Skip to main content

Centers for Medicare & Medicaid Services

CENTERS FOR MEDICARE & MEDICAID SERVICES

On July 1, 2001, the Health Care Financing Administration was reorganized and changed its name to the Centers for Medicare & Medicaid Services (CMS). CMS is an operating division of the health and human services department. It was established in 1977 to combine under one administration the oversight of the medicare Program and the federal portion of the medicaid Program (Reorg. Order of Mar. 9, 1977, 42 Fed. Reg. 13262).

As part of the 2001 reorganization, three new business centers were developed: the Center for Beneficiary Choices, the Center for Medicare Management, and the Center for Medicaid and State Operations. The Center for Beneficiary Choices provides beneficiaries with information about Medicare, Medicare Select, Medicare+Choice, and Medigap options. It also manages the Medicare+Choice plans, consumer research and demonstrations, and grievances and appeals. The Center for Medicare Management oversees the traditional fee-for-service Medicare program. This entails developing payment policies and managing Medicare fee-for-service contractors. The Center for Medicaid and State Operations oversees programs administered by the states, including Medicaid, the State Children's Health Insurance Program (SCHIP), insurance regulation functions, survey and certification, and the Clinical Laboratory Improvements Act (CLIA).

Medicare provides health insurance coverage for U.S. citizens age 65 or older, for younger people receiving social security benefits, and for persons needing dialysis or kidney transplants for the treatment of end-stage renal disease (42 U.S.C.A. § 1395 et seq.). Medicare beneficiaries may receive medical care through physicians of their own choosing or through health maintenance organizations and other medical plans that have contracts with Medicare.

Medicaid is a medical assistance program jointly financed by state and federal governments for low-income individuals (42 U.S.C.A. § 1396 et seq.). Medicaid covers health care expenses for recipients of Temporary Assistance for Needy Families (formerly Aid to Families with Dependent Children), as well as for low-income pregnant women and other individuals whose medical bills qualify them as medically needy. Most states also cover medical expenses for older U.S. citizens who are needy, as well as for individuals who are blind and disabled who receive assistance under the Supplemental Security Income Program. Coverage is further extended to some infants and low-income pregnant women and, depending on the state, to other low-income individuals with medical bills that qualify them as medically needy.

The mission of the CMS is to promote the timely delivery of quality health care to Medicare and Medicaid beneficiaries and to ensure that the Medicare and Medicaid Programs are administered in an efficient manner. The agency must also ensure that program beneficiaries are aware of the services for which they are eligible, that those services are accessible and of high quality, and that agency policies and actions promote efficiency and quality within the total health care delivery system. A quality assurance program administered by the CMS is responsible for developing health and safety standards for providers of health care services authorized by Medicare and Medicaid legislation. This program helps to ensure that Medicare and Medicaid beneficiaries receive quality health care services at a reasonable cost.

further readings

Centers for Medicare & Medicaid Services. Available online at <www.cms.hhs.gov> (accessed July 23, 2003).

Medicare Resource Center. Available online at <www.medicare.gov> (accessed July 23, 2003).

U.S. Government Manual Website. Available online at <www.gpoaccess.gov/gmanual> (accessed November 10, 2003).

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Centers for Medicare & Medicaid Services." West's Encyclopedia of American Law. . Encyclopedia.com. 18 Nov. 2018 <https://www.encyclopedia.com>.

"Centers for Medicare & Medicaid Services." West's Encyclopedia of American Law. . Encyclopedia.com. (November 18, 2018). https://www.encyclopedia.com/law/encyclopedias-almanacs-transcripts-and-maps/centers-medicare-medicaid-services

"Centers for Medicare & Medicaid Services." West's Encyclopedia of American Law. . Retrieved November 18, 2018 from Encyclopedia.com: https://www.encyclopedia.com/law/encyclopedias-almanacs-transcripts-and-maps/centers-medicare-medicaid-services

Learn more about citation styles

Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.