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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
US Healthcare Regulatory Agencies: Guiding the System
Here’s a table outlining five key regulatory agencies within the US healthcare system, highlighting their relevance to APRN/DNP graduates:
| Regulatory Agency | Level of Authority | Scope of Regulatory Authority | Role in US Healthcare System | Relevance to APRN/DNP | Specialty/Practice Relevance |
| Food and Drug Administration (FDA) | Federal | Food, drugs, medical devices, biologics, cosmetics, and radiation-emitting products | Ensures the safety, efficacy, and security of drugs, medical devices, and other consumer products. | APRNs must be aware of FDA-approved medications, device guidelines, and drug safety information. | All specialties, as APRNs prescribe medications and utilize medical devices. |
| Centers for Medicare and Medicaid Services (CMS) | Federal | Medicare, Medicaid, and CHIP programs; healthcare provider reimbursement and regulations | Administers national health insurance programs, sets reimbursement rates, and regulates healthcare providers participating in these programs. | APRNs must understand CMS regulations, billing codes, and reimbursement policies for their practice. | All specialties, particularly those working in settings with Medicare/Medicaid patients. |
| Health Resources and Services Administration (HRSA) | Federal | Healthcare workforce, access to healthcare, and health disparities | Provides healthcare workforce development, support for underserved populations, and resources to improve health equity. | APRNs can utilize HRSA resources for professional development, access to funding opportunities, and information on serving underserved communities. | Relevant to all specialties, particularly those working in rural areas, with underserved populations, or focusing on health disparities. |
| National Committee for Quality Assurance (NCQA) | Non-governmental (National) | Healthcare quality and accreditation; quality improvement initiatives | Accredits healthcare organizations and programs, sets quality standards, and promotes healthcare quality improvement. | APRNs must understand NCQA standards and participate in quality improvement initiatives within their practice settings. | All specialties, as NCQA accreditation influences patient care and practice settings. |
| State Boards of Nursing (BONs) | State | Nursing licensure, scope of practice, and professional conduct | Regulates nursing practice within each state, sets licensure requirements, and enforces professional standards. |
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