Centers For Medicare And Medicaid Services (CMS)
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The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and
health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the
Health Insurance Portability and Accountability Act The Health Insurance Portability and Accountability Act of 1996 (HIPAA or the Kennedy– Kassebaum Act) is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1 ...
of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the
Clinical Laboratory Improvement Amendments The Clinical Laboratory Improvement Amendments (CLIA) of 1988 are United States federal regulatory standards that apply to all clinical laboratory testing performed on humans in the United States, except clinical trials and basic research. CLIA P ...
, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes maintaining the 5-Star Quality Rating System.


History

Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. President Dwight D. Eisenhower held the first White House Conference on Aging in January 1961, in which creating a health care program for social security beneficiaries was proposed. President Lyndon B. Johnson signed the Social Security Amendments on July 30, 1965, establishing both Medicare and Medicaid.
Arthur E. Hess Arthur E. Hess (June 18, 1916 – November 15, 2005), former acting commissioner of the Social Security Administration, was born in Reading, Pennsylvania. Hess graduated from Princeton University in 1939 and received a law degree from the Universi ...
, a deputy commissioner of the Social Security Administration, was named as first director of the Bureau of Health Insurance in 1965, placing him as the first executive in charge of the Medicare program. At the time, the program provided health insurance to 19 million Americans. The Social Security Administration (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 March 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. HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. In January 2018, CMS released guidelines for states to use to require Medicaid beneficiaries to continue receiving coverage. These guidelines came in response to then-President Trump's announcement that he would allow states to impose work requirements in Medicaid. In October, CMS reported a data breach of 75,000 people's personal data due to a hack. In January 2021, CMS passed a rule that would cover "breakthrough technology" for four years after they received FDA approval. In September 2021, CMS submitted a proposal to repeal the rule based on safety concerns.


Workforce

CMS employs over 6,000 people, of whom about 4,000 are located at its headquarters in Woodlawn, Maryland. The remaining employees are located in the
Hubert H. Humphrey Building The Hubert H. Humphrey Building is a low-rise Brutalist office building located in Washington, D.C., in the United States. Originally known as the South Portal Building, the Hubert H. Humphrey Building was dedicated on November 1, 1977. It beca ...
in Washington, D.C., the 10 regional offices listed below, and in various field offices located throughout the United States. The head of CMS is the Administrator of the Centers for Medicare & Medicaid Services. The position is appointed by the president and confirmed by the Senate. On May 27, 2021,
Chiquita Brooks-LaSure Chiquita W. Brooks-LaSure is an American healthcare policy official who is the administrator of the Centers for Medicare & Medicaid Services in the Biden administration since May 2021. Education Brooks-LaSure earned her Bachelor of Arts from Pri ...
was sworn in as Administrator, the first black woman to serve in the role.


Regional offices

CMS has its headquarters in Woodlawn, Maryland, with 10 regional offices located throughout the United States: * Region I  – Boston, Massachusetts : Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island and Vermont * Region II  –
New York New York most commonly refers to: * New York City, the most populous city in the United States, located in the state of New York * New York (state), a state in the northeastern United States New York may also refer to: Film and television * '' ...
,
New York New York most commonly refers to: * New York City, the most populous city in the United States, located in the state of New York * New York (state), a state in the northeastern United States New York may also refer to: Film and television * '' ...
: New York State, New Jersey,
U.S. Virgin Islands The United States Virgin Islands,. Also called the ''American Virgin Islands'' and the ''U.S. Virgin Islands''. officially the Virgin Islands of the United States, are a group of Caribbean islands and an unincorporated and organized territory ...
and Puerto Rico * Region III  – Philadelphia, Pennsylvania : Delaware, Maryland, Pennsylvania, Virginia, West Virginia and the District of Columbia * Region IV  – Atlanta, Georgia : Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee * Region V  – Chicago, Illinois : Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin * Region VI  – Dallas, Texas : Arkansas, Louisiana, New Mexico,
Oklahoma Oklahoma (; Choctaw language, Choctaw: ; chr, ᎣᎧᎳᎰᎹ, ''Okalahoma'' ) is a U.S. state, state in the South Central United States, South Central region of the United States, bordered by Texas on the south and west, Kansas on the nor ...
and Texas * Region VII  –
Kansas City The Kansas City metropolitan area is a bi-state metropolitan area anchored by Kansas City, Missouri. Its 14 counties straddle the border between the U.S. states of Missouri (9 counties) and Kansas (5 counties). With and a population of more ...
, Missouri : Iowa, Kansas, Missouri, and Nebraska * Region VIII  – Denver, Colorado : Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming * Region IX  – San Francisco, California : Arizona, California, Hawaii, Nevada, American Samoa, Guam, and the Northern Mariana Islands * Region X Seattle, Washington : Alaska, Idaho, Oregon, and Washington


List of administrators


See also

* Center for Medicare and Medicaid Innovation *
Zone Program Integrity Contractor The Zone Program Integrity Contractor (ZPIC) is an entity established in the United States by the Centers for Medicare & Medicaid Services (CMS) to combat fraud, waste and abuse in the Medicare program. As a result of the Medicare Prescription Drug ...


References

obinson, P. I. (1957)
Medicare: Uniformed Services Program for Dependents
Social Security Bulletin, 20(7), 9–16.


External links

*
Centers for Medicare and Medicaid Services
in the
Federal Register The ''Federal Register'' (FR or sometimes Fed. Reg.) is the official journal of the federal government of the United States that contains government agency rules, proposed rules, and public notices. It is published every weekday, except on feder ...

Health Care Financing Administration
in the Federal Register
Centers for Medicare & Medicaid Services
reports and recommendations from the
Government Accountability Office The U.S. Government Accountability Office (GAO) is a legislative branch government agency that provides auditing, evaluative, and investigative services for the United States Congress. It is the supreme audit institution of the federal govern ...

Grants to States for Medicaid
account on
USAspending.gov ttp://www.usaspending.gov USASpending.govis a database of spending by the United States federal government. History Around the time of the Act's passage, OMB Watch, a government watchdog group, was developing a site that would do essentially eve ...

Centers for Medicare and Medicaid Innovation
account on USAspending.gov
State Grants and Demonstration
account on USAspending.gov {{DEFAULTSORT:Centers for Medicare and Medicaid Services Medicare and Medicaid (United States) United States Department of Health and Human Services agencies Woodlawn, Baltimore County, Maryland Government agencies established in 1965 1965 establishments in the United States