Health Laws and Regulations
April 29, 2013
Health care organizations are bound by rules and regulations, without these rules and regulations patient would not be allowed to receive quality care. The rules and regulations which demand health care organization to provide quality care is through governmental agencies. The will describe how governmental agencies play a part in the health care organization. The writer will provide two examples of laws and regulations facing the health care industry. Providing analysis and examples of specific laws will allow others to understand how the laws work in a health care setting. The writer will describe how ...view middle of the document...
Two Examples of Laws and Regulations
The first law and regulation currently facing today’s society is health care privacy and security. Laws and regulations which govern the privacy and security of patients are called Health Insurance Portability and Accountability Act (HIPPA). HIPPA was established in 1996 to form standards to protect patient’s medical records, personal information, electronic records, and the patients’ health care plan (U.S. Department of Health & Human Services, n.d.). HIPPA did not just regulate patients’ privacy, but this law establishes limits and condition to be considered and used when employees disclosure of patient information without his or her consent. This law allows patients the right over his or her medical records which include inspecting for errors, review of records at any time, and request of a duplicate copy for his or her personal privacy. If employees fail to comply with HIPPA rules and regulations the individual actions can result in civil and criminal penalties. The minimal criminal penalties are (AMA, 2013)
* Accidental violation: $100 per violation with a maximum of $25,000 for recurrence
* Not due to willful neglect: $ 1,000 per violation, with a maximum of $100,000 for recurrence
* Damage modified within specific period: $10,000 per violation, with a maximum of $250,000 for recurrence
* Willful negligence corrected: $50,000 per damages, with a yearly maximum of $1.5 million
The second law and regulation currently facing today’s society in health care is abuse of Medicare and Medicaid. Health care fraud and abuse has appealed to a superior number of individual because of the monetary damages credited to fraud are assessed to be billions of dollars yearly (Staman, 2010). Health care workers or providers who perform unlawfully services and wish to gain revenue from taxpayer-funded health care programs need to be reported and stopped. A way to control fraud of Medicare and Medicaid is the False Claim Act; this is an effective tool which allows individuals with knowledge of a false claim to file a lawsuit (Whistleblower, 2013). Federal authorities are not allowing fraud to slip through his or her hands; May 2012 these agents announced 107 health care workers in several cities were arrested for filing fraud claims in the amount of $452 million (Forbs, 2013).
Under Section 1128A of the Social Security Act, the Office of Inspector General is authorized to impose civil penalties and assessments on a person who engages in various types of improper conduct. Persons who have violated the statute and have furnished an item or service under which payment could be made under will be punishable with a fine up to $25,000 or five years imprisonment (Staman, 2010). If an individual is involved in connections with false information can be found guilty of a misdemeanor and will be fined up to $10,000 and imprisoned for one - year (Staman, 2010).
Analysis of the Laws
HIPPA plays an...