Over the last few decades, the United States’ healthcare policy has shifted rapidly. This is the result of a number of factors, primarily political and economic, that have shifted the emphasis away from a government-run system and toward a more market-oriented approach.
This article is going to provide you information about a brief overview of 8 regulations will assist in understanding of the current U.S. health care system and how it has shaped up over time.
8 Crucial Health Care Regulations In The U.S
Healthcare Quality Improvement Act of 1986 (HCQIA)
During conduct assessments, the Healthcare Quality Improvement Act (HCQIA) provides immunity resources for medical professionals and institutions. The law was inspired in part by a Supreme Court decision involving abuse of the physician peer review process. HCQIA is still evolving as the act emerges in courtrooms and justices issue new rules.
The legislation was enacted to protect medical professionals from peer review-related lawsuits and to encourage physicians to file official complaints when they encounter unprofessional and dangerous peer conduct.
The Medicare program provides health insurance to nearly 50 million Americans. In 1945, President Harry Truman petitioned Congress for funds to ensure all citizens of the United States. President John F. Kennedy finally succeeded in providing coverage for senior citizens in the United States twenty years later. Today, the Congressional Budget Office predicts that Medicare will continue to exist indefinitely due to comprehensive spending reforms.
President Johnson’s 1965 legislation also included a provision to provide low-income people with health insurance. Medicaid now covers more than 70 million American citizens. The program reimbursed hospitals for nearly half of all medical expenses in 2014.
Medicaid recipients include uninsured expectant mothers, temporarily unemployed workers, and disabled people. Recently, new legislation has reduced the nation’s uninsured rate to less than 9%, the highest coverage rate in US history.
Children’s Health Insurance Program (CHIP)
Along with Medicaid, the Children’s Health Insurance Program (CHIP) has laid a solid foundation for providing health coverage to low-income children who do not have access to health care programs.
The Children’s Health Insurance Program (CHIP) was established by the Children’s Health Insurance Authorization Act of 2009 (CHIPRA) and has successfully served many previously disqualified clients.
The program has a long history of providing insurance to underprivileged children and is funded by the general public, individual states, and the federal government. The Affordable Care Act (ACA) now makes this service available to the most low-income children in the country’s history.
Hospital Readmissions Reduction Program (HRRP)
The Hospital Readmissions Reduction Program (HRRP), a component of the Affordable Care Act, requires the Centers for Medicare and Medicaid Services (CMS) to reduce payments to care facilities that have a high rate of patient readmissions.
The HRRP, which debuted in late 2012, defines readmissions as “repeat patient admissions among participating CMS hospitals in a 30-day period; allowing exceptions for specific conditions, such as heart failure and pneumonia, as well as factors such as poor health and multiple illnesses.”
Health Insurance Portability and Accountability Act (HIPAA) of 1996
The Health Insurance Portability and Accountability Act (HIPAA) protects American workers by allowing them to carry health insurance policies from job to job. The HIPAA regulation also permits workers to apply to a select group of health insurance plans to replace lost coverage and adjust for family changes such as marriages, births and adoptions.
HIPAA bars insurers from discriminating against policy applicants due to health problems. In some instances, if an insurance company denies a worker’s application, the individual may apply for coverage outside of the normal enrollment period. Additionally, the regulation preserves state laws that protect workers’ insurance rights.
Patient Safety and Quality Improvement Act (PSQIA) of 2005
Health care workers who report unsafe conditions are protected under the Patient Safety and Quality Improvement Act (PSQIA). The law was enacted to encourage the reporting of medical errors while protecting patients’ confidentiality rights. To protect patient privacy, the HHS fines those who violate confidentiality agreements.
The law also gives the Agency for Healthcare Research and Quality (AHRQ) the authority to publish a list of patient safety organizations (PSOs) that collect and analyze patient safety data. The Office for Civil Rights (OCR) is in charge of enforcing the law in national health care facilities.
Affordable Care Act of 2010
President Barack Obama signed the Affordable Care Act (ACA) in March 2010, a slightly modified version of the all-inclusive coverage envisioned by presidents since the early 1900s.
The act requires most U.S. citizens to apply for health insurance coverage, imposing a penalty on those who do not obtain coverage but making exceptions for a few protected groups. Businesses with more than 200 employees are required by law to provide health insurance coverage.
The act also created the American Health Benefits Exchange, which allows citizens to review and compare insurance plans. The Affordable Care Act offers health care professionals the opportunity to participate in shaping the delivery of patient services. The medical field can benefit from input that helps deliver better clinical services to the growing patient population while reducing care expenses.
As a current or future decision maker in the healthcare field, care providers must reflect on how to create these results at their respective workplaces.
The health-care system in the United States is complex and ever-changing. That is why it is critical to stay current on the latest regulations and laws, particularly if you work in or own a health care business. This is also useful before proceeding with your plan in the health care department.
If in need of consulting, it is advised that you contact trustworthy medical agencies. Consider this your go-to guide for the most important health care regulations in the United States. We hope you find it helpful and stay tuned to our website for more useful content on laws and general life science.