Select a federal healthcare law other than the ACA that has been passed in the last 50 years. What are the features of the law? Is the law effective? Are there changes that could be made to make it more effective?

for question number 2. 3. 4. 5. 6

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2. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 was signed into law by President George W. Bush. The main aspect of the law was to create Medicaid Part D. This enabled Medicaid to cover the cost of prescription medications. Prior to this, most medications were not covered by Medicaid (Megellas, 2006).

In terms of lowering healthcare costs, the program was a success. This law provided decreased costs to beneficiaries for prescription drugs for seniors. This led to an increase in medication usage. This effect has both beneficial and negative impacts. For those who required medication they previously couldn't afford there was likely a beneficial effect. However, excessive use of medication in the US has consequences caused by adverse side effects and addiction.

A negative impact of the bill involves a provision that prohibited the government from negotiating the prices of medication with pharmaceutical companies. Guaranteed payment through Medicaid in conjunction with no negotiating power has led to increased costs of medication.

While the law is effective in lowering costs for Medicaid recipients, the law has had a negative impact on the overall costs of medication. The law would have likely been more effective if it had enabled negotiations over the cost of drugs. This would allow for decreasing medical costs for seniors while ensuring that pharmaceutical companies aren't price gouging.

3. In 1986 Congress passed The Federal Emergency Medical Treatment and Labor Act (EMTALA), also known as the Patient Anti-Dumping Law; the EMTALA was for hospitals receiving federal funds to stop refusing emergency services to low-income patients. The law requires most hospital emergency rooms to screen all patients seeking emergency care and to stabilize those requiring emergency services before transferring them to another facility. Treatment is to be provided to individuals regardless of their health insurance status or ability to pay. Once the patient is stable and the attending physician decides to have the patient transferred to a nearby hospital, the attending physician or medical staff who calls the ambulance will need to contact the hospital where the patient is being transferred and arrange for receiving physician to take over the patient's care. Therefore, it is a violation of EMTALA to not arrange for receiving physician to assume care. The EMTALA's effectiveness depends on the emergency services staff and physicians who want to comply with this law; there are many injustices that happen daily in the emergency rooms, from discharging patients without proper diagnosis or treatment plan to refusing services because of lack of insurance coverage. Complying with EMTALA has created a financial burden on the hospital. The EMTALA is unfunded and mandated by the government. American College of Emergency Physicians stated that 55 percent of emergency care services go unpaid (Monico, E., 2010). However, there are a few changes that can be made to this law; in order to provide adequate emergency services to patients, the government should compensate those self-funded hospitals for services given to uninsured patients, and insurance companies should compensate non-contracted hospitals when a patient receives emergency services at a non contracted hospital.

4. There are a lot of important laws made by the federal government that keep the healthcare field running and strong fro American citizens. One really important healthcare act was passed in 2009, so a little over ten years ago. This act is known at the HITECH act. This stands for the Health Information Technology for Economic and Clinical Health. This act requires the mandatory audits of medical offices and spaces to ensure that all HIPPA laws are being followed. This law sets and expects compliance from all medical providers all over the United States. This act sets standard for medical professionals when it comes to ensuring patient privacy and protecting medical records. This is very effective and also lets providers and medical offices know they will be fined if it is found that they do not have a strong enough security system protecting patient information. The maximum fine for a violation is 1.5 million, so this is also a motivator for medical companies to comply with this act. It is also effective because it requires a 30 day turn around time. This means any violations must be corrected within 30 days as the provider or medical company is subject to be checked again.

5. In 1986 the Consolidated Omnibus Budget Reconciliation Act (COBRA) was passed. It is to allow the continuation of health coverage for those that lose their jobs, reduction of work hours, a transition between jobs, death, divorce, and other life events (Continuation of Health Coverage (COBRA), n.d.). This gives the families additional coverage for 18 months after losing a job. They have to pay out of pocket for healthcare coverage but maintain the same benefits. This act helps a lot of families keep their current health coverage. The only problem is that when these families qualify, the individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan (Continuation of Health Coverage (COBRA), n.d.). Many families may struggle with financial problems depending on the life event that led them to get COBRA. The one change I would make is to have a payment to make it more affordable or offer similar plans that won't require the entire premium.

6. The Health Insurance Portability and Accountability Act, or HIPAA, is a federal law that is enacted in 1996. The primary purpose of the Health Insurance Portability and Accountability Act, according to the Centers for Disease Control and Prevention, is to create "national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge" (Centers for Disease Control and Prevention, 2022). Consequently, the U.S. Department of Health and Human Services issued other rules in support of HIPAA.

Some elements of the Health Insurance Portability and Accountability Act include standards for the permitted use of disclosure of sensitive patient health information, such as when required by public law, health oversight activities, for use by law enforcement, and others. There is also a security rule in place that set both the standard for preserving the security of patient health information, as well as means of preserving that security such as having readiness in the workplace to combat acts that will affect HIPAA integrity.

The experience that I possess on the topic is that of myself as a patient, and my mother as a working nurse. As a patient, I have not had that concern of my patient's health information being violated as having gone through different medical institutions and being cared for through their methods of practice. This may be a result of the structure of those organizations, but all have been well executed. My mother states the same thing in her experiences, and that on the provider side that HIPAA is, "like a tight leash so people don't go putting their nose where they aren't supposed to". Since its enactment, there have been no amendments or modifications to the federal law, and I agree that up to this point, it has been very effective.