Health Care Law
What is Health Care Law?
Health care law is the area of the law that impacts public health, individual health and medical care, and health insurance. Most public health care statutes and regulations are instituted at the state and local levels, including the creation of boards of health.[1]
Many other laws and health care legal issues also fall under state jurisdiction. These include medical malpractice, durable power of attorney and medical directives, medical records, and living wills.
Federal Health Care Laws
In addition to state laws and statutes regarding health care, the federal government has passed several laws that impact health care over the years:
- Social Security Amendments of 1965. These amendments to the law established Medicare and Medicaid, federal health insurance programs for older adults and low-income individuals and families.
- Emergency Medical Treatment and Active Labor Act. This law requires that health care providers give emergency treatment to anyone who needs it. In other words, an inability to pay is not a reason to deny care in an emergency.
- Consolidated Omnibus Budget Reconciliation Act. Also known as COBRA, this law allows people to maintain their group health insurance coverage after leaving a job. The individual must pay the premium, and it only lasts for a certain period of time.
- Children’s Health Insurance Program. CHIP expanded health coverage access to children in low-income families.
- Health Insurance Portability and Accountability Act. HIPAA protects patient privacy by setting strict rules for how and when patient information can be shared. The law also gives patients the right to access their records.
- Patient Safety and Quality Improvement Act. This is a whistleblower law that protects patients reporting unsafe health care conditions. It encourages patients to report medical mistakes and unsafe conditions without losing the right to confidentiality.
- Patient Protection and Affordable Care Act. Also known as the Affordable Care Act and Obamacare, this law passed in 2010 and expanded eligibility for Medicaid. It also requires all citizens to purchase health insurance and prohibits insurers from discriminating based on pre-existing conditions.
Common Issues in Health Care Law
You may not think of your health care as having anything to do with the law, but several legal issues can arise related to insurance, medical care, discrimination, privacy, and more.
Compliance with Health Care Laws
Legal issues arise when health care providers and insurers fail to comply with regulations. For instance, if an insurer discriminates against a patient for having a pre-existing condition, this violates the affordable care act.
Heath Insurance
The law comes into play in insurance disputes. Not only do health insurance companies need to comply with laws, but patients also run into legal issues when dealing with insurers. They may dispute coverage of a certain condition or treatment, for instance, or be denied coverage unfairly.
Health Care and Insurance Fraud
Financial abuse and fraud are not uncommon in the health care system. Medicare, for example, may be a target of fraud with false claims and extra charges for treatments or therapies a patient didn’t receive. Criminals also use insurance and Medicare to target individuals for fraud or identity theft.
Privacy
Patients have a right to privacy in their medical records, except in certain circumstances. They can take legal action against any health care providers or insurers that violated their privacy by inappropriately sharing or failing to protect medical records.
Discrimination
Several federal laws prohibit discrimination in federally-funded health care. This includes recipients of Medicare and Medicaid. Discrimination means denying services or benefits, offering lesser benefits, or segregating patients based on protected status, such as race or national origin.
The Affordable Care Act prohibits discrimination by gender, banning different insurance rates based on gender. The Age Discrimination Act bans discrimination in coverage and care based on the age of a patient.
Elder Law and Living Wills
Many older adults need additional health care and to plan for long-term care. They and their loved ones can make legal plans for care, such as living wills, durable power of attorney, and medical directives. Elder law also encompasses abuse, which can occur in health care settings, such as nursing homes.
Medical Malpractice
Malpractice is a part of tort law, but it intersects with health care law. When a doctor or other health care provider is negligent, and a patient suffers harm as a result, they can be sued for malpractice. The victim can sue for monetary damages.
Disability Benefits
Disability insurance and Social Security Disability also intersect with health care. People who are disabled and cannot work may be eligible for disability benefits. If they are unfairly or mistakenly denied those benefits, they can take legal action.
Health care law is a broad area of law that overlaps with many others. If you have questions about health care practices, insurance, medical errors, discrimination, planning for care, and other issues related to medical care, contact a lawyer specializing in health care law.