Go to Page Section:
- Defining Health Care Law
- Significance of Health Care Law
- Defining Who is Part of the Health Care Industry
- Components of Health Care Law
- Reasons that the Health Care Law is Important for Government Agencies
- Different Areas of Health Care Law
- The Role of Lawyers in Health Care Law
- The Future of Health Care Law
- Sources
- Frequently Asked Questions
Healthcare law is a comprehensive field that encompasses all aspects of health care.
Some people may assume that health care law only relates to medical malpractice lawsuits or to certain federal documents or policies, such as the Affordable Care Act (ACA) or the Health Insurance Portability and Affordability Act (HIPAA).
The truth is that healthcare law includes the federal, state, and local laws and regulations that govern the health care industry.
It focuses on several areas that go beyond health care delivery models, health care policy and administration, health care fraud, and health insurance.
The primary people who work in healthcare law include lawyers, legal assistants, and paralegals. Many attorneys choose to practice healthcare law and then choose a specialty within the field.
A few examples of those specialties include health policy and administration, antitrust, patient care liability and litigation, and dispute resolution.
Defining Health Care Law
Health care law is all the federal, state, and local legal standards, laws, regulations, and policies that govern the health care industry and health care itself. It encompasses these things in both the private sector and within government settings.
Healthcare, being a highly regulated industry, is subject to many complex state and federal rules.
The daily activities of individual health care providers, health care clinics, hospitals, and large health care organizations all operate within the legal framework of health care law.
Given the various settings where people are involved in health care law, including government agencies, people who run medical facilities, and policymakers, health care law reaches across nearly every aspect of our society.
Significance of Health Care Law
Health care law basically sets the standards for care, ensures access to quality healthcare services, and protects the rights of patients.
It also defines the responsibilities and protects the rights and the interests of all other parties who are involved in the healthcare system.
Health care laws fight fraud and abuse within the industry.
It shapes government policies that are related to the healthcare industry, ensures regulatory compliance, helps healthcare systems to run smoothly, and helps to fight fraud and abuse in healthcare.
The health care industry is constantly evolving, which means that health care laws will continue to have a critical role in emerging trends and challenges.
Defining Who is Part of the Health Care Industry
The parties that are involved in the health care industry often go beyond those that first come to mind for many people.
The groups that make up the health care industry include a long list of professionals and organizations.
Some examples of who is a part of the health care industry include:
- Health care practices and providers
- Mental health facilities
- Care facilities
- Health care organizations
- Health care systems
- Pharmaceutical companies
- Insurers
Components of Health Care Law
The key components of health care law encompass several areas of legal practice.
A few examples of these components include government laws and regulations, informed consent, medical malpractice, compliance, insurance issues, patient privacy laws, and public health law.
Health care law also addresses regulations and issues that relate to Medicare and Medicaid.
Two well-known documents about the components of health care law include the Affordable Care Act and the Health Insurance Portability and Accountability Act (HIPAA).
Affordable Care Act
The official name of the Affordable Care Act of 2010 is the Patient Protection and Affordable Care Act.
The other part of the healthcare reform law is the Health Care and Education Reconciliation Act.
It is commonly referred to as “Obamacare.”
The complex law initially consisted of nearly 1,000 pages of health care reform law regulations.
The Affordable Care Act, including amendments, was nearly 11,000 pages long by 2013.
By 2021, it had more than 21,000 pages, including amendments.
The U.S. Department of Health and Human Services indicates that there are three primary goals.
One goal is to make more affordable health insurance available to more people.
It also supports innovative medical care delivery methods that, in general, lower the cost of health care.
The third goal is to expand Medicaid coverage to cover more adults.
Health Insurance Portability and Accountability Act
The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996.
It addressed the use of, and the disclosure of individuals protected health information by entities such as healthcare providers, and by health care plans.
The law established federal standards that protect the privacy of patients’ health care information.
It also provides the standards for individuals’ rights to understand how their healthcare information is used and to control the use of that information.
Health Insurance Protections and Rights
Individuals and families have protections and rights under the health care law.
The site healthcare.gov explains that health care law protects people in several ways.
People are protected under the health care law, which makes insurance coverage easier to understand.
It also makes coverage fairer.
