Health law is becoming more complicated every year, affecting most doctors and their patients. Considering the complexity of these regulations, it is more important than ever for doctors to understand the applicability of various health laws and how to ensure their practices are operated in compliance with prevailing health law, statutes, and regulations.
Following are some essential laws that health care lawyers suggest every doctor learn about in order to prevent compliance issues and still provide the best service to all of their health care clients.
Patient Protection and Affordable Care Act (PPACA)
Enacted in 2010, the Patient Protection and Affordable Care Act (PPACA) significantly affects doctors and medical practices in the United States. The PPACA was designed to make healthcare more affordable for all citizens as well as prevent denial of insurance coverage and medical care due to pre-existing conditions and other factors. Although it does have its benefits, it also has issues that all physicians must know about.
Most importantly, the law affects what services doctors may provide and how they are reimbursed. Still, health care lawyers stress that it also affects both doctors and patients in additional ways as well. Doctors may have less time to spend with each patient because they are spending more time completing paperwork and keeping up-to-date on the continuous changes being made to the program.
Health Insurance Portability and Accountability Act (HIPAA)
The Health Insurance Portability and Accountability Act (HIPAA) is an essential health law pertaining to patient privacy involving the use and protection of personal patient information. This refers to all information obtained by physicians and their staff and how that information is used, stored, and protected. All information contained within email, fax, electronic, and even oral communications are protected by this important privacy law and must be understood by all medical professionals to maintain compliancy.
The Stark Law
The Stark Law is addresses financial conflicts of interest between referring physicians and their patients. Under the law, doctors are not permitted to refer patients for care that would be provided by any service or facility in which the doctor, or any family member, has a financial relationship. While there are numerous exceptions to this rule, health care lawyers suggest that doctors with financial interests in referral services understand the scope of this law completely before referring patients for care.
The False Claims Act
The False Claims Act addresses the ordering of unnecessary treatment or procedures, healthcare upcoding or over billing, and other perceived examples of fraud. Practitioners may be found liable and face severe penalties if they order unnecessary treatments or procedures and/or overbill for provided care, even if action was unintentional.
The Anti-Kickback Statute
This broadly written health law exists to prevent any provider from accepting anything of value in exchange for promoting the acceptance of any individual into the Medicare or Medicaid programs. Conviction of this criminal offense may result in a doctor being withdrawn from these healthcare programs and criminal charges brought against both parties involved in such an exchange.
Today’s healthcare industry is highly regulated. While this regulation offers extensive guidance on how to provide the best care to all patients, it also places a huge burden on medical professionals who must know about each health law and remain in compliance. Health care lawyers recommend that all practitioners be well-educated on the five important laws referenced above. One of the best and easier ways to accomplish this is to discuss how to keep their practice in compliance with attorneys who are experienced in this area of law.
The Stevenson Law Firm, PC
6302 W. Broadway, Suite 120
Pearland, TX 77581
Phone: (832) 481-4548