Is your medical insurance company denying your claim without sufficient reason?
Did you know that if you are a young adult who cannot afford insurance just yet, your parent’s insurance plan has your back?
Did you have Obamacare?
Have you seen the recently proposed law that aims to keep prescription drug prices under control?
Well, all of your queries have answers in the Healthcare laws of the US.
The Intersection of Health and Environment
Every now and then, we wonder what the government does to ensure our good health and well-being. Additionally, we also see lawmakers make environmental protection laws. Consequently, these laws protect the ecosystem, thus protecting us from the ill effects of environmental toxins.
But apart from that, what else? That is exactly where Healthcare laws come into the scene. Healthcare regulations are a part of the law that deals with all your healthcare needs. Moreover, these laws protect your rights in regular healthcare-related transactions.
Understanding Healthcare Law
In this article, we will give you details on what healthcare law is and how it helps you. Furthermore, we will also tell you about the rights that you enjoy under the healthcare laws of the land.
What Is Healthcare Law?
Healthcare law, at its core, is of service to all citizens who need or get health services. It caters to the rights and duties of the individuals/legal persons getting the care and giving it. If you are a citizen of the United States paying for medicines and treatment, these laws concern you.
The Vast Scope of the Healthcare Industry
Data from 2021 says that Americans spent more than $4 trillion on health care that year. By that, we very well understand the scope of the industry. In the United States, the healthcare sector is one of the largest and with the maximum laws and regulations.
Consequently, these laws are complex because they cater to the needs of each American. So, let us find out what healthcare law consists of.
Healthcare Law’s Influence on Healthcare Industry Operations
The healthcare industry consists of all organizations, individuals, and professionals who provide their services in delivering healthcare. They might all take part directly or indirectly in the process.
Legislation Governing Healthcare Providers
Doctors, nurses, lab technicians, pathologists, and every healthcare provider come under the purview of healthcare laws. Therefore, that means that a wide range of laws and regulations govern their licensing structure and requirements, liability, and even patient care practices.
Remember, these are the laws that allow you to hold healthcare providers accountable for their negligence. Therefore, if you know a doctor has deliberately harmed you, take action against the health care laws of your country.
Upholding Quality Healthcare Practices
They Uphold Guidelines For Healthcare Practices. Healthcare practices, such as medical offices, clinics, and in and out-patient facilities, abide by these laws to keep running successfully. Moreover, these laws ensure that the facilities respect patient privacy and protect healthcare records and other sensitive information.
Health Insurance Portability and Accountability Act (HIPAA)
For example, let’s say that your hospital has sold your healthcare records to a third party. What do you do now? The Health Insurance Portability and Accountability Act (HIPAA) will come to your rescue.
This piece of healthcare law provides strict privacy and security guidelines. According to this federal law, patient health information is to be subject to utmost privacy. Consequently, if your healthcare facility is in violation of these provisions, it can result in severe penalties.
Regulating Physician Practices
Laws That Guide Physician Practices or Practice Groups. Physician practices or groups who deliver healthcare services must adhere to these laws. For example, they should obey the professional conduct guidelines, uphold fair billing practices, and take measures against fraud prevention. A classic example of this component is the Stark Law in healthcare.
The Stark Law
So, what is Stark Law in healthcare?
The Stark Law states that physicians cannot legally refer patients to people with whom they share a financial relationship. This prevents doctors from using their patients for personal gain.
Mental Health Protection
Extension To Mental Health Facilities. We all are aware of the inhuman treatment mentally challenged individuals have to go through early on.
Consequently, these laws pay special attention to mental health facilities so that patient rights are well protected. They do so by making sure that healthcare providers cannot take advantage of these vulnerable populations.
Mental Health Parity and Addiction Equity Act
One such federal healthcare law is the Mental Health Parity and Addiction Equity Act. According to it, insurance companies will provide coverage for mental health and substance use disorder treatments as well. With this provision, this Act establishes that Mental health is just as important as physical health.
Equal Treatment for All Insurers
Public and Private Insurers Must Abide By These Laws. It does not matter whether your health insurance is public or private. Consequently, be it Medicare or Medicaid, healthcare laws do not discriminate.
Affordable Care Act (ACA)
All citizens have the same requirements and enjoy protection under the same anti-fraud measures. Moreover, the Affordable Care Act (ACA) guarantees rights to an individual having private health insurance. They will be enjoying all essential health benefits even if they do not fall under a public insurance policy.
Did you know that if you are a young adult who cannot afford insurance just yet, your parent’s insurance plan has your back? Yes, you are covered under their plans until you turn 26. Consequently, that gives you plenty of time, right? This is yet another example of the scope and the benefit of healthcare law.
Healthcare Laws and Pharmaceutical Companies
How Does Healthcare Law Affect Pharmaceutical Companies? Healthcare laws protect you against unfair practices from pharma companies. All pharma bodies are to conduct their operations, research, marketing, and even pricing according to these laws. Consequently, they will have to adhere to ethical standards when carrying out drug testing and marketing of drugs.
Regulation of Pharmaceutical Companies
The FDA is one of the federal bodies of the United States that checks if the drugs meet the stipulated standards. Only approved drugs can make it to the market supply. Moreover, companies have to be clear and transparent regarding their advertising and labels. Consequently, healthcare law and ethics are closely tied. Pharmaceutical companies and all healthcare providers can face lawsuits for negligence and drug defects.
Concluding The Role Of Healthcare Laws
In addition to all the functions and scopes that we talked about, the role of these laws is never-ending. They protect us by preventing fraud and abuse. Consequently, did you know that any sort of financial incentives to doctors, hospitals, and healthcare providers in exchange for advertising or prescribing their products is unlawful?
Anyone violating these could face severe legal penalties. To add to it, these laws work hand in hand with antitrust laws to encourage market competition for the ease of consumers. To conclude, healthcare laws and regulations help us out in a number of ways. Hope you found our article helpful!