Like all laws, health care laws start as health care policy and make their way through the legislative process to become law. It is important to understand that hundreds of policies and ideas work through this process each year; however, only a select few will become law. The purpose of this assignment is for you to read about a current regulatory issue in health care and understand how laws support the regulation of the health care industry.
Research and identify one article or a current legal case within the last 3 to 5 years (e.g., an issue that went to court to have the court determine the outcome) that involves one of the following issues:
- A regulatory issue in health care
- A regulatory issue specific to institutional health care
Write a 350- to 700-word paper in which you:
- Summarize the case or article.
- Define a law involved with the chosen regulatory issue from both a state level (choose one common state) and a federal level.
- Explain how and why the law was created.
- Consider what you have read in the article or legal case on the selected regulatory issue, and explain the impact that regulatory issues and trends have on the health care industry.
Cite 1 peer-reviewed, scholarly, or similar reference to support your paper.
Format your assignment according to APA guidelines.
Expert Solution Preview
Introduction:
This assignment aims to provide an overview of a current regulatory issue in health care, which has gone through the legislative process to become law. By understanding this process, students will gain an understanding of how laws support the regulation of the health care industry, and the impact regulatory trends have on the industry.
Q: Can you provide a summary of the case or article you have chosen for this assignment?
A: The article selected for this assignment is titled “CMS rule limits surprise medical bills for patients” published on October 2, 2020, by Modern Healthcare. The article reports on the regulatory issue of surprise medical billing, where patients receive unexpected bills for services received from out-of-network providers. The Centers for Medicare and Medicaid Services (CMS) issued a rule to protect patients from such bills.
Q: Can you define a law involved with the chosen regulatory issue from both a state level and a federal level?
A: The federal law involved is the No Surprises Act, which was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act, 2021. It aims to protect patients from unexpected bills for emergency and non-emergency services provided by out-of-network providers. A similar law has been enacted in some states, including New York, Texas, and California, which have their own surprise billing laws.
Q: Can you explain how and why the law was created?
A: The No Surprises Act was created to address the issue of surprise medical bills, which have become increasingly common in recent years. The issue arises when patients receive services from out-of-network providers who charge more than what their insurance provider covers. Patients are then responsible for paying the balance, which can be hundreds or thousands of dollars. The law aims to protect patients from this issue by providing a framework for resolving billing disputes and holding providers accountable for transparent billing practices.
Q: What is the impact of regulatory issues and trends on the health care industry based on what you have read in the article or legal case?
A: Regulatory issues and trends have a significant impact on the health care industry, particularly in terms of cost and quality of care. The surprise billing issue has been a significant concern for patients and has led to increased scrutiny of billing practices among providers. The No Surprises Act aims to address this issue and promote transparency in billing, which will ultimately benefit patients and reduce healthcare costs. However, the law may also have unintended consequences, such as higher costs for providers and potential reductions in network participation.
In conclusion, regulatory issues and trends play a crucial role in shaping the health care industry, and it is essential for healthcare providers to comply with these laws to provide safe and quality care to patients. The No Surprises Act is an example of a regulatory issue that highlights the need for transparent billing practices, and this law will have a significant impact on how healthcare providers bill for out-of-network services. By complying with these laws, healthcare providers can help to reduce costs for patients and promote a more transparent and accountable healthcare system.
