Pro. Maureen Lancellot Health Law and Regulation-Medicare and Medicaid Medicare and Medicaid, created by the Social Security Amendment Act 1965, added Title XVIII and XIX to the Social Security Act. President Lyndon B Johnson was responsible for bringing about this change. Social Security Program started during the Great Depression of 1930s because of the stock market crash and bank failure, which wiped away the retirement savings of the Americans. Poverty rate among senior citizen exceeded 50% during this time. Social Security Act was created in an attempt to limit the five dangers of modern American Society. The Social Security Act was signed by President Franklin D Roosevelt on August 14, 1935, thus becoming the first president to advocate federal assistance to the elderly. Edwin Witt, the executive director of the president committee on economic security is the father of Social Security. If the total benefit paid by social security in 1940 was $35 million, it was $247.8 billion in 1990, after 50 years. In 2009, about 51 million Americans received $650 billion benefits, under different social security programs like social security disability insurance (SSDI), supplemental security income (SSI), retirement insurance benefits (RIB), temporary assistance for the needy families, ticket to work and self-sufficiency program, unemployment benefit, State children’s health insurance...
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...Change and Culture Case Study Understanding mergers and acquisitions in the health care industry has evolved over the years. Health care has become increasingly complex and expensive. It is becoming a multi-trillion dollar industry worldwide. The topic of this research paper; the impact of mergers and acquisitions have in health care from a variety of viewpoints. The paper will discuss the multiple impacts in an effort to better understand mergers and acquisitions and what it means to the health care organizations culture, services, workers, and the patients they serve. What is Organization Culture? The organizational culture is not spoken of in an organization but felt on an everyday basis. The culture is defined by what is expected of people and what is valued. Culture defines the norms of behavior and how things are done in an organization. For an organization to be successful it must understand the culture which allows the organization to be productive. Culture defines the boundaries of behavior and performance which is the way of getting things done within the organization. Cultures are often developed early on in the organization and over time these experiences become the “rules and regulations” of the organization. Once a merger or acquisition is completed, the rules and regulations become something of the past (Eikenberry, 2006). The rules and regulations could have served one organization well; it will not work so well once a merger has been completed. When two...
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...Health Law and Regulations Paper Veronica Jenkins HCS/544 May 26, 2014 Professor: Kelly Gantt In the health care industry, regulations play an important role “Through various regulatory bodies, the Department of Health and Human Services (HHS) protects the public from a number of health risks and provides programs for public health and welfare” (fiercehealthcare.com). Implementing these two helps protect health care agencies and also regulate public health on every level. “The Centers for Medicare and Medicaid (CMS), founded in 1965, oversee most of the regulations related directly to the healthcare system” (fiercehealthcare.com). CMS provide numerous programs through the government. The health care industry has numerous regulations in healthcare. One example of laws and regulations facing health care is HIPPA. The transformation from paper charts to electronic records raises a great concern in the breach of security. “In addition, interoperability of systems is expected to create yet more breaches, as information is traded between networks. Laptop theft is the most common type of data breach, accounting for 24 percent of reported breaches, according to HHS. Desktop computers were involved in 16 percent of breaches and portable devices such as smart phones were involved in 14 percent” (beckershosiptalreview.com). Human and Health Service (HHS) require individual to notify patients when their information was breach. “The regulations, developed...
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...Health Law, Regulations, and Policy Paper Michelle Hobbs HCS/545 June 13, 2016 Qiana Amos Health Law, Regulation, and Policy Paper Today’s health care industry is more than just providing medical services to individuals in need; it encompasses various laws, regulations, and policies that direct how care should be provided and what the ramifications of non-compliance will have on the health care provider and the organizations where services are rendered. There are various kinds of laws, regulations, and policies that affect the health care industry. Some may believe that laws, regulations, and policies all have the same requirements, benefits, and implications, but there are differences between the three and the impact they have on health care. As the ability of the health care industry continues to expand, the need for additional laws, regulations, and policies will be necessary to ensure the quality and equitable delivery of medical services continues to improve alongside the medical services. Title VI of the Civil Rights Act of 1964 One law that governs the manner in which health care services are rendered is Title VI of the Civil Rights Act of 1964. This law states “no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance (United States Department of Labor, n.d.). For health...
