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Regulatory agencies that regulate health and the health care system within the US
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
Sample Answer
Regulatory Agencies in the US Healthcare System
The following table outlines five key regulatory agencies that govern various aspects of healthcare in the United States:
| Agency | Level | Scope of Authority | Role in US Healthcare System | Relevance to APRN/DNP Graduate (Mental Health) |
|---|---|---|---|---|
| Food and Drug Administration (FDA) | Federal | Regulates drugs, medical devices, food, cosmetics, and electronic radiation-emitting products. | Ensures safety and effectiveness of medications, devices, and other products used in healthcare. | Crucial for APRNs/DNPs to stay updated on FDA-approved medications and devices for mental health treatment. |
| Centers for Medicare & Medicaid Services (CMS) | Federal | Oversees Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Sets standards for quality of care and reimbursement for healthcare providers. | Ensures quality care for Medicare and Medicaid beneficiaries. Sets standards for documentation and billing for APRNs/DNPs working with these populations. | Understanding CMS regulations is vital for billing and coding services provided to Medicare and Medicaid patients in mental health settings. |
| Joint Commission (JCAHO) | Private, non-profit | Develops healthcare quality standards and conducts accreditation surveys for hospitals, ambulatory care facilities, and other healthcare organizations. | Promotes quality and patient safety through voluntary accreditation. | Accreditation by JCAHO can be beneficial for mental health facilities, impacting reimbursement and reputation. APRNs/DNPs should be familiar with JCAHO standards as they relate to their practice setting. |
| State Boards of Nursing (BON) | State | Licenses and regulates nurses, including APRNs. Sets practice standards, educational requirements, and continuing education mandates. | Protects the public by ensuring qualified nurses provide care. Governs APRNs’ scope of practice, including prescribing medications and conducting therapy in mental health settings. | Understanding and adhering to state BON regulations is essential for APRNs/DNPs in mental health to practice legally and ethically. |
| Drug Enforcement Administration (DEA) | Federal | Regulates controlled substances, including some medications used in mental health treatment. | Controls access to and prescribing of controlled substances to prevent misuse. | APRNs/DNPs in mental health must obtain a DEA registration to prescribe controlled medications. |
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