Health care laws and regulations governing health care in the United States

Health care laws and regulations governing health care in the United States

The United States has seen several enacting of healthcare laws and regulations that have helped to improve the provision of health care services in the country. The implementation of these laws is done by the department of health and human services (HHS). Through the laws and regulations, and ethical environment for the provision of services is created. Patient confidentiality has been emphasized by health care regulations that have seen improvements in ensuring patients’ medical privacy. Even insurance companies have released regulations that govern how information concerning a patient’s health is issued. Also, through laws and regulations, the relationship between patients and health care providers is regulated. It is unethical for caregivers to enter into personal relationships with their patients. In this case, if they engage in sexuality, the practitioner can lose his or her license. This is because the act is viewed as a severe violation of the patient’s rights, and thus, the doctor can be sued and therefore forbidden from giving any medical service in the future. Malpractices and negligence by doctors have been reduced through the regulations done over the years (Swedler et al. 2017) (2 slides)

Health care laws and regulations

The united states have enacted laws like Medicare, Healthcare Quality Improvement Act (HCQIA) that was enacted in 1986, Medicaid, and the Affordable Care Act of 2010 popularly known as Obama Care. Medicare program was a mechanism that President Harry Truman wanted to provide health insurance to all citizens of the United States of America. The Medicaid legislation was meant to include low-income individuals in the provision of health insurance. This provides health coverage to over 70-million citizens of the United States. The Obama care act of 2010 (Affordable care act 2010) required all citizens to acquire health insurance coverage inclusively. Under the law, all enterprises that would employ more than 200 workers were required to provide insurance cover for its workers. The HCQIA of 1986 provides insurance to medical professionals. Other regulations include the Children’s Health Insurance Program (CHIP) was created to provide health coverage to children from low-income families. Patient Safety and Quality Improvement Act (PSQIA) of 2005 was enacted to protect health care workers who may report dangerous conditions (DiGiorgio & Avram 2018) (2 slides)

Hospital accreditation and regulations

Hospital accreditation is a self-assessment process that care organizations use to access their performance. They measure their performance based on established standards by use of external measures of assessments. The assessment is meant to improve the provision of services in the health organization. Accreditation does not only involve setting standards but also includes self-improvement dimensions, analysis, and counseling process. As such, hospital accreditation is mainly meant to improve the safety of patients. The process of accreditation is a voluntary process that is conducted by external reviewers to a hospital (Lazzeri et al. 2019.) This is different from regulations that govern medical organizations. Regulations guide the process of provision of services in health organizations. The regulations govern the cord of conduct of health practitioners in the health organizations, and thus, it is not a process of self-evaluation. Laws are put in place to maintain ethical relationships in health care organizations and therefore ensure services are provided with integrity (2 sides)

Importance of Continuous readiness

According to Vaishnavi et al. (2019), continuous readiness is a process that involves proactively maintaining the safety of the health organizations in a country. This ensures all workers do the right thing as they understand the importance of maintaining ethics. The significance of this is to ensure the safety of patients.  The process involves regular training of staff members to ensure they are compliant with the requirements of their work. Also, continuous readiness ensures the staff stays current in maintaining records, inspections, and testing. This improves the experiences with staff members. Also, it is a way that enables the health organization to abridgment issues that affect the organization and act on them accordingly. This improves the provision of services in the organization. As such, a plan of training with the best practices is developed during the training of staff members. The program involves creating a culture that encourages compliance. This enables downward communication from the top management to the junior workers. Also, it should including training on the power of proof that will allow the workers to feel secure during unannounced accreditations. The training should be engaging to ensure all members participate and benefit from the practice. The training should also include the principles of adult training. Individuals trained in compliance readiness are individuals who have personal differences, which should respect during training. Employing the principles of adult training will ensure smooth training (3 slides)

Oversight practices carried out by regulatory bodies

In the United States, health care is provided by the federal government, state governments, and the private sector. Regulations from the federal government and the states regulate the provision of health care services in the country and the states. The government is the main body that has oversight functions and control of the health sector. The government funds programs like Medicaid, Medicare, and affordable health care act, but the private sector provides the services. It is the function of both federal government and state governments to ensure these programs are adequately financed to ensure every citizen benefit from them. Apart from funding, the government enacts laws and regulations that regulate and govern the process of providing health care services. This involves licensing and certification of people and organizations involved in the provision of health care services.

