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Centers for Medicare and Medicaid Services

 
Centers for Medicare and Medicaid Services

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Centers for Medicare and Medicaid Services



 
 
The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services
United States Department of Health and Human Services

The United States Department of Health and Human Services , is a United States Cabinet department of the United States government of the United States with the goal of protecting the health of all Americans and providing essential human services....
 (DHHS) that administers the Medicare
Medicare (United States)

Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria....
 program and works in partnership with state governments to administer Medicaid
Medicaid

Medicaid is the United States American health care system program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states....
, the State Children's Health Insurance Program
State Children's Health Insurance Program

The State Children's Health Insurance Program is a Federal Government of the United States program that gives matching funds to states in order to provide health insurance to families with children....
 (SCHIP), and health insurance
Health insurance

The term health insurance is generally used to describe a form of insurance that pays for medical expenses. It is sometimes used more broadly to include insurance covering Disability insurance or Long term care insurance needs....
 portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act
Health Insurance Portability and Accountability Act

The Health Insurance Portability and Accountability Act was enacted by the U.S. Congress in 1996. According to the Centers for Medicare and Medicaid Services website, Title I of HIPAA protects health insurance in the United States coverage for workers and their families when they change or lose their jobs....
 of 1996 (HIPAA), quality standards in long-term care
Long-term care

Long-term care is a variety of services which help meet both the medical and non-medical need of people with a chronic illness or disability who cannot care for themselves for long periods of time....
 facilities (more commonly referred to as nursing home
Nursing home

A nursing home, skilled nursing facility , or skilled nursing unit , also known as a rest home, is a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living....
s) through its survey and certification process, and clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments
Clinical Laboratory Improvement Amendments

Clinical Laboratory Improvement Amendments of 1988 are United States federal regulatory Standardization that apply to all medical laboratory testing performed on humans in the United States, except clinical trials and basic research....
.

ident Lyndon B. Johnson
Lyndon B. Johnson

Lyndon Baines Johnson , often referred to as LBJ, was the List of Presidents of the United States President of the United States and List of Vice Presidents of the United States Vice President of the United States ....
 signed the Social Security Act on July 30, 1965, establishing both Medicare and Medicaid.






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The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services
United States Department of Health and Human Services

The United States Department of Health and Human Services , is a United States Cabinet department of the United States government of the United States with the goal of protecting the health of all Americans and providing essential human services....
 (DHHS) that administers the Medicare
Medicare (United States)

Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria....
 program and works in partnership with state governments to administer Medicaid
Medicaid

Medicaid is the United States American health care system program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states....
, the State Children's Health Insurance Program
State Children's Health Insurance Program

The State Children's Health Insurance Program is a Federal Government of the United States program that gives matching funds to states in order to provide health insurance to families with children....
 (SCHIP), and health insurance
Health insurance

The term health insurance is generally used to describe a form of insurance that pays for medical expenses. It is sometimes used more broadly to include insurance covering Disability insurance or Long term care insurance needs....
 portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act
Health Insurance Portability and Accountability Act

The Health Insurance Portability and Accountability Act was enacted by the U.S. Congress in 1996. According to the Centers for Medicare and Medicaid Services website, Title I of HIPAA protects health insurance in the United States coverage for workers and their families when they change or lose their jobs....
 of 1996 (HIPAA), quality standards in long-term care
Long-term care

Long-term care is a variety of services which help meet both the medical and non-medical need of people with a chronic illness or disability who cannot care for themselves for long periods of time....
 facilities (more commonly referred to as nursing home
Nursing home

A nursing home, skilled nursing facility , or skilled nursing unit , also known as a rest home, is a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living....
s) through its survey and certification process, and clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments
Clinical Laboratory Improvement Amendments

Clinical Laboratory Improvement Amendments of 1988 are United States federal regulatory Standardization that apply to all medical laboratory testing performed on humans in the United States, except clinical trials and basic research....
.

History

President Lyndon B. Johnson
Lyndon B. Johnson

Lyndon Baines Johnson , often referred to as LBJ, was the List of Presidents of the United States President of the United States and List of Vice Presidents of the United States Vice President of the United States ....
 signed the Social Security Act on July 30, 1965, establishing both Medicare and Medicaid. The Social Security Administration
Social Security Administration

The United States Social Security Administration is an Independent agencies of the United States government of the United States federal government of the United States that administers Social Security , a social insurance program consisting of retirement, disability, and survivors' benefits....
 (SSA) became responsible for the administration of Medicare and the Social and Rehabilitation Service (SRS) became responsible for the administration of Medicaid. Both agencies were organized under what was then known as the Department of Health, Education, and Welfare (HEW).

In 1977, the Health Care Financing Administration (HCFA) was established under HEW. HCFA became responsible for the coordination of Medicare and Medicaid. The responsibility for enrolling beneficiaries into Medicare and processing premium payments remained with SSA.

In 1980, HEW was split into two agencies: the Department of Education
United States Department of Education

The United States Department of Education is a United States Cabinet-level department of the United States government of the United States. Created by the Department of Education Organization Act , it was signed into law by President Jimmy Carter on October 17, 1979 and began operating on May 4, 1980....
 and the Department of Health and Human Services (HHS). HCFA became an agency under the Department of Health and Human Services.

In 1999, CMS created the PSC (Program Safeguard Contractor) program to support the Medicare Integrity Program (MIP). MIP was created as part of HIPAA.

