Why You Need to Understand Healthcare Laws


healthcare and law

It takes more than just doctors and nurses to deliver quality healthcare to patients. Healthcare managers, medical assistants, medical administrative assistants, billing and coding specialists, and many more trained professionals work tirelessly to make healthcare facilities run well. Whether they have direct or indirect contact with patients, all of these healthcare team members can make a positive impact. That’s why they all need to know and follow healthcare laws and regulations. If you plan to start a rewarding career in healthcare, you’ll need to learn the healthcare laws behind acronyms like HIPAA, HITECH, EHR, and more. Are you up for the challenge?

Why Do I Need to Know Healthcare Laws?

Sure, doctors and nurses need to know healthcare laws. After all, they are professionals who diagnose, treat, and care for patients. But even if you don’t treat or care for patients, your job still affects the delivery of their healthcare. If you manage a physician’s office or are in charge of electronic health records, or if your job is to schedule appointments, prepare exam rooms, or work with patients in any capacity, you need to understand the healthcare the laws. It’s also important to know the regulations because they help to:

  • Protect patients: The purpose of healthcare law is to protect patients from mistakes, fraud, or an abuse of the system. It also protects their rights, such as their right to privacy.
  • Let you know what you can and cannot do: Healthcare laws set the boundaries of your position. They tell you how you can and cannot treat patients, so you don’t inadvertently cause harm.
  • Standardize care: It wouldn’t be fair or right for medical facilities to set their own rules. The quality of care would differ vastly from office to office and from hospital to hospital. Having a solid set of standardized procedures helps to ensure that all patients are treated equally.

What Healthcare Laws Do I Need to Know?

The most commonly known healthcare law is the Health Insurance Portability and Accountability Act, or HIPAA. This law prevents healthcare professionals from discussing patients’ medical records with anyone but the patient or authorized personnel. That might be other team members treating the patient, insurance providers, or maybe a healthcare proxy. The important takeaway is that if you’re a patient, you get to decide who sees—and doesn’t see—your private medical records.

What Does HIPPA Do?

  • Allows workers to carry health insurance from their current job to their next job
  • Sets the standards for providing healthcare information electronically
  • Establishes a means to reduce healthcare fraud and abuse
  • HIPAA is one of the most important healthcare laws to learn. However, there are others you should know:

Other Important Healthcare Laws

  • The Health Information Technology for Economic and Clinical Health Act (HITECH): This law was created a little over a decade ago as electronic health records (EHRs) were becoming the new standard for recording patients’ medical history. It requires healthcare providers to show that electronic health records are used to measure the improvement of the delivery of healthcare, including increased engagement between the patient and doctor, and a reduction in healthcare disparities. This act also supports the HIPAA privacy policy by requiring healthcare professionals to keep electronic health records private and securely stored.
  • The Patient Safety and Quality Improvement Act (PSQUIA): This act allows healthcare workers to report medical errors and unsafe conditions where they work without retaliation. To understand when your facility is running afoul of the law, you’ll need to become familiar with the Occupational Safety and Health Act (OSHA), which sets the safety standards for the medical workplace.
  • The Anti-Kickback Law: This law prohibits any healthcare worker from accepting a bribe in exchange for a referral for an item or service paid for by Medicare or Medicaid. A similar law, known as the Stark Law, prohibits physicians from accepting bribes for referrals to medical services such as lab testing, hospital services, or even prescription drugs.
  • The False Claims Act: This act prohibits anyone from making a false medical claim or a false record of services billed to a federally funded medical program. This includes billing for services not provided, or billing multiple times for a single service. The act also protects whistleblowers who report these false claims. A similar act has been passed that specifically covers false claims to the Medicaid program.

Even if a certain law doesn’t apply to your job, such as the Stark Law, it’s important to be familiar with it. If you see something happen that is not within the law, you can report it and potentially save yourself, your facility, and your patients from liability and harm.


When it comes to a career in healthcare, there is so much more to learn than the law. If you’re ready to start a career in this rewarding field, contact National American University today. We offer online degree programs in healthcare management, medical services management, and health information technology. Fill out the form to request more information today.


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