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3 regulatory issues the health care industry currently faces

On Behalf of | Oct 31, 2019 | Medicare & Medicaid |

The health care industry is no stranger to stringent federal regulations. They are often put in place to hold medical professionals accountable and protect patient interests.

Unfortunately, many industry workers feel some regulations do the exact opposite of what they’re supposed to, which is to increase the quality of patient treatment. According to a recent report, many physicians find it frustrating to use complex and expensive efficiency systems, as they’ve often created daunting barriers for doctors providing patient care.

Common regulatory obstacles faced by medical professionals

These measures can create hurdles for doctors and others:

  • HIPPA and medical data breaches: While electronic data has become more vulnerable across all industries, it has been especially devastating in the health care sector. As a result, more than half of states in the U.S. have implemented strict punishments for medical professionals if a patient’s data is wrongfully released. Here in Texas, clinicians who wrongfully disclose a patient’s medical records could face civil penalties, which may result in costly annual fines.
  • False claims and whistleblower litigation: Under the False Claims Act, it is illegal for health care providers to participate in fraud against government programs like Medicare or Medicaid. But recent reforms to the legislation could decrease whistleblower transparency in false claims suits. For example, informants could move forward with fictitious allegations based on publicly disclosed information. This could mean they don’t have to be the primary source for filing a claim, which could subject health care organizations to more frequent litigation.
  • Changes in hospital-physician relationships: The original goal of the Stark Law was to prevent conflicts of interest between doctors and their referrals. Under the policy, doctors cannot refer patients reimbursed by any federal health care programs to other organizations they receive compensation from. However, this can complicate how hospitals arrange payments with doctors as intent does not need to be proven for the statute to be violated.

Regulations can make matters challenging

As the health care industry primarily deals with human lives, tight government regulations provide a necessary, if problematic, function. When medical professionals are facing a lawsuit or have other legal concerns, a knowledgeable health care attorney can be a valuable resource. They can help address any questions doctors may have and make sure they’re complying with current federal and state regulations.