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Discussion 5.3: Regulations

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In your initial posting explain the regulatory means that are used by regulators of hospitals, physicians, drugs, health insurance, and managed care.

In your student replies choose one regulatory means listed by your class and explain why that item has had a negative or adverse impact on patient care.

Your initial posting should contain at least 300 words with a reference list. Student replies must contain at least 100 words to assure credit. Support your answer through research. Sources should be documented in APA.

David · Accepted Answer

What are the regulatory means that are used by regulators of hospitals, physicians, 
drugs, health insurance, and managed care. 
Several laws, policies, and regulations have been made throughout the years that had a 
profound effect on present day health care. Various regulations that have effected hospitals, 
physicians, drugs, patients, health insurance and managed care in the US are given below: 
Hospitals 
The main regulation is regarding licensing of hospitals at state level including pharmaceutical 
and medical devices approval and testing by USFDA and laboratory testing. These 
regulations have been designed for the protection of consumers from fraudulent and low-
quality healthcare.  
Another regulation is self-policing of health care providers by providers themselves as a part 
of oversight. Many hospitals voluntarily undergo inspection and certification by Joint 
Commission on Hospital Organization Accreditation, JCAHO. Health care providers 
voluntarily submit to testing for obtaining board certification for getting attestation on their 
skills. ("Health care in the United States", 2017) 
Patients 
Under EMTALA, emergency department of hospitals are required to treat emergency 
conditions of all patients irrespective of their paying capacity and is an important regulation 
for those who do not have any medical insurance. However, indirect federal and state 
government payments and reimbursements are insufficient to fully compensate both private 
and public health care providers for the full treatment cost of care under this act. 
Another important regulation for protection of patients is the HIPAA Privacy Rule which 
provides complete federal protection to patients for personal health information held by 
covered providers.  It provides many rights w.r.t information and also in some cases allows 
disclosure of personal health information required for patient care.

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Discussion 5.3: Regulations

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