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Regulation plays a major role in the health care industry and health care insurance coverage. The various regulatory bodies protect the public from a number of health risks and provide numerous programs for public health and welfare. Together, these regulatory agencies protect and regulate public health at every level. Health care regulations are developed and implemented not only by all levels of government (federal, state and local) but by private organizations as well.

Health care regulations and standards are necessary to ensure compliance and to provide safe health care to every individual who accesses the system. The health care regulatory agencies in turn monitor practitioners and facilities, provide information about industry changes, promote safety and ensure legal compliance and quality services.(Grimm2014)

Federal, state and local regulatory agencies often establish rules and regulations for the health care industry, and their oversight is mandatory. Some other agencies, such as those for accreditation, require voluntary participation but are still important because they provide rankings or certification of quality and serve as additional oversight, ensuring that health care organizations promote and provide quality care.

The Centers for Medicare and Medicaid (CMS) oversee most of the regulations related directly to the health care system. CMS provides government-subsidized medical coverage through a number of programs:

• Medicare for the elderly and disabled
• Medicaid for lower-income individuals and families
• State Children’s Health Insurance Program (SCHIP) for health insurance coverage for children under 19

CMS is also responsible for ensuring compliance to the Health Insurance Portability and Accountability Act (HIPAA). HIPAA, which works to reduce costs while protecting patients and providing better medical care, is a major piece of health care regulation and was instituted to improve the efficiency and effectiveness of the health care system.

The Agency for Healthcare Research and Quality (AHRQ) is another agency that falls under the U.S. Department of Health & Human Services (HHS). It conducts research aimed at improving the quality of health care, reducing costs and addressing patient safety and medical errors.

There are also several non-profit organizations that serve as watchdogs and accreditation institutions for health care in America:

• The Joint Commission on Accreditation of Health Care Organizations (JCAHO) works to ensure that health Care organizations provide quality care. JCAHO employs a system in which health care organizations are examined and then given a score of 1-100, with higher scores being better. These scores are important to health care organizations as they are a factor when determining reimbursement from Medicare.
• The National Committee for Quality Assurance (NCQA) ensures the quality of managed care plans. It was established in 1991 to provide standard and objective information about HMOs.

Grimm, N, 2014 Whose in charge of regulation. Accessed

You have presented an elaborate and well-detailed post explaining the role of regulations in organizations, especially the healthcare industry. You have stated that regulatory bodies are either public or government set organizations that assist in imposing requirements, standards, and ensuring organizations’ compliance. I agree that regulatory bodies help protect the public from risks arising from health issues. The regulations and standards in healthcare maintain compliance with various facilities to ensure that patients access the highest form of services. You have stated that healthcare regulatory bodies also ensure patient safety by ensuring facilities comply with the various standards developed by the federal government, survey and keep tabs of various practitioners and facilities, and facilitate information sharing, especially when it comes to changes in the practice or rules. There are several regulating bodies in healthcare, including the provider licensing boards, public health departments, and insurance commissioners.