MHA FPX 5062 Assessment 2 Laws, Regulations and Oversight

Student Name

Capella University

MHA-FPX5062 Healthcare Delivery: New Environments in Health Informatics

Prof. Name:

Date

Laws, Regulations, and Oversight

Introduction

The field of health information management (HIM) continues to evolve with the overarching aim of enhancing clinical documentation, reducing medical errors, and ensuring compliance with regulatory standards. Historically, healthcare systems relied heavily on physical recordkeeping, which often posed challenges in accessibility and accuracy. However, the transition to electronic health records (EHRs) has revolutionized data storage and sharing. Despite this technological advancement, the growing volume of healthcare data and the increasing demand for interoperability underscore the necessity for consistent and structured information governance. Effective HIM practices are now essential in ensuring that data remains accurate, secure, and efficiently managed across healthcare institutions.

Purpose

The primary purpose of this discussion is to explore the laws, regulatory agencies, and stakeholders that influence the health information management landscape. These components collectively establish the standards and frameworks required to ensure ethical and compliant healthcare delivery.

Key areas include:

Regulatory agencies
Laws guiding business operations
Stakeholder involvement

Outline

The following topics will be addressed:

Department of Health and Human Services (HHS)
Office of the National Coordinator for Health Information Technology (ONC)
Centers for Medicare and Medicaid Services (CMS)
Health Insurance Portability and Accountability Act (HIPAA)
Health Information Technology for Economic and Clinical Health Act (HITECH)
Affordable Care Act (ACA)
Stakeholders in healthcare management
Health informatics and management roles
Best practices and strategies
Conclusion

Department of Health and Human Services (HHS)

The Department of Health and Human Services (HHS) functions as both a federal and state-level governing body responsible for safeguarding public health and delivering essential human services. It allocates funding to various healthcare initiatives, ensures compliance with federal mandates, and provides oversight for programs that influence population health outcomes. HHS plays a vital role in enforcing healthcare regulations and guiding health policy at the national level.

Office of the National Coordinator for Health Information Technology (ONC)

The Office of the National Coordinator (ONC) is tasked with fostering the development of a secure, interoperable, and efficient health information technology infrastructure. Through legislation and policy, the ONC promotes interoperability among electronic health record systems, thereby ensuring seamless data exchange across healthcare settings. Its mission emphasizes the use of health IT to improve care coordination, patient engagement, and overall healthcare quality.

Centers for Medicare and Medicaid Services (CMS)

CMS represents the single largest payer in the United States healthcare system. It develops and enforces policies, processes, and procedures for healthcare providers, influencing how care is delivered and reimbursed. CMS also designs incentive programs that encourage providers to adopt health information technologies, improve care quality, and maintain compliance with regulatory standards.

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA establishes national standards for protecting sensitive patient health information. It ensures portability, enabling individuals to maintain insurance coverage when changing jobs, and promotes administrative simplification to enhance efficiency in healthcare transactions. HIPAA applies to covered entities such as healthcare providers, insurers, and business associates. Regular training and compliance programs are mandated to ensure that all stakeholders adhere to privacy and security rules.

Health Information Technology for Economic and Clinical Health Act (HITECH)

The HITECH Act expanded upon HIPAA by strengthening privacy and security protections for health data. It introduced the concept of Meaningful Use, encouraging healthcare providers to adopt certified EHR systems to improve patient care quality, safety, and efficiency. Additionally, HITECH emphasizes compliance measures, imposes penalties for breaches, and promotes the use of health IT to enhance the healthcare delivery system overall.

Affordable Care Act (ACA)

The Affordable Care Act (ACA) represented a transformative overhaul of the U.S. healthcare system. It sought to reduce the number of uninsured individuals, improve care delivery models, and emphasize preventive care. The ACA encouraged value-based care, integrated care coordination, and expanded access to health insurance through exchanges and Medicaid expansion.

Stakeholders

Stakeholders play a crucial role in healthcare oversight and strategic management. They contribute to policy formation, ethical compliance, and performance improvement within healthcare organizations.

Stakeholder Group	Roles and Responsibilities
C-Level Executives	Provide leadership, set organizational vision, and champion a culture of compliance and innovation.
Chief Operating Officer (COO)	Oversees internal and external operations, ensuring processes are collaborative and efficient.
IT Managers and Technicians	Support system interoperability, cybersecurity, and infrastructure reliability.
Human Resources, Finance, and Business Services	Uphold hiring standards, maintain financial health, and reinforce value-based care initiatives.

Health Care and Health Informatics Managers

Health care and health informatics managers serve as gatekeepers of clinical and operational data. They oversee the integration of technology into healthcare settings, ensuring that information systems support quality improvement, decision-making, and compliance. These professionals function as collaborators across departments, bridging gaps between clinical, technical, and administrative functions while maintaining the integrity of patient data.

Strategies or Best Practices

To ensure efficient management and compliance within healthcare organizations, the following best practices are recommended:

Code of Conduct – Establishing clear ethical standards for all personnel handling health information.
Document Management – Implementing structured systems for data storage, retrieval, and retention to ensure accuracy and compliance.
Periodic Assessments – Conducting regular audits and risk assessments to identify vulnerabilities and ensure ongoing improvement.

Conclusion

The regulatory environment governing health information management is both multi-layered and comprehensive, encompassing federal oversight, technological innovation, and ethical considerations. Successful management requires continuous adaptation to evolving regulations, commitment to data security, and an outcome-driven approach that prioritizes patient safety and organizational transparency.

References

About ONC | HealthIT.gov. (2021). Https://Www.Healthit.Gov/Topic/about-Onc. Retrieved February 26, 2022, from https://www.healthit.gov/topic/about-onc

Accountable Care Organizations (ACOs): General Information | CMS Innovation Center. (2021). Https://Innovation.Cms.Gov/Innovation-Models/Aco. Retrieved February 28, 2022, from https://innovation.cms.gov/innovation-models/aco

Office for Civil Rights (OCR). (2021, June 28). HITECH Act Enforcement Interim Final Rule. HHS.Gov. Retrieved March 3, 2022, from https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement-interim-final-rule/index.html