Agencies & Regulations

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When Congress passes laws, they rarely contain enough specific language to guide their implementation completely. It is the responsibility of the federal administrative agencies to fill in the details of new or amended laws with rules and regulations. Regulations/rules are used to clarify definitions, authority, eligibility, benefits, and standards. Their development is shaped not only by the law but also with the ongoing involvement and input of professional associations like ANA, other providers, third party payers, consumers and other special interest groups.

The development of rules takes time and follows a defined process:

  • The publication of the proposed rule in the Federal Register offers an opportunity for those with an interest in the particular rule to react to the draft rule before it becomes final. ANA routinely reviews the Federal Register for proposed regulations.
  • ANA reviews regulations of particular interest to the nursing community, analyzing them and identifying concerns.
  • If necessary, ANA submits comments to the agency recommending changes to the proposed regulation. Commenting on draft rules is one of the most active points of involvement in the entire legislative process.
  • The agency reviews all public comments received within the comment period and may make changes to the proposed rule.
  • After additional agency review the final rule is published and takes effect.

What Federal Agencies Does ANA Monitor?

   Agency for Health Research and Quality-(AHRQ) sponsors and conducts research that provides evidence-based information on healthcare outcomes; quality; and cost, use, and access. The information helps healthcare decision makers-patients and clinicians, health system leaders, purchasers, and policymakers-make more informed decisions and improve the quality of healthcare services.
   The Centers for Disease Control and Prevention-(CDC) is recognized as the lead federal agency for protecting the health and safety of people - at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. CDC serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.
   Centers for Medicare and Medicaid Services- (CMS) The HHS agency responsible for administering the Medicare program and parts of the Medicaid program. CMS has historically maintained specifications for various certifications and authorizations used by the Medicare and Medicaid programs. CMS is responsible for oversight of HIPAA administrative simplification transaction and code sets, health identifiers, and security standards. CMS also maintains the HCPCS medical code set.
   The Department of Health and Human Services- (HHS) is the United States government's principal agency for protecting the health of all Americans and providing essential human services through more than 300 programs which are administered by 11 HHS operating divisions, including eight agencies in the U.S. Public Health Service and three human services agencies.
   Department of Justice (DOJ) Anti-trust Division exists to promote and protect the competitive process - and the American economy - through the enforcement of the antitrust laws. The antitrust laws apply to virtually all industries and to every level of business, including manufacturing, transportation, distribution, and marketing. They prohibit a variety of practices that restrain trade, such as price-fixing conspiracies, corporate mergers likely to reduce the competitive vigor of particular markets, and predatory acts designed to achieve or maintain monopoly power.
   Department of Labor-(DOL) is charged with issues relating to workplace safety and health, pensions and benefit plans, employment and other issues related to the American workplace.
   Department of Veterans' Affairs (VA) provides information on VA programs, veteran benefits, VA facilities world wide and VA medical automation systems.
   Drug Enforcement Agency-(DEA) enforces the controlled substances laws and regulations of the United States.
   Food and Drug Administration-(FDA) is the federal agency responsible for ensuring that foods are safe, wholesome and sanitary; human and veterinary drugs, biological products, and medical devices are safe and effective; cosmetics are safe; and electronic products that emit radiation are safe. FDA also ensures that these products are honestly, accurately and informatively represented to the public.
   The Health Resources and Services Administration-(HRSA) HRSA's mission is to improve and expand access to quality health care for all by eliminating barriers to care, eliminating health disparities, assuring quality of care and improving public health and healthcare systems.
   The National Institute for Occupational Safety and Health-(NIOSH) is the Federal agency responsible for conducting research and making recommendations for the prevention of work-related disease and injury. The Institute is part of the Centers for Disease Control and Prevention (CDC).
   The National Institute of Nursing Research-(NINR) supports clinical and basic research to establish a scientific basis for the care of individuals across the life span-from management of patients during illness and recovery to the reduction of risks for disease and disability, the promotion of healthy lifestyles, promoting quality of life in those with chronic illness, and care for individuals at the end of life.
   Occupational Safety and Health Administration-(OSHA) is the government agency that establishes protective standards, enforces those standards, and reaches out to employers and employees through technical assistance and consultation programs.
   The Substance Abuse and Mental Health Administration-(SAMHSA) is the Federal agency charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses.
   U.S. Immigration and Naturalization Service-(INS) transitioned into the Department of Homeland Security (DHS) as the Bureau of Citizenship and Immigration Services (BCIS). The BCIS is responsible for the administration of immigration and naturalization adjudication functions and establishing immigration services policies and priorities.

How Can Individual Nurses Impact Federal Rules and Regulations?

  • Learn about the federal rule making process and how to make your voice heard.
  • Become informed about the public policy and the health policy issues currently under consideration at the federal level of government.
  • Check out the Federal Register. It is the very best source of information about proposed new rules and changes to existing rules for federal programs. It is printed every day and contains all complete directions on where to send your comments and the deadlines for the public comment period.
  • Work with your state nurses association by offering your expertise to assist in developing new regulations or modifying existing regulations.
  • Work with your state nurses association to offer your expertise to help prepare comments on proposed regulations.
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