At Polishan Solfanelli, we help physicians navigate the complexities of health care law in contract negotiation, dispute resolution, mediation, arbitration, litigation, hearings and trials. Our health law attorneys in Pennsylvania provide answers to some of the most common questions we receive from clients. For personalized assistance, call us at (570) 562-4520 to schedule a consult.
What is Health Care Law?
Health law is a specialized area of law that focuses on legal issues related to healthcare, medical treatment, and patient rights. It encompasses a wide range of topics, from healthcare regulations and compliance to medical malpractice, patient privacy, and more. Health law ensures the ethical and legal practice of medicine while protecting the rights of both patients and healthcare providers.
Health care law also provides a framework to combat the abuse and fraud that runs throughout the industry. It establishes what is and is not allowed in the treatment of patients. Health care law creates a standard level of care that all medical institutions are required to adhere to.
What Key Aspects of Health Law Do Health Care Providers in Pennsylvania Need to Know?
There are many different federal laws that regulate the healthcare industry. Likewise, each state has enacted its own specific laws.
Examples of Federal Laws and Regulations
- Health Insurance Portability and Accountability Act (HIPAA). HIPAA mandates the protection of patient health information (PHI). Providers must establish and maintain safeguards to protect PHI, including electronic health records (EHRs).
- Americans with Disabilities Act (ADA). The ADA provides protections to United States citizens with disabilities, helping disabled people have the same chances and opportunities that persons without disabilities experience
- Family Medical Leave Act (FMLA). FMLA protects an employee's job when they take unpaid leave for certain medical reasons and also provides certain entitlements to military families
- Anti-Kickback Statute (AKS). Providers should understand anti-kickback laws, which prohibit offering, receiving, or soliciting compensation or rewards for referrals or services under federal healthcare programs.
- Section 1877 of the Social Security Act. Also known as the physician self-referral law or Stark Law, this Act prohibits physician self-referral for certain designated health services. Healthcare providers should be aware of exceptions and safe harbor provisions.
- Emergency Medical Treatment and Labor Act (EMTALA). EMTALA requires providers to treat all patients presenting to an emergency room, regardless of their ability to pay.
Overview of State Laws and Regulations
- Licensing and Credentialing. Healthcare professionals must maintain valid licenses and credentials to practice legally. Understanding state-specific licensing requirements is crucial.
- Drug Prescribing and Dispensing. Providers should understand the laws governing the prescription and dispensing of controlled substances.
- Medical Malpractice. Providers need to be aware of medical malpractice laws, including the elements of negligence, statute of limitations, and the importance of maintaining accurate medical records.
- Telemedicine Laws. Telemedicine is subject to state-specific regulations. Providers should be familiar with licensure, reimbursement, and practice standards for telehealth services.
- Fraud and Abuse Laws. Providers must be vigilant to prevent healthcare fraud and abuse, including billing for services not provided and improper coding.
Each healthcare provider must know and comply with the requirements established by these and other relevant health laws and regulations. Consulting with our health law lawyer at Polishan Solfanelli in Pennsylvania will help you make sure you are in compliance and can benefit from that compliance.
What Are Healthcare Providers Obligated to Do under Healthcare Laws?
Healthcare providers operate in a complex legal environment to ensure patient care and privacy are maintained while complying with various regulations and laws. Provided below are key aspects that healthcare providers need to know to ensure their obligations are being met.
- Informed Consent. Healthcare providers must ensure patients fully understand their diagnosis, proposed treatment, potential risks, and alternatives before obtaining informed consent.
- Healthcare Contracts. Healthcare providers frequently enter contracts with insurers, facilities, and other entities. Understanding contract terms, including reimbursement rates, is essential.
- Health Insurance. Understanding health insurance laws and regulations is crucial for healthcare providers, as they often interact with insurers for reimbursement.
- Advance Directives. Healthcare providers should be familiar with laws governing advance directives, such as living wills and durable power of attorney for healthcare.
- End-of-Life Care. Laws surrounding end-of-life care, including Do-Not-Resuscitate (DNR) orders and palliative care, vary by jurisdiction.
- Medical Records Management. Properly maintaining and protecting patient medical records is essential. Providers should follow record-keeping guidelines and be aware of retention requirements.
- Patient Rights. Providers should be aware of patient rights, including the right to privacy, access to medical records, and the right to refuse treatment.
- Healthcare Compliance. Providers should stay up-to-date with federal, state, and local healthcare regulations, as they may change over time.
- Medical Ethics. Providers must adhere to ethical principles, including patient confidentiality, informed consent, and the duty to provide care regardless of a patient's background.
- Cultural Competency. Understanding diverse patient backgrounds and cultural norms is vital to providing equitable healthcare and avoiding discrimination.
- Reporting Obligations. Healthcare providers may have obligations to report certain diseases, injuries, or suspected abuse to relevant authorities.
This list is not exhaustive, as healthcare law is vast and constantly evolving. Healthcare providers in Pennsylvania should consult with our health law attorney to ensure they remain in compliance and provide the best possible care to their patients.
When Does a Medical Facility or Professional Need a Health Care Lawyer in Pennsylvania?
A medical facility or professional will benefit from the assistance of a health care attorney in various scenarios. Examples of these scenarios include situations when medical facilities or professionals:
- Require assistance negotiating, drafting, or entering into contracts
- Require guidance on compliance with applicable laws, including regulations and administrative matters involving, for example, Medicare or Medicaid
- Require guidance on their privacy and consumer protection measures
- Require help with taxes in the healthcare industry
- Defend against allegations of failure to comply
- Defend against allegations of ethics violations
If you operate a medical facility or are a medical professional, it works in your favor to build a working relationship with a health law attorney to ensure compliance, avoid legal issues, or promptly address legal challenges when they arise.
What Types of Cases Fall under Health Law?
Health law encompasses a large area of intersecting laws and regulations. A case specific to health law can, therefore, fall under one of many different issues. Some of the most common types of cases can involve any of the below matters.
- Medical malpractice
- Healthcare facility regulations
- Patient rights
- Healthcare contracts
- Insurance disputes
- Medical licensing
- Telemedicine
- Compliance with federal and state healthcare laws
Whether you think you have a healthcare case or not, it is important to speak with an attorney in your Pennsylvania. At Polishan Solfanelli, we can help you understand what type of case you might have and outline your options moving forward.
What Are Patient Rights in Terms of Treatment and Privacy?
Healthcare providers must protect the rights and privacy of patients. Some of these rights include:
- The right to informed consent
- The right to confidentiality of medical information
- The right to access medical records
- The right to refuse treatment.
Our health law attorney in Pennsylvania can help you understand what these rights mean in practice and how to ensure you are meeting your obligations. A proactive and thorough plan can prevent legal issues and challenges in the future.
Can You Help Healthcare Professionals with Disciplinary Matters?
At Polishan Solfanelli, we have helped healthcare professionals handling disciplinary actions.
Contact a Health Care Attorney in Northeastern Pennsylvania Today
At Polishan Solfanelli, our health law lawyers in Pennsylvania help clients comply with relevant federal and state laws, create strategies to maintain compliance and avoid civil liability or criminal action, and provide guidance regarding healthcare law. Contact us today by either filling out the online form or calling us at (570) 562-4520 to schedule a consult.