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Mgmt 520 Administrative Agency

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1. State the administrative agency which controls the regulation. Explain why this agency and your proposed regulation interests you (briefly). Will this proposed regulation affect you or the business in which you are working? If so, how? Submit a copy of the proposed regulation along with your responses to these five questions. The proposed regulation can be submitted as either a separate Word document (.doc) or Adobe file (.pdf). This means you will submit two attachments to the Week 2 Dropbox: (a) a Word document with the questions and your answers and (b) a copy of the proposed regulation you used for this assignment. (10 points)

- Centers for Medicare Medicaid Services (Department of Health and Human Services) is the department that has introduced this regulation. When it comes to health care it affects every citizen of the United States. I show interest in this because it can affect me with the cost of health insurance. Health care has been a big topic lately especially with the introduction on Obama Care. When it comes to what I pay for Health Care it concerns me because that’s more money that has to be spent on it and with some of the prices of health care it is already an outrageous price. The penalties that they are wanting to establish for CHP could potentially raise our Health Care prices.
2. Describe the proposal/change. (10 points)

- This proposed rule would require a controlling health plan (CHP) to submit information and documentation demonstrating that it is compliant with certain standards and operating rules adopted by the Secretary of Health and Human Services (the Secretary) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This proposed rule would also establish penalty fees for a CHP that fails to comply with the certification of compliance requirements.
3. Write the public comment that you would submit to this proposal. If the proposed regulation deadline has already passed, write the comment you would have submitted. Explain briefly what you wish to accomplish with your comment. (10 points)

- I agree with the proposal of the new regulation that the Centers of Medicare and Medicaid Services has proposed. The Secretary of Health and Human Services has put rules and regulations into effect and they need to be followed just like anything else. This will provide status that everyone is following these rules and regulations and that no one is getting services that they don’t need or not qualified for. I would want all the reports and documents myself to show that what I have put into place is being followed. This will help prevent fraud and help save money because people who do not qualify for certain services won’t receive it. The one issue I have with the proposed regulation change is the fees that will be issued. I agree that the providers should be issued a fee if they don’t follow the protocols of reporting the information, but if they are issued these fees then they should be responsible for the cost and not punish their subscribers by raising the premiums. The only reason that they should if any reason charge the subscribers is if it’s their fault that the documents were not turned in on time like requested.
4. Provide the "deadline" by which the public comment must be made. (If the date has already passed, please provide when the deadline was). (5 points)

- Comments must be submitted by 5pm on March 3, 2014
5. a. Once you have submitted your comment, what will you be legally entitled to do later in the promulgation process (if you should choose to do so)? (See the textbook's discussion of the Administrative Procedure Act.)

- Once its completed through the comment part the regulation can go into effect or they can modify the regulation and then go through the comment part again. If it's just a small modification it does not have to go through the comment part again. If you don't agree with the finial out come you do have some legal grounds. First thing you can do is arbitary and capricious

b. If the proposal passes, identify and explain the five legal theories you could use in an attempt to have (any) administrative regulation declared invalid and overturned in court. * 1. You can challenge the agency’s rule if it’s arbitrart, capricious, an abuse of discretion, or if it is in violation of other laws. This is usually for informal rulemaking and requires the agency to provide evidence to support the proposed rule. If there is no evidence then the rule can be held arbitrary and capricious.
2. If the regulation is not supported by substantial evidence then it can be challenged as well. The evidence is applied in the review of formal rulemaking. Arbitrary and capricious standard only requires some sort of proof for the regulation.
3. A regulation can be put to the side if the agency did not apply with the APA requirements of notice, publication, and public comment. The rulemaking procedures must be followed for the regulatory process and for the resulting rules to be valid. If the agency asks for the public to comment for the drafting the legislation cannot then turn the legislation into rules after the close date for comments.
4. If the regulation is unconstitutional then you can challenge it as well. Most challenges that are based on constitutional grounds deal with the regulations that has given an agency the authority to search records or for those that impose discriminatory requirements for licensed professionals.
5. If a regulation is ultra vires then you can challenge it. Ultra Vires regulations goes beyond the authority that was given to an agency during the enabling act. Most agencies will stay within their authority. If the agency tries to change the purpose of the enabling the regulation would then be ultra vires.

c. Which of these challenges would be the best way to challenge the regulation you selected for this assignment if you wanted to have the regulation overturned and why?

- If you are going to challenge it then the best route to go would be if the regulation was unsupported by the proper evidence. There must be evidence to support why they are wanting to put this regulation into affect.

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