The Federal Register and Its Role in Health Care

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Billed as "the Daily Journal of the United States Government," the Federal Register was created with the objective of helping "citizens and communities understand the regulatory process, and to participate in government decision-making." The mission of the Federal Register is to inform citizens of their rights and obligations, to document the actions of federal agencies, and to provide a forum for public participation in the democratic process.

There are four types of entries in the Federal Register: Presidential documents, such as executive orders; rules and regulations such as policy statements and interpretations of rules; proposed rules, including petitions for rules, and notices, which include scheduled hearings, grant applications, administrative orders and other announcements

The Office of the Federal Register was created in 1935 under the Federal Register Act, and its mission was enlarged by the Administrative Procedure Act and the Freedom of Information Act. At first, the Federal Register was a print publication, and today it is also online, proving a high level of access to the workings of the federal government. The main authority for the Federal Register is via the Federal Register Act.

The Federal Register is published by the Office of the Federal Register and the Government Printing Office.

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Both are within the organizational structure of the federal government, which is an independent agency within the federal government, meaning that it exists outside of the executive organizational structure, and thus is outside of Presidential control. It is difficult to find out where the funding for this agency comes from.

The Federal Registry contains millions of documents, which makes search challenging. In any given search in health care, for example, most of the documents will either be rules or proposed rules. Searching for an actual policy is exceptionally difficult even with the advanced search function, a major disadvantage of not segregating actual laws from random policy documents -- a proposal that is not undertaken is more likely to show in the search than an actual policy, and there is no way to filter these out. For example, HIPAA was passed in 1996 but a search for HIPAA in 1996 does not yield the text of this law. Searches for other years will, however, provide information on a number of rules that govern the implementation of laws like this.

If we substitute "rule" for "policy" some results arise. One such rule is "Medicare Program: End-stage renal disease….....

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