Healthcare industry stakeholders are bound to several healthcare laws and regulations that they must uphold. Compliance is extremely important in healthcare for both provider and patient.
A staple of Hudson, Potts & Bernstein’s practice for more than a century has been its service to the healthcare industry. From solo practices to large, multi-specialty groups and hospitals, HPB advises healthcare providers in all manner of regulatory, legal, and litigation matters.
This includes advising cliens regarding:
The healthcare industry is a vital component of our society. The laws that regulate it are the foundation of the relationship between healthcare providers and the people who receive that care. There are many legal matters on both sides of the coin and keeping the entire process operating smoothly ensures that the framework of our clinics, hospitals, and practitioners remains intact.
Healthcare industry stakeholders are bound to several healthcare laws and regulations that they must uphold. Compliance is extremely important in healthcare for both provider and patient.
Patient Protection and Affordable Care Act-Expands Medicaid eligibility and requires every US citizen to purchase health insurance. It also requires insurers to accept all applicants and forbids discrimination. It also requires uniform rates regardless of medical history.
Social Security Amendments of 1965 – Established the federal Medicaid and Medicare programs.
COBRA – Consolidated Omnibus Budget Reconciliation Act. Allows individuals and families to keep their group insurance for a certain amount of time after their employment has been terminated.
EMTALA – Emergency Medical Treatment & Active Labor Act. Requires healthcare providers to offer treatment or care to any person who is having a medical emergency, including active labor, even if they can’t pay for the services.
HCQIA – Health Care Quality Improvement Act. Created to protect medical providers from litigations related to peer reviews and encourages filing an official complaint against unprofessional peer conduct
HIPAA – Health Insurance Portability and Accountability Act. Gives workers in the US the ability to carry their health coverage from job to job. It also prohibits insurance providers from discriminating against policy applicants due to any health issues they may have. But HIPAA is probably best known for protecting a patient’s medical information.
CHIP – Children’s Health Insurance Program. A federal program that provides health insurance for children living in low insurance households.
Abuse and Fraud
Unfortunately, abuse and fraud can sometimes find their way into the healthcare arena.
Some areas of healthcare fraud include:
Third-party payers like insurance companies are an integral part of the healthcare system. It is often the insurance provider that will cover all or part of a patient’s healthcare costs. Medicare and Medicaid are government sponsored insurance programs that are also used to help patients pay for their healthcare instead of having to pay out of pocket. When disputes arise between our clients and health insurance providers, we are there to ensure fairness and see to it that our client’s rights are protected.
Accidents happen, but in the healthcare arena, an error can be deadly. Patients who have been a victim of medical malpractice or healthcare providers who are involved in a medical malpractice case need solid representation to make sure that the case has the best possible outcome and that the letter of the law is followed.
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