Magazine article American Nurse Today

Exploring Health Policy: Federal Register Rules, Regulations, and Notices

Magazine article American Nurse Today

Exploring Health Policy: Federal Register Rules, Regulations, and Notices

Article excerpt

Government health policy has an impact on nearly every aspect of healthcare delivery. It drives payment methodology, influences the quality of the care that is delivered, and affects the day-to-day operations of healthcare systems. In short, it creates the environment in which nurses and other providers deliver health care to patients and populations. As the largest single group of healthcare providers (3.4 million), it is essential that registered nurses (RNs) engage in the formulation and development of health policy, particularly since physicians and other providers, as well as healthcare entities (such as insurance companies and hospitals), have a strong voice in healthcare matters.

What is health policy?

Policies are "authoritative decisions made within government," and public-sector health policy includes "authoritative decisions regarding health or the pursuit of health made in the legislative, executive, or judicial branches of government that are intended to direct or influence the actions, behaviors, or decisions of others." All levels of government (federal, state, and local) establish health policies.

One aspect of the American Nurses Association's (ANA) health policy work at the federal level involves monitoring the actions of agencies. This is accomplished, in part, by reviewing and analyzing proposed rules, final rules and regulations, notices, and Presidential documents (such as executive orders) published in the Federal Register. Through review and analysis, we not only become aware of the planned activities of executive agencies, but also can help shape those activities by providing comments on how the policies will affect nurses, patients, and the broader healthcare system.

Understanding the Federal Register

The Federal Register was created by the Federal Register Act (FRA) in 1935. It is a repository of documents for public inspection. The Federal Register includes final rules and regulations published by executive agencies; proposed rules (called notices of proposed rulemaking), requests for information, and other documents seeking public comment; presidential documents (including presidential proclamations and executive orders); and agency notices that provide information to the public.

The framework initially established by the FRA was further refined by the Administrative Procedures Act in 1946, which standardized the rulemaking process and established a mechanism for the public to comment on pending regulations. The advent of the digital age has made it easier than ever to follow the proposals of federal agencies and administrations. The Federal Register is available electronically for review at, while documents scheduled for future publication in the Federal Register are available for advance review by the public at

Writing regulatory comments

ANA staff review and analyze federal agency decisions, regulations, and rules affecting registered nurses, our profession, our patients, and the public health, and develop feedback to federal policymakers through written comments. …

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