A few ways that the health care law protects people include:
- Helps people understand the coverage that they are getting
- Provides free preventative health care
- Requires insurance plans to cover pre-existing conditions, including pregnancy, without charging more for that care
- Makes it illegal for insurance companies to cancel health care coverage when people get sick
- Holds insurance companies accountable for their rate increases
Reasons that the Health Care Law is Important for Government Agencies
Healthcare law has an important role in shaping the government policies that relate to and affect the healthcare industry.
The maze of regulations is nearly impossible for people who are not lawyers to navigate.
Government agencies employ health care attorneys who work with them in several important ways.
Some ways that health care lawyers assist government agencies are to promote public health, to ensure that people have access to quality health care, and to develop and implement laws that protect patients.
They also enforce the health care laws that protect patients and their rights.
Different Areas of Health Care Law
Many different areas of practice relate to health law.
A few of the areas of healthcare law include:
- Health policy and administration
- Health care finance and transactions
- Fraud and abuse
- Dispute resolution
- Long-term care
Some other areas that relate to the practice of healthcare law include antitrust, governance, behavioral health, life sciences, and health insurance.
Many lawyers choose to specialize in a certain area of health care law, which they usually base on their personal interests and career goals.
The Role of Lawyers in Health Care Law
Lawyers have a vital role in health care law.
The work of attorneys in health care law spans many areas of law.
They have comprehensive knowledge and experience related to working within the framework of healthcare laws and regulations.
Health care lawyers provide legal advice and legal representation to hospitals, health care providers, government agencies, and insurance companies.
Health care attorneys may also provide legal advice and representation to physicians’ groups, private physicians’ practices, home health care agencies, nursing homes, long-term care facilities, and pharmacies.
Many health care lawyers choose to specialize in a certain area of health law, which they usually base on their personal interests and career goals.
Some health care lawyers specialize in litigation, especially when they represent individuals or defendants in certain issues, such as insurance denial, medical malpractice, or to protect the rights of certain demographic groups.
Lawyers who work in areas such as policy and legislative advocacy have several duties, which may include researching the extensive healthcare laws and regulations, helping to develop new legislation, or changing existing laws and legislation.
The health care lawyers who work in regulatory practice usually work for government agencies.
They can revise new regulations or draft new regulations.
They can defend or prosecute violations of regulations.
The work of health care lawyers may overlap with other niche specialties.
One such area is medical malpractice.
Although medical malpractice is outside the scope of practice for health care lawyers, they may become involved if a case involves regulatory issues.
The Future of Health Care Law
Health care law is an evolving field that requires health care lawyers to stay informed of the changing healthcare insurance landscape and to be able to adapt to those changes.
They need to learn about new developments in related fields such as intellectual property law, ethics, civil rights law, and tax law.
Emerging opportunities, the development and integration of new technologies, and issues such as bioethics and genetic testing require that health care lawyers gain expertise and skills in these areas to continue and expand their role in health care law.
Sources
- https://www.americanhealthlaw.org/about-ahla
- https://www.hhs.gov/healthcare/about-the-aca/index.html
- https://www.healthcare.gov/health-care-law-protections/rights-and-protections/
- https://www.cdc.gov/phlp/php/resources/health-insurance-portability-and-accountability-act-of-1996-hipaa.html
Frequently Asked Questions
Where do health care lawyers work?
Some healthcare lawyers work for healthcare institutions, while others work for government agencies or for nonprofits that have a focus on healthcare.
They also work in private practice.
How does health care law affect patients and health care providers?
Health care law ensures that patients have access to quality health services.
It sets the standards for care across the U.S. and protects patients’ rights.
How do I become a health care lawyer?
Health care lawyers follow the same general path as other people who choose to become lawyers.
The states vary in their laws that govern who may practice law, so it is important that students check the pathway to becoming a lawyer in their state.
Law students who want to become health care lawyers usually choose a specialization.
They need to check the requirements of the schools where they want to attend, and apply for jobs in health care law after earning their Juris Doctor (JD).
That is great! It’s like a change for the health care law itself as well but it is different. It is a huge help for those who are in need.
I haven’t heard of the Affordable Care Act just now, this is really good for those who need better healthcare procedures.