False Claims Act
False Claims Act (FCA)
The False Claims Act (FCA) was enacted in 1863. The law makes it unlawful for any person or company to defraud various government programs. In the healthcare sector, the law prohibits individuals from submitting fraudulent claims for payment to Medicaid and Medicare (Patel & Rushefsky, 2019).
The Flexner Report
The Flexner Report was a commentary on the state of medical education in both the United States and Canada during the early 20th century. The report was written in 1910. It was authored by Abraham Flexner. The report has made a significant contribution to the growth of modern medical education (Jacobs & Skocpol, 2019).
Hospital Standardization Program
This was a collection of published healthcare standards that guided the work of nurses, doctors, and administrators. The American College of Surgeons Board of Reagents adopted the program in the year 1919. The report laid the foundation for accreditation of hospitals (Field, 2018).
Hill-Burton Act
This act gave states grants for construction, surveying, and modernization of healthcare facilities. The hospitals in return agreed to provide free services to people who were unable to pay. The law was adopted by the US Congress in 1946. It marked the beginning of provision of free healthcare services (Patel & Rushefsky, 2019).
Founding of the Joint Commission on Accreditation of Hospitals
This was a commission which was given the task of improving healthcare services. It ensured that healthcare organizations provided safe, effective, and quality services. The commission was founded in 1951. It was the mother of the modern Joint Commission that accredits over 22,000 healthcare organizations in the United States (Jacobs & Skocpol, 2019).
Title XVIII of the Social Security Act
This act was enacted on July 30, 1965. It sought to establish a Federal health insurance program for persons aged 65 years and older, irrespective of their income as well as health status. Currently, the program is popularly known as Medicare. Over 55 million depend on it for their health insurance (Field, 2018).
Title XIX of the Social Security Act
This act was in form of a Federal and State entitlement through which families and individuals from low income backgrounds received medical assistance. The program was also put in place on July 30, 1965. Currently, the program is called Medicaid. It continues to serve as the US’ public health insurance for persons with low incomes (Field, 2018).
Darling v. Charleston Community Hospital
This was a court case that was ruled on September, 1965. It addressed the hospitals’ duty to employ adequately trained nursing and medical staff. The ruling of the case also obliged healthcare facilities to provide emergency healthcare regardless of the ability of patients to pay for the services (Jacobs & Skocpol, 2019).
Tarasoff v. Regents of the University of California
This was a court case determined in 1976. The ruling of the case obliged mental health professionals to protect both patients and individuals threatened with harm by the patients. The case helped to improve the wellbeing of the intended victims of mentally ill patients (Huberfeld et al., 2018).
The Belmont Report
This was a report compiled by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in 1978. It provides a summary of ethical guidelines and principle pertaining to research that involves human subjects. The report has made a great contribution to healthcare research (Huberfeld et al., 2018).
Emergency Medical Treatment and Labor Act (EMTALA)
Emergency Medical Treatment and Labor Act (EMTALA) was passed in 1986. The law requires emergency departments of Medicare-approved hospitals to provide medical screening examination (MSE) to any person regardless of his or her ability to pay or citizenship. The act helps to promote health equity (Entress & Anderson, 2020).
Medicare and Medicaid Patient Protection Act
This law was passed in 1987. It empowered authorities to exclude or sanction rogue health insurance providers. The act contributed to the creation of criminal penalties for any fraud committed against Medicaid, Medicaid or other American healthcare programs (Crowley et al., 2020).
Stark Law
Also known as the Physician Self-Referral Law, Stark Law prohibits physicians from referring Medicaid and Medicare patients to receive “designated health services” (DHS) from entities that the physicians or their immediate family members have a financial interest or relationship with. The law was passed in 1989. It has helped to prevent fraud in the health care system (Huberfeld et al., 2018).
HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) was enacted in the year 1996. It defines various offenses pertaining to healthcare. The law also sets both criminal and civil penalties against the offenses. The HIPAA laid the foundation for creation of several programs meant for control of abuse as well as fraud in the health care system (Field, 2018).
National Academies of Sciences, Engineering, and Medicine – To Err is Human
To Err is Human was a landmark report prepared in 1999 by the Institute of Medicine (IOM) of the United States. The report sought to increase awareness about medical errors. As a result, it helped to improve patient safety (Field, 2018).
National Academies of Sciences, Engineering, and Medicine-Crossing the Quality Chasm-A New Healthcare System for the 21st Century
Crossing the Quality Chasm-A New Healthcare System for the 21st Century was a healthcare quality report which was prepared by the IOM in 2001. The report recommended improvements in patient-centeredness, patient safety, care efficiency, care effectiveness, equity, and timeliness. Generally, this report resulted in the improvement of the quality of healthcare services (Huberfeld et al., 2018).
Medicare Modernization Act (MMA)
Medicare Modernization Act (MMA) was passed in 2003. The law led to the introduction of prescription drug coverage for Medicare beneficiaries. By doing this, it helped to improve accessibility of healthcare services to many Americans (Crowley et al., 2020).
Genetic Information Nondiscrimination Act (GINA)
Genetic Information Nondiscrimination Act (GINA) was ratified in the year 2008. The law protects individuals against genetic discrimination perpetrated by health insurers and employers. By doing so, the act also helps to enhance health equity (Entress & Anderson, 2020).
American Recovery & Reinvestment Act- Health Information Technology for Economic Clinical Health Act (ARRA-HITECH)
The American Recovery & Reinvestment Act (ARRA) of 2009 led to the establishment of the Health Information Technology for Economic Clinical Health Act (HITECH Act) that aimed at promoting adoption of health information technology within the healthcare system. The law has helped to improve healthcare efficiency, safety, as well as quality (Field, 2018).
Patient Protection and Affordable Care Act (ACA)
The Patient Protection and Affordable Care Act (ACA) was ratified in 2010. It was a comprehensive healthcare bill that sought to increase the availability of affordable health insurance to more Americans. By providing subsidies to consumers, the law helped to lower the cost of healthcare services (Entress & Anderson, 2020).
References
Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care. Annals of Internal Medicine. https://doi.org/10.7326/M19-2415
Entress, R. M., & Anderson, K. M. (2020). The Politics of Health Care: Health Disparities, the Affordable Care Act, and Solutions for Success. Social Work in Public Health, 35 (4): 152-162. https://doi.org/10.1080/19371918.2020.1767750
Field, R. I. (2018). Health Care Regulation in America: Complexity, Confrontation, and Compromise. Oxford: Oxford University Press.
Huberfeld, N., Leonard, E. W., & Outterson, K. (2018). The Law of American Health Care. Boston: Aspen Publishing.
Jacobs, L. R., & Skocpol, T. (2019). Health Care Reform and American Politics: What Everyone Needs to Know. Oxford: Oxford University Press.
Patel, K., & Rushefsky, M. E. (2019). Healthcare Politics and Policy in America. New York: Routledge.
