Examining Health Care Laws Essay

Excerpt from Essay :

Code §70.41.250

The RCW 70.41.250 is a law that provides cost disclosure to health care providers. It is a state law that offers some control over the spiraling expenses of health care by creating transparency within hospital and medical bills (Wash. State, 2016). Made to ensure health care providers provide only necessary services and reduce inflationary rates, RCW 70.41.250 also gives the option for a health care provider or physician to inform patients of such expenses to further increase transparency and perhaps fuel a more communicative provider-patient relationship.

A hospital's chief executive officer licensed under this chapter as well as superintendents of state hospitals must maintain and establish a procedure for releasing to health care providers and physicians that have admitting privileges the expenses of all ordered health care services for their patients. This includes copies of hospital charges if they make orders for inpatient/outpatient services. The health care provider and/or physician has the option of informing patients of said charges as well as explicitly review them. Directives are given to hospitals to examine strategies for making daily charges accessible to any prescribing physician through the utilization of computerized information and/or interactive software. This allows the review the expenses of past and present services and also future contemplated charges for additional therapeutic medications and diagnostic studies.

3. The ethical principles here concern fairness and transparency. Hospitals in Washington before the passing of this legislature could charge inflated prices for services, and order extraneous services without worrying about revealing the prices for each service. This led to increasing higher prices for medical services and higher costs for insurance companies. By passing this law, hospitals and other medical facilities in Washington have to disclose how much each service is and physicians and other health care providers must choose what is needed versus what they can make the most money from. It also gave the option to physicians and other health care providers to discuss with patients the costs of each procedure, reducing potential medical costs.

4. There are three scenarios that may cause conflict between ethical and law considerations. The first one is if a cancer patient is made aware of how much a procedure will cost. A physician may want to notify the patient of the expenses of chemotherapy because he/she has the option to do so under said law, however the patient may reject the treatment if the costs seem too high. A second scenario is when a physician attempts to diagnose an ailment. The physician will need to perform multiple tests and may have to take the patient through several X-rays or scans and if the patient is made aware of the costs, the patient may opt out of it, resulting in potentially hazardous results. The hospital may feel a patient really needs a certain procedure and may not want to divulge the price of the procedure to the insurance company for fear of the being denied.

5. The law affects hospitals like the University of Washington Medical Center because they will have to disclose information concerning medical charges. Providers will have to provide itemized lists of each charge. Patients will be made more aware of the medical costs even if the medical providers do not discuss with the expenses, the insurance company will. And Administrators will have to enforce the new policy safeguarding the transparency that the law provides.

6. The hospital has to reduce extraneous services. If a test or procedure is not needed, they need to not order it. They need to educate staff on providing efficient service. They also have to provide clear and itemized lists of expenses to insurance companies changing their billing procedures.

The Patient Protection and Affordable Care Act (PPACA)

1. PPACA is a federal law enacted and signed by President Barack Obama March 23, 2010. 2. "Obamacare" ensures everyone in the United States has health insurance. If they do not have health insurance, Americans will be penalized a fee of $600 (Grass, 2013, p. 3). This law provides Americans with affordable options to health insurance while also encouraging hospitals and other medical facilities to reduce costs and promote higher quality health care. The act places emphasis on preventative medicine and introduced mechanisms like insurance exchanges, mandates, and subsidies. With new minimum standards, insurance companies had to accept all applicants and offer similar rates regardless of sex or pre-existing conditions.

3. The ethical principles for this law are fairness and affordability. Anyone can apply for health insurance and be approved regardless of pre-exiting condition. Everyone who has health insurance should get high quality health care regardless of insurance carried. Rates must remain the same for each person in the same plan and that through higher quality health care, patients will not have to spend more to get what they need.

