Health Legislation and Advocacy
Health Legislation and Advocacy
- Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)
Part 1: Legislation Comparison Grid
Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:
- Determine the legislative intent of the bill you have reviewed.
- Identify the proponents/opponents of the bill.
- Identify the target populations addressed by the bill.
- Where in the process is the bill currently? Is it in hearings or committees?
- Is it receiving press coverage?
Part 2: Legislation Testimony/Advocacy Statement
Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:
- Advocate a position for the bill you selected and write testimony in support of your position.
- Describe how you would address the opponent to your position. Be specific and provide examples.
- Recommend at least one amendment to the bill in support of your position.
SAMPLE ANSWER
Health Legislation and Advocacy
Part 1: Legislation Comparison Grid
| Health-related Bill Name | Strengthening the Healthcare Fraud Prevention Task Force Act of 2019 (H.R. 525). |
| Description | This bill is focused on amending the title XI of the Social Security Act with the aim of guiding the Secretary of Health and Human Services to create private-public collaboration with the purpose of identifying fraud, waste, and abuse in the healthcare system (Govtrack, n.d.).
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| Federal or State? | Federal |
| Legislative Intent | The bill entails statutory authority and requirements to establish an effective collaboration between government agencies, insurance plans, healthcare organizations, and law enforcement. This measure is to ensure that fraud, abuse, and waste in the healthcare system are detected. The collaboration is required to be developed under the Health Care Fraud and Abuse Control Program. This program is overseen by the Department of Justice and the Department of Health and Human Services (Govtrack, n.d.).
The bill intends to ensure that collaboration among healthcare parties involve promotion of data sharing to ensure that there is sufficient information to make a decision. Moreover, it focuses on ensuring that there is sufficient analysis of data to identify fraudulent activities. It also enforces the requirement to refer criminal activities to the Department of Justice. Another intention is to ensure that sufficient outreach and education is enhanced in the healthcare system (Govtrack, n.d.).
According to the sponsor, Greg Walden, the purpose of the new partnership is to ensure that voluntary sharing of data is done in all areas of the healthcare system. He also adds that the proposed bill transfers all functions, assets, and administrative activities of the existing partnership to the new collaboration (Govtrack, n.d.).
|
| Target Population | Secretary of Health and Human Services, Department of Justice, government agencies, insurance firms, healthcare organizations, and law enforcement. |
| Status of the bill (Is it in the hearings or committees? Is it receiving press coverage?) | The bill is in the hearing. It has passed the House of Representatives and awaits hearing in the Senate for consideration. The bill is receiving press coverage with the media focusing in attaining opinion from the public. The press is also providing information on the legislators’ views of the bill. |
| General Notes/Comments | In order for the healthcare system to establish a suitable coordination, proper partnership plans need to be put in place. This move requires the establishment of partnership education among different agencies in the healthcare system. Failure to engage in this change means that vices such as fraud will continue in the system. As a result, efficiency in one sector may not improve the healthcare services in the country. Therefore, passing the bill will ensure that drawbacks in healthcare are controlled fully. |
Part 2: Legislation Testimony/Advocacy Statement
Healthcare services in the United States are viewed to be among the most costly in the world. While this rise is partly due to the quality of services delivered, it is opined that it is majorly caused by abuse and fraud in the system. For instance, Medicare professionals are observed to be aware of fraud during the process of developing insurance plans. They hand over their information to new clients while hoping for illegitimate claims and deception. From this perspective, it can be postulated that fraud is a major flaw in the healthcare system and has made the industry to reduce the effectiveness of its services. In that regard, it is very important to control fraud through efficient partnership among various healthcare agencies (van Capelleveen et al., 2016).
Health Legislation and Advocacy
The introduction of the Healthcare Fraud Prevention Taskforce act is observed to have led to a significant reduction of fraud in various healthcare departments. The act has ensured that all the activities are accounted for through suitable provision of data. Since 2018, there has been a suitable link between the Secretary of Health and Human Services and third parties. Despite these achievements, it is viewed that there is inefficient partnership between the Department of Health Services and the Department of Justice. This depiction is seen in the low conviction rate of offenders in the healthcare system. Therefore, it can be argued that while the original act has been positively influential in reforming the healthcare system, there are still some gaps that it needs to reduce to attain suitable results. While there will be no direct effect on direct spending by clients, the act has been able to codify existing healthcare agency practice (Congregational Budget Office, n.d.).
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In order to bring better understanding the importance of fraud prevention act, it is essential to reveal the impact of its benefits. The bill amended the Social Security Act by providing a public-private partnership in the healthcare sector. Prior to the ct, there was little coordination between the agencies, thereby limiting their efficiency. Moreover, the development of a contract between the Health Department and third parties is viewed to have limited the increase of fraud in the system. From the above depiction, it is easy to understand that the bill is more beneficial to healthcare system as it focuses in one of the major challenges in the industry (Govtrack, n.d.).
To ensure that there is a better control of fraud, in the healthcare system, there is a need to amend the time required for making reports. Currently, the bill proposes that the Secretary of Health should make a report every two years. This period is long given that the review of activities can be done within a year o operation. Therefore, reporting should be done on a yearly basis to increase efficiency in fraud control (Govtrack, n.d.).
References
Congregational Budget Office (n.d.). H.R. 6753: Strengthening the health care fraud prevention
task force act of 2018. Retrieved from https://www.cbo.gov/publication/54552
Govtrack (n.d.). H.R. 525: Strengthening the health care fraud prevention task force act of 2019.
Retrieved from https://www.govtrack.us/congress/bills/116/hr525
Van Capelleveen, G., Poel, M., Mueller, R. M., Thornton, D., & van Hillegersberg, J. (2016).
Outlier detection in healthcare fraud: A case study in the Medicaid dental domain. International Journal of Accounting Information Systems, 21, 18-31.
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