On July 1, 2001, HHS Secretary Tommy Thompson
Tommy Thompson

Tommy George Thompson , a United States politician, was the 42nd List of Governors of Wisconsin and the 7th United States Secretary of Health and Human Services....
 renamed HCFA the Centers for Medicare & Medicaid Services (CMS). Secretary Thompson explained that in order "to give the agency a new direction, a new spirit, it is necessary that we give it a new name - one that truly reflects the agency's vital mission to serve millions of Medicare and Medicaid beneficiaries across America."

The previous CMS Administrator, Mark McClellan
Mark McClellan

Mark Barr McClellan is currently the Director of the Engelberg Center for Health Care Reform, Senior Fellow in Economic Studies and Leonard D....
, MD, PhD, was sworn in on March 25, 2004. On September 5, 2006, McClellan announced his resignation from the post. The current Acting Administrator as of September 20, 2007 is Kerry Weems.

Workforce


The CMS employs approximately 4,100 employees, of which 2,700 are located at its headquarters in Woodlawn, Maryland
Woodlawn, Baltimore County, Maryland

Woodlawn is an unincorporated community and a census-designated place in Baltimore County, Maryland, Maryland, United States. The population was 36,079 at the 2000 census....
. The remaining employees are located in the Hubert H. Humphrey Building in Washington, D.C.
Washington, D.C.

Washington, D.C. , formally the District of Columbia and commonly referred to as Washington, the District, or simply D.C., is the Capital of the United States, founded on July 16, 1790....
, the 10 regional offices listed below, and in various field offices located throughout the United States.

Regional offices


CMS has its headquarters in Woodlawn, Maryland
Woodlawn, Baltimore County, Maryland

Woodlawn is an unincorporated community and a census-designated place in Baltimore County, Maryland, Maryland, United States. The population was 36,079 at the 2000 census....
, with 10 regional offices located throughout the United States:
  • Region I - Boston
Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island and Vermont.
  • Region II - New York
    New York

    The State of New York is a U.S. state in the Mid-Atlantic States and Northeastern United States regions of the United States and is the nation's List of U.S....
New Jersey, New York as well as the U.S. Virgin Islands and Puerto Rico.
  • Region III - Philadelphia
Delaware, Maryland, Pennsylvania, Virginia, West Virginia and the District of Columbia.
  • Region IV - Atlanta
Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee.
  • Region V - Chicago
    Chicago

    Chicago is the largest city in the U.S. state of Illinois and the Midwestern United States, as well as the List of United States cities by population city in the United States with more than 2.8 million residents....
Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin.
  • Region VI - Dallas
Arkansas, Louisiana, New Mexico, Oklahoma and Texas.
  • Region VII - Kansas City
    Kansas City, Missouri

    Kansas City is the largest city in the U.S. state of Missouri. It encompasses in parts of Jackson County, Missouri, Clay County, Missouri, Cass County, Missouri, and Platte County, Missouri counties....
Iowa, Kansas, Missouri and Nebraska.
  • Region VIII - Denver
Colorado, Montana, North Dakota, South Dakota, Utah and Wyoming.
  • Region IX - San Francisco
Arizona, California, Hawaii, Nevada and the Territories of American Samoa, Guam and the Commonwealth of the Northern Mariana Islands.
  • Region X - Seattle
Alaska, Idaho, Oregon and Washington.


See also

  • Administration on Aging
    Administration on Aging

    The Administration on Aging is an agency of the United States Department of Health and Human Services. AoA awards annual grants to State government agencies on aging and Native American tribal organizations to support programs mandated by the Congress in the Older Americans Act....
  • Medicare (Australia)
    Medicare (Australia)

    Medicare is Australia's publicly-funded universal health care system, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all resident citizens and permanent residents except for those on Norfolk Island....
  • Medicare (Canada)
    Medicare (Canada)

    The term medicare is the unofficial name for Canada's universal health care. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories....
  • National Health Service
    National Health Service

    The National Health Service is the name commonly used to refer to the four publicly funded healthcare systems of the United Kingdom, collectively or individually, although only the health service in England uses the name 'National Health Service' without further qualification....
     (United Kingdom)
  • Quality improvement organizations
    Quality improvement organizations

    Quality Improvement Organizations monitor the appropriateness, effectiveness, and quality of care provided to Medicare beneficiaries. They are private contractor extensions of the federal government of the United States that work under the auspices of the U.S....
  • Stark Law
    Stark Law

    Stark law, actually three separate provisions, governs physician self-referral for Medicare and Medicaid patients. The law is named for United States Congressman Pete Stark, who sponsored the initial bill....
  • Medical billing
  • Health Insurance Portability and Accountability Act
    Health Insurance Portability and Accountability Act

    The Health Insurance Portability and Accountability Act was enacted by the U.S. Congress in 1996. According to the Centers for Medicare and Medicaid Services website, Title I of HIPAA protects health insurance in the United States coverage for workers and their families when they change or lose their jobs....
  • Emergency Medical Treatment and Active Labor Act
    Emergency Medical Treatment and Active Labor Act

    The Emergency Medical Treatment and Active Labor Act is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act....


  • Thomas A. Scully
    Thomas A. Scully

    Thomas A. Scully was the Administrator of the Centers for Medicare and Medicaid Services from 2001-2003 under President George W. Bush. Scully currently is Senior Counsel at Alston & Bird LLP, a law firm and lobbying firm, where he focuses on health care regulatory and legislative matters, as well as on advising clients on health policy an...


External links

    • , a quarterly journal published by CMS.
    • - Find CMS publications as well as historic, current, and projected facts and figures pertaining to the U.S. Health Care System.