Regulatory agencies that regulate health and the health care system within the US

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Identify regulatory agencies that regulate health and the health care system within the US, create a table (use the one provided here on link below) 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 organizations authority to the APRN/DNP graduate.
Describe relevance to specialty area, area of practice, or setting of practice. For an example, mental health.

 

Sample Solution

Regulatory Agencies in the US Healthcare System

Note: The specific relevance of these agencies to your APRN/DNP specialty, area of practice, or setting may vary. It’s essential to conduct further research based on your specific field.

Table of Regulatory Agencies

Agency Level of Regulatory Authority Scope of Regulatory Authority Role in US Healthcare System Relevance to APRN/DNP Relevance to Specialty/Practice
Centers for Medicare & Medicaid Services (CMS) Federal Oversees Medicare, Medicaid, and CHIP programs; sets reimbursement rates; establishes quality standards. Primary payer for healthcare services; influences healthcare delivery and reimbursement. Determines reimbursement for APRN services, establishes quality measures, and regulates healthcare settings. Impacts reimbursement, licensure, and practice scope for APRNs.
Food and Drug Administration (FDA) Federal Regulates food, drugs, medical devices, and cosmetics. Ensures safety and efficacy of medical products. Influences medication prescribing, medical device utilization, and patient safety. Relevant for prescribing medications and utilizing medical devices.
Department of Health and Human Services (HHS) Federal Oversees and coordinates health and human services programs and policies. Sets national health priorities, provides funding for health programs, and conducts health research. Influences healthcare policy, research, and funding opportunities. Impacts access to care, research funding, and public health initiatives.
State Board of Nursing (BON) State Licenses and regulates registered nurses and advanced practice nurses. Protects the public by ensuring nurse competency. Determines APRN licensure requirements, scope of practice, and disciplinary actions. Directly impacts APRN licensure, practice, and professional development.
Joint Commission Private, but influential Accredits and certifies healthcare organizations. Sets quality standards for healthcare facilities. Influences quality of care, patient safety, and organizational performance. Impacts practice environment and patient care standards.

Explanation

  • CMS: This federal agency plays a crucial role in healthcare financing and delivery. APRNs must understand CMS regulations to ensure appropriate reimbursement for their services and to comply with quality standards.
  • FDA: The FDA’s oversight of medications and medical devices is essential for APRNs to safely and effectively prescribe and utilize these products.
  • HHS: While broader in scope, HHS influences healthcare policy and funding, which impacts APRNs indirectly.
  • State Board of Nursing: This agency directly regulates APRN practice, including licensure, scope of practice, and disciplinary actions. Understanding state-specific regulations is critical for APRNs.
  • Joint Commission: Although not a government agency, the Joint Commission sets quality standards for healthcare organizations, which directly impact APRN practice.

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