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...Health Care Law and Regulations University of Phoenix Louise Underhahl HCS 545 Health Care Law and Ethics 2012 Health Care Law and Regulations One of the areas that are currently affecting the Health Care industry is Regulatory agencies. There is much dissatisfaction over the current state of healthcare in the U.S. Within all of our organizations, regulatory agency surveys are conducted to better the organizations as well as its employees. The purpose of the regulatory surveys is to focus on the areas that need improvement as well as promoting better health care access to the people in the community. Regulatory agencies serve as authority as well as enforcement to regulate laws from the government. Some examples of regulatory agencies are Food and Drug Administration (FDA), Agency for Healthcare Research and Quality (AHRQ), and Occupational Safety Health Administration (OSHA). There are many examples of laws and regulations that are currently being faced in health care. Analysis of health care laws and regulations help one understand their influences on the provider. There are many ways that laws and regulations affect our lives and community. The FDA is responsible for the oversight of drugs, medical devices, vaccines, blood products and biologics, establishing rules for testing, clinical trials and approval of new products. The AHRQ is a federal agency under Health & Human Services working to improve the quality, effectiveness and safety of health care...
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...AHRQ Health Law and Regulations Shelia Y. Janice HCS/545 Donna Lupinacci RN, MSN January 22, 2013 AHRQ-Health Law and Regulations Today we will have the pleasure of learning about the Agency for Healthcare Research and Quality. This government agency is tasked with improving safety, quality, effectiveness and efficiency in the health care system. We will examine the role of this governmental regulatory agency and the impact it has on the health care industry, current laws and regulations being faced by the AHRQ and the impact these laws and regulations have on providers and hospitals. Once we are done learning, we will all be able to relate situations we see or have seen in our own lives and communities. AHRQ Snapshot Dedicated to improving quality, safety, efficiency, and effectiveness of health care, AHRQ continues to build the knowledge base for what works and what doesn’t work in health care by working with public and private sectors and translates the information into everyday practice and policymaking. (AHRQ, 2013). The impact of AHRQ’s research is essential and very beneficial as people are able to understand the many ways to improve service delivery in the health care arena as well as addressing any other areas of need. Some major areas that have been under research such as information technology, health care utilization and costs, medication safety, disaster preparedness, illness prevention and other special needs in specific...
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...Health Law and Regulations Stephanie Sauceda HCS/545 March 17, 2014 Mary Cummings Health Law and Regulations Health care in the United States has changed over the years and the federal government saw need to establish regulatory agencies such as the Centers for Medicare & Medicaid Services (CMS) to ensure the elderly, disabled and low income receive quality and cost-effective health care. As a result of health care costs sharply increasing, the government determined it needed to have oversight on the health care industry and pushed for the establishment of managed care organizations (MCO). CMS enforces the Emergency Medical Treatment & Labor Act (EMTALA); this act was created to ensure health care organizations provide a minimum of a medical screening exam to determine if complaint is emergent or not. Most importantly for EMTALA is the obligation to treat emergent cases regardless of the patient’s ability to pay for services. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was approved by the United States Congress to regulate the use of and protect patient health records and the Department of Health & Human Services oversees the compliance and violations of HIPAA (Department of Health & Human Services, n.d.). The intentions of many of these regulatory agencies is to oversee that the health care industry is providing quality, affordable health care and treating patients with fairness and privacy. In 2008, the Centers for Medicare...
