Legal Regulatory Requirements in Nursing: A Comprehensive Analysis

This report delves into the legal and regulatory requirements governing nursing practice, focusing on the roles of state regulations, federal agencies like the Centers for Medicare & Medicaid Services (CMS), and accrediting bodies such as The Joint Commission. The analysis highlights the New York Health Care Reform Act (HCRA) as a significant state regulation, emphasizing its impact on hospital reimbursement and healthcare initiatives. The report also examines the CMS's function in administering Medicare and Medicaid, ensuring health insurance portability, and using quality measures to assess the safety and quality of care provided by healthcare organizations. Furthermore, it explores The Joint Commission's role in accrediting healthcare organizations and certifying programs for chronic diseases, thereby improving healthcare standards and patient safety. The report underscores the importance of these regulations in maintaining patient safety and ensuring quality healthcare delivery.

Running head: LEGAL REGULATORY AND REQUIREMENTS
Legal regulatory and requirements
Name of the student
Name of the University
Author Note

1LEGAL REGULATORY AND REQUIREMENTS
Professional regulation in nursing may be described as a process where the governmental
agencies usually grant legal authority to practice a chosen profession provided such individual
has fulfilled particular qualifications. It is essential to have a regulatory requirement of nursing,
as it is a health profession, which, if any incompetent and unprepared person practices, might
pose a risk of harm to the public. The regulatory requirement that from each of the following is
as follows:
State- One of the essential regulations of the New York State is the enactment of the New York
Health Care Reform Act that has been established to govern the hospital reimbursement
methodologies and targets the funding for a huge number of health care initiatives (Blumenthal
& Collins, 2014). The establishment of HCRA marks a positive change, as the regulation
requires that some of the third-party providers and payers of the health care services should take
part in sponsoring some of the initiatives by submitting assessments and surcharges. It marked
the enactment of the Affordable Patient Protection and Affordable Care Act.
This state regulation has a $1 billion HCRA-supported Indigent Care Pool usually
distribute money to the hospitals on the basis of the level of free care such hospitals provide to
those who are uninsured and primarily on the extent of assistance the uninsured persons have
received from the hospitals in the past.
Federal Agency- The Centers for Medicare & Medicaid Services (CMS) is a federal agency
operating within the US Department of Health and Human Services (HCFA), which
administers the Medicare program and works in association with state governments for
governing Medicaid, the Children’s Health Insurance Program (SCHIP). It further ensures that

2LEGAL REGULATORY AND REQUIREMENTS
health insurance portability standards are maintained effectively. The CMS falls under the Social
Security Act 1965.
The regulation uses quality measures to assess the level of quality and safe care that the
health care organizations are exercising towards their patients. The CMS plays a significant role
in ensuring quality measures are maintained by the health care organizations. CMS measures
quality and safe care provided by health care organizations based on the fact whether such health
care is providing patient-centered and equitable care to the patients (McKay, 2017).
The quality measures enable the public to be aware of the functions and programs
provided by the health care organizations and the overall quality improvement of such
organizations that is achieved from the medical claims, self-reporting data, assessment
instruments, registries etc (Harewood & Alsaffar, 2015).
Accrediting Body- One of the most significant accreditation organizations that includes
healthcare workers is The Joint Commission. This system keeps a record of every patient that it
has provided treatment for a long time to determine whether such treatment was effective (Joint
Commission, 2016).
The Joint Commission performs two essential functions to ensure safety of the patients. Firstly, it
provided accreditation that is earned by the HCO like hospital. Secondly, it provides certification
for programs dealing with chronic disease and conditions such as diabetes, heart failure and
asthma.
This accreditation body persists to improve health care for the public in association with
other stakeholders by evaluating health care organizations and inspire them to provide safe,
quality and effective care of highest value.

3LEGAL REGULATORY AND REQUIREMENTS
Reference list
Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act—a
progress report.
Harewood, G. C., & Alsaffar, O. (2015). No association between Centers for Medicare and
Medicaid Services payments and volume of Medicare beneficiaries or per-capita health care
costs for each state. Clinical Gastroenterology and Hepatology, 13(3), 609-612.
Joint Commission. (2016). Joint Commission on Accreditation of Healthcare Organizations.
McKay, D. (2017). American politics and society. John Wiley & Sons.