Monday, November 8, 2010

Government Regulation Of Health Care Providers

Government has a large role in health care provisions.


Regulation of health care providers and insurers permeates almost every aspect of health care provision in the U.S. today. From how medical treatments are provided, to licensing, to the management of insurance policies, government rules exists directing how businesses should behave.


Background


Since their start in the 1930s, managed health care and related insurance programs have been involved in a relationship with government. With the introduction of Medicare, the relationship became even closer as the government began keeping an eye on the provision of medical services. During the 1980s and 90s, the regulation levels grew extensively, with added state-level oversight.


Regulatory Players


Both the federal and state government perform supervisory functions in health care, ranging from licensing of medical providers, to audits of insurance companies' financial books. Given the number of government agencies involved, overlapping jurisdictions occur, which creates a bureaucracy that insurance companies and providers must wade through regularly.


Regulatory Reform


Changes to the regulations that exist frequently focus on welfare and health care, since these two programs retain the largest annual federal government costs. Depending on the political party in charge, regular attempts are made to reduce government size, or to reduce the costs of services. Fraud prevention also tends to be frequently pushed in regulatory reform.







Tags: health care, health care, insurance companies