4. Obamacare is meant to offer high quality health care to everyone. However there are many instances where that has not been the case. The first is when a hospital does not accept the insurance plan the patient has. In an emergency situation, an ambulance drives a person to a hospital that does not accept his/her health insurance and still has to pay for the medical services. The second is medicals services are not accepted uniformly by insurance companies. Physicians may charge someone for a service and if the insurance does not accept to pay for it, may still charge the patient for the service, increasing medical costs. Third, there is more red tape in relation administrative efforts. This increases insurance costs because of administrative duties.

5. Providers must actively seek to provide higher quality health care to every patient and not just the ones with certain health insurances. Patients must apply for health insurance or face a financial penalty. Administrators have it the hardest because they are the ones that have to communicate the expenses and handle the multiple referrals needed with the new healthcare system. Insurance companies do not accept all charges therefore administrators have to educate staff on what services can be performed with certain health insurance.

6. The medical center needs to provide physicians and other health care providers with a list of insurance companies they work with to avoid unnecessary billing problems. They need to promote higher quality care in every department. They need to emphasize preventative services. Finally, they need to make sure those wishing to apply for health insurance have avenues where they can apply for health insurance.

Health Information Technology for Economic and Clinical Health Act of 2009

1. The HITECH Act created in 2009 is a federal law signed by President Obama. This was done as part of the ARRA or American Recovery and Reinvestment Act of 2009 economic stimulus bill. 2. The HITECH Act was passed in order to give the Office of the National Coordinator the authority to set and managed standard for the government's stimulus program. The law also helped establish grants for personnel and training centers required to support expansion of health IT infrastructure within current and emerging healthcare organizations. Since 2011, the government provides financial incentives to healthcare providers for showing "meaningful use" of EHR's. This ended in 2015. In its place are time penalties for those failing to show such use.

3. Put simply, standardization is required of the health care industry. Hospitals and other medical facilities must transition to electronic health records in order to improve patient care and bring on the changes the government wants to enact. If hospitals are resistant to advances in technology, they will fail to meet the base requirements expected from the government in relation to patient care.

4. There are some scenarios where law and ethical consideration may contradict. The first scenario is a small clinic that is having trouble transitioning to electronic health records. They do not have the money to buy new systems and have passed the deadline for transition from paper records to EHRs. The second is a hospital suffering from budgetary concerns. While the financial incentive provides some motivation, it is not enough for them to make the full transition to EHRs and they would face closing if they make the transition. The third is a hospital makes the transition to EHRs but do not have the manpower to train newcomers and those not used to EHRs and are decreasing productivity due to the confusion and changes.

5. Providers in UW Medicine have to fully integrate technology into the hospitals files. That means sending prescriptions online versus writing them out and sending and receiving medical records online. Patients will have to get used to accessing their records online via online accounts and providing pharmacies for providers to send prescriptions to. Administrators must implement the transition from paper health records to electronic health records and change policies that incorporate more technology along with hiring IT specialists in case problems arise in their systems.

6. The biggest change that the hospital and others like it face now is the transition from paper prescriptions to electronic ones.…

Sources Used in Document:


Adler, R. (1992). Overview of the Washington Health Care Information Act: Rights and Duties of Provider and Patient - Adler Giersch PS. Adler Giersch PS. Retrieved 7 April 2016, from http://www.adlergiersch.com/overview-of-the-washington-health-care-information-act-rights-and-duties-of-provider-and-patient/

ASPE,. (2015). Standards for Privacy of Individually Identifiable Health Information. ASPE. Retrieved 7 April 2016, from https://aspe.hhs.gov/basic-report/standards-privacy-individually-identifiable-health-information

Grass, J. (2013). The Impact of Obamacare on Financial Disclosure Laws for Nonprofit Hospitals: Some Say They Don't Go Far Enough, 3(5). Retrieved from http://www.americanbar.org/publications/gpsolo_ereport/2013/december_2013/impact_obamacare_financial_disclosure_laws_nonprofit_hospitals.html

U.S. Dept of State,. (2016). The Privacy Act: U.S. Department of State - Freedom of Information Act. Foia.state.gov. Retrieved 7 April 2016, from https://foia.state.gov/Learn/PrivacyAct.aspx

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