Health care law is a cross-disciplinary practice centered on the laws impacting the delivery and financing of health care goods and services. In the United States, the health care industry is heavily regulated at the federal, state, and local levels. Regulation of the industry is characterized by constant and rapid change, often involving efforts to contain health care costs, improve access to health care goods and services, and enhance the quality of care.
Much of the federal government’s regulation of the health care industry derives from its oversight of the Medicare and Medicaid programs, which provide health benefits to the elderly and indigent. Examples of other significant federal health care laws include the Food, Drug and Cosmetic Act, which regulates the human drugs, biological products, and medical devices; the Health Insurance Portability and Accountability Act, which includes protections on the privacy and security of protected health information; and the False Claims Act, which gives private individuals a right to bring an action on behalf of the government to recover improper payments. The Patient Protection and Affordable Care Act of 2010, also known as Obamacare, is sweeping federal legislation designed to expand access to health insurance, reduce health care spending, expand federal fraud and abuse authorities, and institute a variety of other health policy reforms.
State governments generally oversee health and safety and regulate providers of health services and insurance within the state. Typically, a state licenses health care facilities and individual health care professionals, such as physicians, dentists, nurses, therapists, and others. State “corporate practice” rules may govern the manner in which professional services can be offered. Some states have health planning laws that require the issuance of a “certificate of need” before certain new health services or facilities may be furnished in the state. Under common law authority or specific state statutes, state attorneys general oversee charitable health care assets, and often play a central role in the review of merger and acquisition transactions involving non-profit health care providers.
These and other health care laws have a pervasive effect on the activities of participants in the health care industry. As a result, health care lawyers play a central role in counseling on compliance in connection with operations; structuring and negotiation transactions; responding to governmental investigations; pursuing and defending litigation in courts and before administrative agencies; advocacy on legislation and regulation; and corporate governance matters.