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Healthcare Regulation

What is a healthcare regulation?

Healthcare regulations are laws created and enforced by private organizations and all levels of government, including local, state, or federal. Healthcare regulations are designed to ensure that safe, quality healthcare is provided to the public by maximizing the compliance of healthcare personnel and providers. Ultimately, healthcare regulations protect the public, healthcare personnel, and healthcare providers. 


Why is healthcare so regulated?

Healthcare is heavily regulated because people’s health and lives are at stake. Healthcare is regulated because healthcare standards must be upheld, public confidence in the healthcare organization must be secured, healthcare professionals and providers must be safeguarded, and most important of all, the patients and public as a whole must be protected. 


What are examples of regulations in healthcare?

Some examples (with summaries) of regulations in healthcare include the following:

    • The Healthcare Quality Improvement Act of 1986 (HCQIA): HCQIA was designed to offer a certain amount of immunity in regard to the peer review of healthcare professionals. In other words, protection is to be offered for healthcare professionals or hospitals that have conducted “good faith” peer reviews.

    • Health Insurance Portability and Accountability Act of 1996 (HIPAA): HIPAA was passed in order to ensure that Americans continued to receive health insurance coverage when moving from one job to another. Additionally, HIPAA requires that patient data and privacy be secured. 

    • Patient Safety and Quality Improvement Act of 2005 (PSQIA): The PSQIA was written to encourage the reporting of unsafe healthcare conditions by providing protection for healthcare professionals that report those conditions. However, it is important to ensure patient confidentiality is maintained during the process. 

    • The Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH): The purpose of HITECH was to promote the use of health information technology by healthcare providers. This act was important because it supported the use of electronic health records (EHRs). 

    • Affordable Care Act of 2010: The Affordable Care Act of 2010 required that United States citizens be covered by health insurance. There were exceptions for select groups. The Affordable Care Act also created the American Health Benefits Exchange. 

    • 21st Century Cures Act of 2016: The 21st Century Cures Act of 2016 was passed to support medical research and innovation in addition to bettering the healthcare system. 


How many healthcare regulations are there?

According to the American Hospital Association, there are a total of 629 healthcare regulations. Of these 629 healthcare regulations, 341 are related to hospitals, while 288 are related to PAC (post-acute care). 


What is the purpose of healthcare regulation?

The purpose of healthcare regulation is to provide safe, quality healthcare by ensuring compliance in the healthcare professions. Healthcare regulations help to provide the public with many healthcare programs in addition to protecting the general population from health risks. To sum it up, healthcare regulation allows for the provision, regulation, and protection of public health. 


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