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...Health Law, Regulation, and Policy Paper The Affordable Care Act is a law that has had a significant impact on the health care industry. The Affordable Care Act, also known as the ACA, is a health care law implemented in 2010 that gives consumers more control over their health care. The law gives Americans the ability to make knowledgeable decisions about their health. The law is influenced by lack of comprehensive insurance coverage, high insurance costs, and limited choice of health care. The law makes health care more reasonably priced, accessible, and of higher quality for families, the elderly, businesses and tax payers. Also, the law allows previously uninsured Americans to obtain sufficient coverage. The law is important because it improves health care. It improves health care by increasing insurance coverage. Medical coverage is available to adults up until the age of 26 and denial for pre-existing medical conditions is prohibited. The law is also important because it improves health care costs. The law ends lifetime limits on coverage and reviews premium increases. More care options are also available with the law. The law removes insurance company barriers to emergency services, allows patients to choose their health care provider, and covers preventative care without an out-of-pocket cost to the patient. Throughout this paper, there will be discussion on several different topics regarding the impact of the Affordable Care Act on health care organizational policies...
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...Running head: HEALTH CARE LAWS, POLICIES, AND REGULATIONS Health Care Laws, Policies, and Regulations Frank Frimpong Manso HCS 545 July 4, 2016, 2016 Prof Elam Health Care Laws, Policies, and Regulations Health Law, Regulation, and Policy has become the means of health protection and prevention for the American people. The government highly regulates these laws improving the health of the public by developing programs, resources, and tools, aiding in health care access, however, there are also different private bodies involved in regulating the healthcare sector. Health care regulation is focused on three main roles; cost control, quality control, and access expansion and control. This paper will discuss the impact of ACA on health care organizational policies. The Affordable Care Act (ACA) The Affordable Care Act (ACA) is a health care regulation signed into law on the 23rd of March, 2010. The law’s main focus had been to increase the affordability and quality of American health insurance. Its policies were focused on lowering the rates imposed on the uninsured through the expansion of both the private and public insurance covers. It had also aimed to reduce the health care costs incurred by the government along with citizens. Barely seven days after its enforcement had a new health care law come into effect with amendments to the ACA. On March 30, 2010, the president of the United States signed into law the Healthcare and Education Reconciliation Act of 2010. The law had been enacted...
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...Regulatory Issues in Health Care Fremgen (2009) defines medical laws or actions set by the federal government and the court system that have binding legal force that address legal rights and obligations affecting patients and protecting the individual rights of patients and health care employees. 50 state have statutes for medical practice acts which apply to precisely to the way that medicine is practiced in a particular state. Laws begin as act acts which define the meaning of “practice of medicine” and set the requirements and procedures for licensure. Medical practice acts also establish what can be considered as unprofessional conduct in particular states. Examples of unprofessional conduct include practicing medicine without a license, practicing healthcare or the inability to practice health care while under addiction or mental illness, felony convictions, insufficient record keeping, employing unlicensed persons to practice medicine, and prescribing drugs in excessive amounts. We currently live in a litigious society. Medical providers must balance providing quality and keeping abreast with current health care regulations to protect themselves from health care law suits (Fremgen, 2009). Laws are enforceable rules set by a government authority. An article related to a regulatory issue in health care will be analyzed to reflect how laws affect the regulatory process in health care. The Four Categories of Law Laws fall into different categories which include constitutional...
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...Health Care Law, Regulations and Policy HCS/545 November 23, 2015 Health Care Law, Regulations and Policy Health Care law and legislation came about to define the scope of acceptable practice of clinicians, while protecting the public’s individual rights. Miller and Hutton states “Law can be defined as a system of principles and processes by which people who live in a society attempt to control human conduct to minimize the use of force in resolving conflicting interests.” When creating laws, conflicting interest often takes into consideration the basis ethical principles that includes autonomy, beneficence, nonmaleficence, and justice to name a few. Laws, particularly health care laws are often in the form of a statutes, such as the nurse practice act, that serves as a guidance for nurses to know what defines and limits our practice. As such, the law also regulates how statures must be enforced. Administrative agencies, such as the Center for Medicaid and Medicare Services under the auspices of the Health and Human Services, have created rules and regulations to enforce statutory laws. When we look at laws in nursing and other industries, it is an extension to address ethical issues that universally affects our society. Health care agencies are mandated to adhere to the rules that are created by regulatory agencies that can come in the form of laws, regulations, or codes, and are enforced through controls that make sure that these rules are adhered...
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