The healthcare industry has come a long way and it’s important to note all of the laws that help keep everyone safe.
In a perfect world, we would not have to draft laws to regulate industries that can decide the fate of human life. The world is not perfect, however, so there are now numerous laws standing guard against irresponsible behavior and threats to patient or worker safety. Here are just a few lawful requirements that hospitals must follow to stay compliant.
Patient Safety and Quality Improvement Act (PSQIA) of 2005
In 2005, the government enacted the Patient Safety and Quality Improvement Act of 2005 (PSQIA) to help improve the conditions at medical facilities. The law states that any healthcare professional can report errors and hazardous conditions in the medical field without compromising the confidentiality of the patients involved. Medical facilities may, for example, disregard hygienic best practices that could easily be fixed with the purchase of scrub jackets women.
Health Insurance Portability and Accountability Act (HIPAA) of 1996
In 1996, the government placed HIPAA into action to help recently unemployed individuals maintain health insurance as they sought new work. As the years passed, the law evolved to include provisions for using, storing, and transmitting confidential health information about patients. Anyone caught violating the law is subject to criminal and/or civil penalties.
Fraud and Abuse Laws
The federal and state governments have laws that deter acts of fraud and abuse. These laws collectively discourage health professionals from:
- Participating in fraud or abuse of the healthcare system
- Recommending or prescribing procedures unneeded by patients for financial gain
- Recommending or prescribing medications unneeded by patients for financial gain
- Invoicing fraudulent bills to government or private insurance providers
- Engage in money laundering
Healthcare professionals must abide by these laws or face legal consequences.
Emergency Medical Treatment and Labor Act (EMTALA) of 1986
In 1986, the government passed the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals to take in everyone arriving at the Emergency Room (ER). They must provide treatment and stabilize patient conditions. Medical facilities may not reject admittance based on their ability to pay the bill or the status of their health insurance.
Anti-Kickback Statute (AKBS) and Stark Laws
The healthcare system can sometimes be abused for financial gain, and the Anti-Kickback Statute (AKBS) aims to prevent any intentional misconduct. Under the AKBS, healthcare professionals must not engage in any valuable exchange in return for financial compensation or gainful referrals. Violating this statute is considered a crime.
Physicians must comply with the Stark Law, a set of anti-fraud and abuse laws in the medical domain. These laws prevent healthcare professionals from referring patients to third-party entities providing the same care that is already covered by Medicare. Violation of this law is not considered a crime but does carry civil penalties.
Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009
In 2009, the government enacted the Health Information Technology for Economic and Clinical Health Act (HITECH) to ensure that healthcare facilities comply with HIPAA. Auditors will verify that healthcare providers follow regulations designed to keep patient information confidential, including the use of the safest and most secure technology available. Should a healthcare entity fail to comply with regulations, financial penalties may result accordingly.
Hospital Readmissions Reduction Program (HRRP) of 2012
A derivative of the Affordable Care Act initiative, the Hospital Readmissions Reduction Program (HRRP) directs the Centers for Medicare and Medicaid Services (CMS) to administer lower payouts to healthcare facilities with chronic patient readmittance. Hospitals collaborating with CMS are subject to such penalties for admitting repeat patients in excessive amounts over 30 days.
The healthcare industry has come a long way and it’s important to note all of the laws that help keep everyone safe. Laws protect the rights of healthcare workers, focus on patient confidentiality, and prevent abuse of the healthcare system. As time goes on, more laws will emerge to continue providing adequate protections to everyone within the medical domain.