Auditing the record books of the health care organization is another way of exercising oversight functions in the health care sector. Both the federal government and the state government allocate funds to the areas which are used for infrastructural development, acquisition of new facilities medicines, and conducting research. Auditing is done to ensure all funds are used according to the plans and within budgets and avoid embezzlement of funds. There is also the creation of regulatory bodies that set standards that have to be met by health organizations and practitioners before that are allowed to provide health care services to the citizens of the United States of America (Buchbinder, Shanks, & Kite, 2019) (3 slides)

Compliance training

Compliance training is training that enables employees to be in accordance with the guidelines and regulations put in place to regulate the operation of an organization. The management of the organization puts training efforts on compliance to ensure the employees abide by government legislation and regulations. Non-compliance can risk and has numerous consequences for the organization and the employees. (1 slide)

Risks and consequences of non-compliance

Non-compliant health organizations face the risk of fines and penalties that may be imposed on the organizations. The penalties can be barriers to access markets, financial penalties, or limitations on the operation. This affects the activities and services provided by the organization. There are also delays in products and market access that minimize the markets served by an organization. Products and services from the health care organization can be blocked and ensure there is no entry of the products to the markets. The organization can also be charged with criminal charges for violating the federal laws and regulations on health care (Rosly et al. 2017) (1 slide)

Compliance practices in training

Training staff members on compliance is affected by various factors that force organizations to develop compliance training programs that are compliant with the forces. An organization measures what should be attained by the training. This enables the organization to develop goals for the training. Also, the training is affected by its applicability to the existing systems. As such, any health organization has to develop a training program that will ensure compliance of the employees (1 slide)

To provide practical compliance training, the organization should train the employees on retention rates. Learning and retention of the learned information are critical to any training process and thus should be emphasized. To enable retention training, the organization should use a course that employs gamification (quizzing). Also, they should introduce refresher training that will increase the retention of the trainees (Baxter et al. 2016). (1 slide)

After the training, the organization should enquire about employee feedback about the training. This will highlight the engagement of the trainee, information retention, and usability of the process. The training should, therefore, issue forms that trainees should respond to. This will also increase the chances and engagement of the trainees. Through feedback, employees will highlight areas that will be considered in training (1 slide)

The trainers should implement changes that are created by the compliance training and rates at which the trainees complete the training. Implementation and percentage of completion improve the efficiency of the employees as it reduces the time used in carrying various activities. Also, it enables them to co-operating compliance training in their daily lives (Van 2019). (1 slide)

Conclusion

Compliance training is quite essential for any organization. The government should, therefore, put in place measures and guidelines that guide organizational management on how to carry out compliance training of their employees. The employees should take the training more positively as it improves their skills and experience. More training also enhances the ability of employees to carry out their daily tasks and thus become more effective (1 slide)

References

Baxter, R. J., Holderness Jr, D. K., & Wood, D. A. (2016). Applying basic gamification techniques to IT compliance training: Evidence from the lab and field. Journal of information systems, 30(3), 119-133.

Buchbinder, S. B., Shanks, N. H., & Kite, B. J. (2019). Introduction to health care management. Jones & Bartlett Learning.

DiGiorgio, C. M., & Avram, M. M. (2018). Laws and regulations of laser operation in the United States. Lasers in surgery and medicine, 50(4), 272-279.

Lazzeri, G., Troiano, G., Centauri, F., Mezzatesta, V., Presicce, G., Porchia, B., … & Gusinu, R. (2019). Accreditation and Quality in the Italian National Health Care System: a ten years long review. Epidemiology, Biostatistics, and Public Health, 16(2).

Rosly, S. A., Naim, M. A., & Lahsasna, A. (2017). Measuring Shariah non-compliance risk (SNCR): claw-out effect of al-bai-bithaman ajil in default. Journal of Islamic Accounting and Business Research.

Swedler, D., Miller, T., & Levy, D. (2017). 70 Lives saved by laws and regulations that resulted from the Bloomberg road safety program.

Vaishnavi, V., Suresh, M., & Dutta, P. (2019). Modeling the readiness factors for agility in a healthcare organization: a TISM approach. Benchmarking: An International Journal.

Van, N. T. T. (2019). The lack of effective training program in compliance management (2 slides).