Identify Regulatory Agencies That Regulate Health 847609
Identify Regulatory Agencies That Regulate Health And The Health Care
Identify regulatory agencies that regulate health and the health care system within the US, create a table listing your 5 regulatory agencies and address the following: Describe the agency, level of regulatory authority (local, state, federal), scope of regulatory authority, and role within the US healthcare system. Address relevance of the organization or the organization’s authority to the APRN/DNP graduate. Describe relevance to specialty area, area of practice, or setting of practice. For an example, mental health. Submission Requirements: In the table, write the 3 criteria above and respond to them. Incorporate at least 3 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions).
Paper For Above instruction
The regulation of healthcare in the United States involves numerous federal, state, and local agencies, each playing a vital role in ensuring healthcare quality, safety, and access. For Advanced Practice Registered Nurses (APRNs) and Doctor of Nursing Practice (DNP) graduates, understanding these agencies' functions and regulatory scope is essential for compliant and effective practice within their specialty areas. This paper presents a table of five key regulatory agencies, describing their authority, scope, and relevance to healthcare providers, particularly APRNs/DNPs.
| Agency | Description | Level of Regulatory Authority | Scope of Regulatory Authority | Role within the US Healthcare System | Relevance to APRN/DNP Practice |
|---|---|---|---|---|---|
| Centers for Medicare & Medicaid Services (CMS) | CMS administers national health programs including Medicare, Medicaid, and the Children's Health Insurance Program, regulating provider reimbursement, quality standards, and coverage policies. | Federal | States and providers participating in federal programs; broad influence across healthcare policies and reimbursement mechanisms. | CMS sets nationwide policies that impact healthcare delivery, financing, and quality assurance. It enforces regulations that APRNs/DNPs must comply with to participate in Medicare and Medicaid programs. | For APRNs/DNPs, CMS guidelines influence scope of practice, billing, and reimbursement. Understanding CMS policies ensures appropriate billing, compliance, and participation in federal programs, especially relevant in primary care and specialized settings like mental health or geriatrics. |
| State Boards of Nursing (SBON) | SBON are responsible for licensure, regulation, and discipline of nurses, including APRNs, ensuring safe nursing practice within each state. | State | Statewide jurisdiction over nursing licensure, practice standards, and disciplinary actions. | SBONs establish licensure requirements and scope of practice regulations, directly overseeing nurse practitioners' authority and practice standards. | For APRNs/DNPs, SBON regulations define the legal scope of practice, prescribing authority, and continuing education requirements, which vary by state. Critical for maintaining licensure and legal compliance in practice, especially in specialized areas like mental health or family practice. |
| Food and Drug Administration (FDA) | FDA regulates the safety and efficacy of drugs, medical devices, and biological products used in patient care. | Federal | Nationwide regulatory oversight over pharmaceutical and medical device approval, labeling, and safety monitoring. | FDA approval is essential for the availability of medications and medical devices. It impacts prescribing practices and innovations in healthcare delivery. | For APRNs/DNPs, especially in specialties like anesthesiology or mental health prescribing, FDA regulations influence medication availability, safety standards, and prescribing authority. |
| Occupational Safety and Health Administration (OSHA) | OSHA ensures safe and healthy working conditions by setting and enforcing standards and providing training in workplaces, including healthcare facilities. | Federal | Workplace safety standards applicable across various industries, including healthcare settings. | OSHA regulations safeguard healthcare workers from occupational hazards such as infectious diseases, needlestick injuries, and chemical exposures. | For APRNs/DNPs practicing in clinical or hospital settings, OSHA standards are vital for maintaining a safe practice environment and complying with safety regulations, especially relevant during infectious disease outbreaks like COVID-19. |
| The Joint Commission (TJC) | A non-governmental organization that accredits healthcare organizations based on quality and safety standards to improve patient care. | Private; accreditation body recognized by CMS | Accredits hospitals, clinics, and other healthcare facilities nationally, influencing certification and reimbursement eligibility. | TJC accreditation signifies compliance with safety and quality standards, affecting hospital funding and patient trust. | For APRNs/DNPs working in accredited facilities, adherence to TJC standards is integral to quality care delivery, patient safety, and institutional credibility, especially in specialized areas like mental health or community health. |
Relevance of Agencies to APRN/DNP Practice
Understanding these agencies' roles and regulations is critical for APRNs and DNPs to ensure legal compliance, deliver high-quality care, and advocate effectively within their practice areas. CMS policies influence billing and reimbursement, essential in primary care and mental health specialties. State Boards of Nursing delineate scope of practice and prescriptive authority, which vary geographically but are vital for clinical autonomy and legal protection. FDA regulations guide medication management, especially relevant in specialties requiring pharmacologic treatment. OSHA standards protect healthcare workers, ensuring safe environments, and TJC accreditation underscores quality assurance, which directly impacts patient outcomes and institutional reputation. Collectively, these agencies shape the regulatory landscape that APRNs and DNPs navigate daily to provide safe, effective, and compliant healthcare services.
References
- Glick, N. D., & Polivka, B. J. (2018). The role of the Centers for Medicare & Medicaid Services in healthcare reform. Journal of Nursing Regulation, 9(3), 28-34.
- O'Conner, T. et al. (2020). State Nurse Practice Acts and APRN Scope of Practice: A Comparative Review. Nursing Outlook, 68(4), 480-488.
- U.S. Food and Drug Administration. (2021). Medical Devices: Overview. Retrieved from https://www.fda.gov/medical-devices
- Occupational Safety and Health Administration. (2023). Healthcare Wide Hazards. Retrieved from https://www.osha.gov/healthcare
- The Joint Commission. (2022). Standards for Hospital Accreditation. Retrieved from https://www.jointcommission.org
- National Academy of Sciences. (2018). The Future of Nursing: Leading Change, advancing health. National Academies Press.
- Fletcher, K. & Breen, C. (2019). The Impact of CMS Payment Policies on Nursing Practice. Nursing Economics, 37(2), 92-97.
- Hick, J. L., & Hanfling, D. (2020). Healthcare Policing and Regulatory Agencies in a Pandemic. Chest, 157(2), 335-337.
- Wexler, L., & White, M. (2020). Legal and Ethical Considerations for APRNs. Journal of Law, Medicine & Ethics, 48(4), 709-713.
- American Nurses Association. (2021). Scope and Standards of Practice for Nurse Practitioners. ANA Publishing.