University of Phoenix Material
Benchmark Assignment—Laws and Regulations in Health Care
Research the following health care regulations and select one law or regulation to focus on for this assignment:
Patient Protection and Affordable Care Act of 2010
HIPAA Privacy Rule
Occupational Safety and Health Act of 1970
False Claims Act
Stark Law (Physician Self-Referral Law)
Human Research Protections
Use the law or regulation above to respond to each of the following prompts in 350 to 525- words.
Evaluate the impact the law or regulation selected has on the health care industry (350 to 400- words).
The Patient Protection and Affordable Care Act of 2010 also known as Obamacare is a law that was enacted by President Barrack Obama in 2010 to improve health care service delivery system in the United States (Thompson, 2015). The law was aimed to increase the number of American citizens with health insurance, which would enable them to access quality health care services (Thompson, 2015). This was to be achieved through a mandatory requirement for every American citizen to have health insurance or face legal penalties. The platforms to access health insurance were availed which included Medicare, through their employers, or through private insurance providers. The health insurance costs depend on one’s age, the insurance plan, and their income (Thompson, 2015).
The Patient Protection and Affordable Care reduced the government spending on the provision of health care services to the public (Rosenbaum, 2011). This law positively impacted the health care industry which is now able to provide services to majority of the American citizens. The main goal of the health care industry is to provide health care services to American citizens improving the health of all citizens (Rosenbaum, 2011). Through this law, this has been achieved with an increase in the number of American citizens having access to health care services that they used to. With the United States government having a reduced spending in provision of health care services to the public, the funds can be directed on the improvement of the health care industry, which can include availing new machines, and equipment, which will improve the health care service delivery (Rosenbaum, 2011). The government can also concentrate on other aspects of the health care system, which are also important in ensuring quality health care services. This can include increase the nurse to patient ratio (Rosenbaum, 2011).
For health care facilities to provide better health care services, the nurse to patient ratio must be sufficient (Feldman et al., 2015). With the government increasing the number of nurses in the health care industry, the health care goals and objectives can be better achieved. With every citizen being able to access health insurance, low-income families who were not able to have access to health care services are now in a position to have access to the important service (Feldman et al., 2015). Health care facilities will better manage the patients who were not able to seek medical services due to the costs associated with the services, which resulted to worsening of their health conditions, which would later require complex treatment methods (Feldman et al., 2015).
Evaluate what impact the legal and regulatory requirements of the law or regulation you selected has on the health care industry (350 to 400- words).
The Patient Protection and Affordable Care Act of 2010 legal and regulatory requirements have positively impacted the health care industry (Bagley ; Levy, 2014). With the requirement that every individual should have health insurance, this has increased the number of individuals able to access health care services with the health care industry offering its services to a larger population than it did before (Bagley ; Levy, 2014). Most low-income families are unable to access health care services due to the high costs involved but with health insurance, this can be achieved. Through this act, health care facilities are able to provide health care services equally without discrimination. Since most health care plans have the same coverage, individuals can all access public health care services equally (Bagley ; Levy, 2014).
The health care industry is now more accountable to a larger population and there is a reduction on the wastage of resources, which has led to a more effective heath care industry (Bagley ; Levy, 2014). With an increase in total population health coverage, health care facilities are able to provide preventive health care to a larger population, which will ultimately improve the overall health of the American citizens (Bagley ; Levy, 2014). With rules and laws regulating the health care insurance providers, the providers are unable to charge large premiums to the consumers and paying back of rebates to the consumers will benefit the consumers. This will increase the number of those seeking the insurance services (Bagley ; Levy, 2014).
An increase in the number of insured citizens means improved health care since more citizens are able to access health care services across the country (Bagley ; Levy, 2014). Individuals with low-income are also able to access health insurance coverage, which are provided by Medicare and Medicaid programs (Feldman et al., 2015). This will increase the total number of covered citizens. With the requirement that every citizen must have health insurance, children and individuals with special needs are also able to access health care services (Feldman et al., 2015). Most individuals with special needs and children are mostly discriminated against access to health care insurance plans and have a difficult time in accessing health care services due to the high costs. With a mandatory requirement for health insurance, health care facilities will be able to provide health care services to these individuals at an affordable rate and without discrimination (Feldman et al., 2015).
Analyze the role accreditation and regulatory agencies play in the law or regulation you selected (350 to 400- words).
Accreditation and regulatory agencies ensure that health care laws and policies are implemented in the right order providing support and advice whenever necessary (Thompson, 2015). The roles played by accreditation and regulatory agencies in the Patient Protection and Affordable Care Act of 2010 include an analysis of the clinical quality measures which is to be done by an agency recognized by the secretary for the accreditation of health insurance issuers or plans (Thompson, 2015). The accreditation and regulatory agencies also ensure that insurance consumers are protected from insurance providers who might not comply with the set regulations. These agencies approve any programs related to consumer health insurance plans (Thompson, 2015).
Accreditation and regulatory agencies also ensure that the health care quality is continuously improved as the Patient Protection and Affordable Care Act is aimed to improve health care service delivery in the United States (Thompson, 2015). This is achieved through supporting health care facilities in integrating new policies and laws in their system while at the same time maintaining productivity (Thompson, 2015). Accreditation and regulatory agencies also ensure accountability in the health sector. Accountability is important especially in public institutions as they are meant to provide services to the public and if accountability is not taken into consideration, resources may be misused which may result to under performance and poor service delivery (Thompson, 2015). The health sector is an important department in any country and laws and policies are made to ensure that services are provided and accessible to each citizen.
The Patient Protection and Affordable Care Act is meant to improve service delivery and accountability must be undertaken to ensure this is achieved (Rosenbaum, 2011). There are organizations which accredit health care providers to ensure that the qualified and skilled employees are selected who are able to follow set rules and regulations for the benefit of the public (Rosenbaum, 2011). The government has appointed individuals who evaluate accreditation agencies depending on the main goals, which include improvement of health care service delivery (Rosenbaum, 2011). The joint commission is a commission responsible for the certification of health care programs in the United States to ensure quality programs are implemented (Rosenbaum, 2011). The Children Health Insurance Program (CHIPP) has a role of ensuring that all eligible children have health insurance cover from the health insurance exchange (Rosenbaum, 2011). Accreditation and regulatory agencies ensure that all insurance providers follow the patient protection and affordable care requirements without any discrimination (Rosenbaum, 2011).
Cite at least 3 peer-reviewed, scholarly, or similar references to support your assignment.
Formatyour references according to APA guidelines.
Bagley, N., ; Levy, H. (2014). Essential health benefits and the Affordable Care Act: Law and process. Journal of Health Politics, Policy ; Law, 39(2), 441-465.
Feldman, H. M., Buysse, C. A., Hubner, L. M., Huffman, L. C., ; Loe, I. M. (2015). Patient Protection and Affordable Care Act of 2010 and Children and Youth With Special Health Care Needs. Journal of Developmental and Behavioral Pediatrics, 36(3), 207–217.
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Reports, 126(1), 130–135.
Thompson, T. (2015). The Affordable Care Act. Farmington Hills, Mich.: Green Haven Press.