Centers for Medicare and Medicaid Services (CMS)
What are the Centers for Medicare and Medicaid Services (CMS)?
The Centers for Medicare and Medicaid Services (CMS) is a federal agency that provides health insurance coverage to Americans via Medicare and works with state governments to provide insurance through Medicaid and CHIP. CMS is also responsible for overseeing HIPAA administration, quality standards in long-term care facilities, clinical quality guidelines, and management of HealthCare.gov.
Why are the Centers for Medicare and Medicaid Services (CMS) important in healthcare?
CMS is the organization responsible for creating health and safety guidelines for U.S. hospitals and healthcare facilities, including introducing and enforcing clinical and quality programs. As a government payor, CMS also reimburses care facilities for the healthcare services its Medicare patients receive.
In addition to regular care costs, CMS penalizes care facilities performing below its clinical and quality standards—usually in the form of fines or lower reimbursement rates. CMS also pays bonuses to high-performing care facilities to incentivize proper care procedures and lower overall care costs.