Healthcare

Quality healthcare services are important to maintaining health and preventing disease. Education about the rights and protections consumers have in regard to healthcare can be very beneficial. Click below to learn about consumer healthcare topics.

Topics of Interest - Healthcare

Dietary Supplements

  • Supplements are regulated by the Food and Drug Administration under the Dietary Supplement Health and Education Act of 1994 (DSHEA).
    • Manufacturers and distributors of supplements are prohibited from marketing products that are adulterated or misbranded.
    • However, the FDA does not review supplement products for safety and effectiveness before they are sold.
  • “Natural” does not always mean “safe.”
    • For example, the herbs comfrey and kava can cause serious harm to the liver.
  • Supplements can interact with prescription and over-the-counter medications.
    • Asking your health care providers before taking supplements is the best way to prevent dangerous interactions.
  • The National Center for Complementary and Integrative Health maintains useful resources on using dietary supplements wisely.
  • The FDA has created a Dietary Supplement Ingredient Advisory List to help consumer avoid ingredients that appear to be unlawfully marketed in dietary supplements.

Weight Loss

  • Scammers frequently try to sell products that promise quick and easy weight loss without diet or exercise.
    • Most of these claims are false, and some of these products may harm your health.
    • The best way to lose weight is to eat fewer calories and exercise more.
      • This is true even for people taking FDA-approved pills to help them lose weight, which are supposed to be combined with a low-calorie, low-fat diet and regular exercise.
    • If you think you may have been scammed, you can report it the Federal Trade Commission or your state attorney general.

Health Insurance

  • Federal laws attempt to make healthcare coverage fair and easy to understand, whether you are insured through the Government Health Insurance Marketplace or through an individual insurance plan provider, such as through your employer.
  • Federal and state laws provide a number of protections for health insurance policy holders. Some of these protections include the following:
    • Protections
      • Free preventative care.
      • More coverage options for young adults.
      • The prevention of applicant denials due to a pre-existing health condition, including pregnancy, without charging more to the applicant.
      • No lifetime or yearly insurance coverage caps.
      • Clear and understandable benefits and coverage.
      • Protection from unreasonable insurance rate increases and other ways insurance companies are held accountable.
      • Prevention of plan cancellations for minor mistakes on coverage applications.
      • The ability to choose your primary care provider of choice and access to out-of-network emergency room services.
      • Access to OB-GYN services without a referral from a primary care provider.
      • Protection from employer retaliation.
    • Rights
      • Health insurance plans must provide breastfeeding support, counseling, and equipment before and after the birth of your baby.
      • Counseling and methods for birth control without a copayment.
      • Mental health and substance abuse services.
      • Options to choose a plan from the Marketplace rather than an employer-offered plan.
      • The right to appeal a health plan application denial or claim denial.
    • How to get the most out of your health insurance plan:
      • Many states have consumer assistance programs that help consumers solve insurance problems.
      • The Centers for Medicare & Medicaid Services maintains a directory of state consumer assistance programs.
      • You can also minimize your out-of-pocket costs with a little research:
        • Know your plan’s rules and coverage.
        • Be aware of any pre-certifications, prior approvals, or referrals your insurance plan may require for coverage.
        • Verify your provider is in-network before booking an appointment.
        • Always request generic drugs instead of brand name.
        • Ask questions when deciding on a health plan and what best fits your needs.

Fraud Prevention

  • Consumers can protect themselves from fraud when buying health insurance by taking some simple precautions.
    • If you are enrolling through a state marketplace, look for official government seals, logos, or web addresses (which end in “.gov”) on materials.
    • Be suspicious of high-pressure sales tactics from people who claim to work for the government.
      • No one should threaten you with legal action if you do not sign up for a plan on the phone or in person.
    • If you think you may have been scammed, you can report it the Federal Trade Commission or your state attorney general.

Medical Research

  • Medical research is important to both scientific advancement and public health. In 2018, the Department of Health and Human Services (HHS) created a basic policy that applies to all research involving human subjects that any federal department or agency conducts, supports, or regulates.
  • The policy’s most basic requirements are for any department or agency conducting research to comply with federal laws that protect human research subjects.
  • Some “human subject research” might include clinical trials, collection and use of information for scholarly writing when the information is related to a specific individual, and collection and testing of bio-specimens used for public health studies.
  • The concept of “informed consent” is an important aspect of the policy. The HHS policy established general requirements that are needed before research on a human subject is allowed.
  • For more information, you can visit the Office for Human Research Protections page and learn how and when you should participate as a subject in a medical research study.

Prescription Drugs

  • Currently, prescription drugs are an issue when it comes to both affordability, deceptive practices, and potential for abuse.
  • State and national efforts reflect increased awareness of these issues and the threats they pose to public health and safety. Currently, addressing prescription drug costs, the national opioid crisis, and deceptive marketing related to risks and benefits of prescription drugs and ways to protect consumers from these dangers.

The Department of Justice

  • At the federal level, the Department of Justice’s Consumer Protection Branch litigates civil and criminal Food, Drug, and Cosmetic Act matters, some of which include preventing drug compounding, taking enforcement actions, and preventing off-label drug promotion, the illegal practice of pharmaceutical companies promoting their products for non-FDA approved use.
  • The Substance Abuse and Mental Health Services Administration
  • The Substance Abuse and Mental Health Services Administration, SAMHSA, is an agency within the U.S. Department of Health and Human Services (HHS) tasked specifically with advancing and improving behavioral health efforts across the country. SAMHSA’s mission is to reduce substance abuse and mental illness impact on American communities.

The Federal Drug Administration

  • The Federal Drug Administration(FDA) is also a big part of the fight against prescription drug issues consumers’ face. The Office of Prescription Drug Promotions, specifically, helps make sure that drug companies are truthful and not misleading when communicating information about their drugs to consumers and health care providers who may prescribe those drugs. You can read more about the Bad Ad Program.

Attorneys General

  • Your state attorney general is another office that works to help protect consumers from certain practices that harm their constituents.
  • Some states have come together to sue drug manufacturers for price-fixing schemes that make drugs unaffordable. Other states, Maryland for example, are passing new laws to prevent price gouging, or when a manufacturer arbitrarily raises its prices on an existing drug and makes it unaffordable to the average consumer.
  • New laws are also being proposed to promote transparency among drug manufacturers. Transparency bills will require public disclosure of the costs associated with drug research and development. This, in turn, will make give states more negotiating power when working with drug companies.

Privacy

  • Legislators, the Federal Trade Commission, and other government agencies, such as the Department of Health and Human Services all have some aspect of their work that protects your healthcare privacy rights.
  • Protecting your private health information is an important aspect of your overall wellness and safety.
  • The Health Insurance Portability and Accountability Act (HIPAA), the “Privacy Rule” was enacted through Congress to create protections for your private information while also ensuring the flow of information healthcare providers need to provide quality patient care.
  • Through HIPAA, you have more control over your health information, as well as a means to enforce safeguards that healthcare providers must follow to protect your private information.
    • HIPAA establishes a national standard to protect your private health information.
    • The Privacy Rule applies to health plans, health care providers, health care clearinghouses, and “business associates,” meaning a billing agency or other similar administrative service that may use your private health information for some purpose.
    • The Privacy Rule covers individually identifiable health information, whether oral or documented electronically or on hard copy. This information is referred to as “Protected Health Information.”
  • If you believe you or someone else has experienced a HIPAA privacy right violation, you may file a complaint here.