Role of CMS

The Centers for Medicare & Medicaid Services (CMS) is a branch of the U.S. Department of Health and Human Services. CMS is the federal agency which administers Medicare, Medicaid, and the Children’s Health Insurance Program.  The CMS provides a framework for health care business. CMS was established to protect the interest of the customer along with expanding the purview of Insurance. CMS works with various bodies to ensure quality and synchronization among providers and beneficiaries.

The various roles and responsibilities carried out can be broadly classified as below:

Guardian to the healthcare industry

The CMS lays down manuals and records to be referred by the industry to execute administrative task and ensure adherence to the laws and by-laws. It offers suggestions on record and office management. It acts as an Ombudsman for small business to settle disputes. It brings all bodies together and ensures compliance to the norms permitting certification and smooth adjudication of disputes among them.

Legislative Body

The vital function of CMS is to make laws to hold businesses together. The CMS has the authority to pass laws and ensure compliance. It also modifies existing laws based on the need. Some Act passed by the CMS is as follows:

  • Deficit Reduction Act
  • Freedom of Information Act (FOIA)
  • Paperwork Reduction Act (PRA) of 1995
  • Economic Recovery Act of 2009
Reformative Role

CMS is considered as a role model in bringing reform in the sector. The stakeholder’s relies on CMS to enhance value to the customer and society at large. With the pool of knowledge and power available to CMS enjoys liberty in making decision and implementing laws to bring about value and contentment.

Administrative Role

CMS guides the health care sector to manage their administrative duties effectively. It works towards simplifying the administrative task and providing effortless and easy procurement of service. CMS facilities innovation and automation with integrating system and method to manage resource effectively and produce higher value with the same level of input.

CMS reviews the practices and methods followed by the industry to ensure clean and ethical environment to conduct business.

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