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Health Care Law and Regulations

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Health Law and Regulations
Stephanie Sauceda
HCS/545
March 17, 2014
Mary Cummings

Health Law and Regulations
Health care in the United States has changed over the years and the federal government saw need to establish regulatory agencies such as the Centers for Medicare & Medicaid Services (CMS) to ensure the elderly, disabled and low income receive quality and cost-effective health care. As a result of health care costs sharply increasing, the government determined it needed to have oversight on the health care industry and pushed for the establishment of managed care organizations (MCO). CMS enforces the Emergency Medical Treatment & Labor Act (EMTALA); this act was created to ensure health care organizations provide a minimum of a medical screening exam to determine if complaint is emergent or not. Most importantly for EMTALA is the obligation to treat emergent cases regardless of the patient’s ability to pay for services. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was approved by the United States Congress to regulate the use of and protect patient health records and the Department of Health & Human Services oversees the compliance and violations of HIPAA (Department of Health & Human Services, n.d.). The intentions of many of these regulatory agencies is to oversee that the health care industry is providing quality, affordable health care and treating patients with fairness and privacy.
In 2008, the Centers for Medicare & Medicaid Services (CMS) projected that by 2017 the “annual health care spending in the United States [will] reach more than $4.3 trillion” ("CMS: Steady Growth in Health Spending," 2008). Health care costs will continue to rise so it is important that CMS works to manage those costs. CMS is one of the biggest governmental regulatory agencies known in the health care industry. It…...

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