The Centers for Medicare & Medicaid Services, established in 1977 and referred to as CMS, is a division of the U.S. Department of Health and Human Services (HHS). Formerly known as the Health Care Financing Administration, the department is headquartered in Woodlawn, Maryland and is responsible for administrating the Medicare program and partnering with states to oversee Medicaid services.
Prior to 1977, Medicare and Medicaid were administered by the Social Security Administration and Social and Rehabilitation Services, respectively. Joseph A. Califano Jr., President Carter’s Secretary of Health, established the Health Care Financing Administration to oversee the two programs under one roof. This was done in order to improve administration of both Medicare and Medicaid, improve the staffing of the Medicaid program, and to create a new administrative structure to implement national health insurance.
In 2001, the agency became the Centers for Medicare & Medicaid Services. With over 4,000 employees in 10 regional offices nationwide, the duties of CMS extend beyond these two programs. CMS is also responsible for the Children’s Health Insurance Program (CHIP), which provides healthcare to over 8 million children whose families cannot afford private health plans but make too much money to qualify for Medicaid.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is administrated and enforced by CMS. HIPAA has two main parts, the first dealing with protection of health coverage for workers who lose their jobs and their dependents. The second section of HIPPA deals with patient privacy and provides for establishing standards for security and confidential treatment of all patient data.
CMS also oversees the financial management of the Clinical Laboratory Improvement Amendments (CLIA). Passed by Congress in 1988, CLIA established quality standards for all laboratory testing to ensure the accuracy, reliability and timeliness of patient test results regardless of where the test was performed.
National training and education regarding Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplaces (i.e. exchanges) is available through CMS. Training modules including webinars and in-person workshops are extended to partners and stakeholders, not-for-profit professionals and volunteers who work with seniors and people with disabilities, and others who help people make informed health care decisions.
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