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Laws of Medicine pp 185–211Cite as

Administrative Law—And Its Application in Health Law

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Abstract

In the United States, while the practice of medicine itself is regulated by the individual states, federal administrative agencies play a crucial role in the promulgation and implementation of national health policy, and the provision of health insurance and disability benefits. This chapter discusses the activities of these agencies and the limitations on them as imposed by administrative law. It provides a general overview of federal administrative law, and then a more detailed look at how these principles are applied (or differ) in the key federal health-related agencies, primarily the Department of Health and Human Services and its many important agencies such as the Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, and the National Institutes of Health. It also covers the activities of the Social Security Administration and benefit programs in the Departments of Labor and Veterans Affairs.

Keywords

  • Administrative law
  • Rulemaking
  • Administrative adjudication
  • Judicial review
  • Food and drug regulation
  • Medicare appeals
  • Social security disability

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Notes

  1. 1.

    This chapter will primarily focus on administrative law at the federal level, and hence will be concerned with federal agencies. The same overall concepts generally apply at both the state and local levels, although the actual implementation and emphasis differ jurisdiction by jurisdiction. The allocation of responsibilities between the federal government and the states and between the states and local governments within the states is usually analyzed in “constitutional law” and in “state and local government law”.

  2. 2.

    There are, of course many other aspects of administrative law that cannot be detailed here, such as constitutional separation-of-powers restrictions; agency investigative, information collection, and enforcement powers; openness laws, including the Freedom of Information Act; and suits for money damages against the government or officials. These matters are described more fully in [7].

  3. 3.

    Space does not permit a discussion of other government health care programs, such as the TRICARE program for active and retired military personnel and their dependents, the Indian Health Service (part of HHS), which provides direct medical and public health services to members of federally recognized tribes, or the various subsidized health care insurance plans offered to government employees. Of course, other regulatory programs administered by agencies such as the Environmental Protection Agency, National Highway Traffic Safety Administration, and the Consumer Product Safety Commission are also intended to protect our health.

  4. 4.

    These are the “traditional Medicare” programs. Part A is Hospital Insurance and Part B is Supplemental Medical Insurance. Later, Part C (an alternative private “managed care” program that beneficiaries may choose instead of Parts A and B) and Part D (optional subsidized additional prescription drug benefits) were added.

  5. 5.

    The Department also administers the ERISA program (and the Affordable Care Act provisions) that govern employer-funded health insurance coverage that most Americans still rely on.

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Acknowledgement

Thanks to my colleague, Professor Lindsay Wiley for her helpful comments on an earlier draft.

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  1. Washington College of Law, American University, Washington, DC, USA

    Jeffrey S. Lubbers

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Correspondence to Jeffrey S. Lubbers .

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  1. Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Amirala S. Pasha

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Lubbers, J.S. (2022). Administrative Law—And Its Application in Health Law. In: Pasha, A.S. (eds) Laws of Medicine . Springer, Cham. https://doi.org/10.1007/978-3-031-08162-0_11

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