HIPAA: Health Insurance Portability and Accountability Act - Federal law that includes Privacy Rule, Security Rule, Breach Notification Rule, and Enforcement Rule to protect patient health information
HITECH Act: Health Information Technology for Economic and Clinical Health Act - Expands and strengthens HIPAA privacy and security protections, and increases penalties for violations
Stark Law: Physician Self-Referral Law - Prohibits physicians from referring patients to entities with which they have a financial relationship for designated health services payable by Medicare
Anti-Kickback Statute: Federal law that prohibits the exchange of anything of value to reward or induce referrals of federal healthcare program business
False Claims Act: Federal law that imposes liability on persons and companies who defraud governmental programs, including Medicare and Medicaid
Affordable Care Act: Comprehensive healthcare reform law that affects healthcare delivery, reimbursement, and provider requirements
Medicare/Medicaid Requirements: Federal programs' specific requirements for healthcare providers, including conditions of participation and payment rules
State Medical Practice Acts: State-specific laws governing the practice of medicine and healthcare delivery within each state's jurisdiction
State Privacy Laws: State-specific privacy regulations that may impose stricter requirements than federal HIPAA regulations
State Licensing Requirements: State-specific requirements for healthcare provider licensing, credentialing, and maintaining practice privileges
State Insurance Regulations: State-specific rules governing insurance coverage, reimbursement, and provider network participation
CMS Regulations: Centers for Medicare & Medicaid Services rules governing healthcare delivery, quality measures, and payment systems
Joint Commission Standards: Accreditation requirements for healthcare organizations covering patient safety, quality of care, and organizational functions
Professional Standards of Care: Industry-accepted standards for medical practice and healthcare delivery specific to various specialties and services
Compliance Programs: Required organizational policies and procedures to ensure adherence to all applicable healthcare laws and regulations
