What Are Health Care Regulatory Agencies?

Health care regulatory agencies monitor health care practitioners and facilities, provide information about industry changes, promote safety and ensure legal compliance and quality services. Federal, state and local regulatory agencies often establish rules and regulations for the health care industry, and their oversight is mandatory. Some agencies, such as those for accreditation, require voluntary participation but are important because they provide rankings or certification of quality. Business Net (BNET) provides an extensive list of regulatory agencies.

FDA

    The Food & Drug Administration (FDA) is responsible for the oversight of drugs, medical devices, vaccines, blood products and biologics, establishing rules for testing, clinical trials and approval of new products. The FDA monitors safety, medical errors and adverse reactions to treatment, alerting the health care industry of risks associated with treatments. The FDA also monitors food products to ensure safety of your food supply.

AHRQ

    The Agency for Healthcare Research & Quality (AHRQ) is a federal agency under Health & Human Services working to improve the quality, effectiveness and safety of health care. AHRQ gathers information in surveys, funds research projects and provides evidence-based practice guidelines for health care practitioners. The AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS) program provides a national benchmarking (health care standards) database.

CMS

    The Centers for Medicare & Medicaid Services (CMS) work with health care providers to ensure quality, efficient and cost-effective care for those who are older adults, disabled or low income. CMS establishes reimbursement levels and standards of care and works to modernize the health care industry, such as by implementing electronic record keeping. CMS provides health care coding (for diseases and treatment) used throughout the health care industry and determines if treatment is medically necessary and appropriate.

CDC

    The Centers for Disease Control & Prevention (CDC) monitors and controls infectious diseases and assists other local, national and international agencies/facilities to prevent the spread of disease. The CDC requires health care providers to report some infectious diseases, maintains statistics of rates of infection and provides resources, such as infection control and treatment guidelines and research personnel.

OSHA

    The Occupational Safety & Health Administration (OSHA) establishes and monitors safety regulations regarding workers. OSHA provides on-site inspections to evaluate workplace hazards, investigates accidents and provides educational materials to promote workplace safety, such as guidelines for working in hot weather.

Accrediting Agencies

    George Mason University provides information about health care accreditation agencies, including The Joint Commission (TJC), the National Committee for Quality Assurance (NCQA) and the Accreditation Commission for Healthcare (ACHC). While accreditation is technically voluntary, reimbursement by Medicare/Medicaid/insurance often requires accreditation. Accrediting agencies set standards and provide regular thorough inspections of facilities, practices and records to ensure quality care and compliance with safety standards. Accrediting agencies may require particular practice standards, such as using two identifiers (name, birthdate) when providing care to patients.

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