Centers for Medicare & Medicaid Services

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, 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 1965. Since then, HEW, has been reorganized as the Department of Health and Human Services (HHS) in 1980. This consequently brought Medicare and Medicaid under the jurisdiction of the HHS.

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. This was later codified in law by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

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 February 2018, CMS removed a notice from its website that informed insurance companies they were not allowed to charge physicians a fee when the companies paid the doctors for their work. This has resulted in doctors being charged up to a 5% fee on their compensation, adding up to billions of dollars annually.

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.

On September 19, 2023, the Subcommittee on Health held a hearing titled "Examining Policies to Improve Seniors’ Access to Innovative Drugs, Medical Devices, and Technology." Dora Hughes, the acting director of the Center for Clinical Standards and Quality at the U.S. Centers for Medicare and Medicaid Services (CMS), defended the proposed Transitional Coverage for Emerging Technologies (TCET) pathway, which aims to restrict coverage for breakthrough medical devices to five reviews a year. Some lawmakers and medtech trade groups called for expanding the pathway to include diagnostics. Various other legislative proposals were discussed during the hearing, including bills related to Medicare coverage, drug pricing, and transparency in healthcare.

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 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 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 :New York State, New Jersey, U.S. Virgin Islands 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 and Texas
• Region VII  – Kansas City, 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

References

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

References

1. "Five-Star Quality Rating System".
2. Robinson, P. I. (1957). Medicare: Uniformed Services Program for Dependents. Social Security Bulletin, 20(7), 9–16.
3. Tibbits C. "The 1961 White House Conference on Aging: it's rationale, objectives, and procedures". J Am Geriatr Soc. 1960 May. 8:373–77
4. Mcnamara PAT, Dirksen EM, Church F, Muskie ES. The 1961 White House Conference on Aging: basic policy statements and recommendations / prepared for the Special Committee on Aging, United States Senate 87th Congress, 1st Session, Committee Print, May 15, 1961.
5. (15 August 2016). "Today's Document from the National Archives".
6. Fritze, John. (21 November 2005). "Arthur E. Hess, 89, lawyer, served as 1st director of Medicare program".
7. Centers for Medicare and Medicaid Services. "Administrator Tenure Dates & Biographies".
8. Digital Communications Division (DCD). (March 14, 2023). "HHS Historical Insights".
9. (2015-07-01). "Administrator Tenure Dates & Biographies, 1965 — 2015".
10. (2006-10-06). "20TH ANNIVERSARY 1977;TIME CAPSULE".
11. "CNN.com - Medicare agency renamed as prelude to reforms - June 14, 2001".
12. [[Medicare Prescription Drug, Improvement, and Modernization Act. Medicare Prescription Drug, Improvement, and Modernization Act of 2003]], Title IX, § 900(e).
13. Ellis, Blake. (2013-11-01). "Fraud, dumb mistakes lead Medicare to pay $23 million to dead people".
14. (2014-04-09). "Sliver of Medicare Doctors Get Big Share of Payouts". The New York Times.
15. Sanger-Katz, Margot. (2018-01-11). "Can Requiring People to Work Make Them Healthier?". The New York Times.
16. Pear, Robert. (2018-01-11). "Trump Administration Says States May Impose Work Requirements for Medicaid". The New York Times.
17. (October 20, 2018). "Hackers breach Healthcare.gov system, taking files on 75,000 people".
18. (14 August 2023). "The Hidden Fee Costing Doctors Millions Every Year".
19. (2021-01-12). "Medicare approves coverage of 'breakthrough' medical devices".
20. (2021-09-13). "Biden to toss Medicare coverage for "breakthrough" technology".
21. "Memorandum for September 19, 2023, Health Subcommittee Hearing". Committee on Energy and Commerce.
22. Paul Taylor, Nick. (2023-09-21). "CMS leader defends breakthrough device reimbursement proposal at House hearing".
23. Brooks-LaSure, Chiquita. (November 2022). "CMS Financial Report FY 2022". Centers for Medicare and Medicaid Services.
24. Kliff, Sarah. (23 Nov 2011). "Medicare administrator Donald Berwick resigns in the face of Republican opposition". [[The Washington Post]].
25. (2021-05-25). "Chiquita Brooks-LaSure becomes the first Black administrator confirmed to lead Medicare and Medicaid.". The New York Times.
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31. "Office of Program Operations and Local Engagement".
32. "Office of Program Operations and Local Engagement".
33. "Region 8 – Denver".
34. "Office of Program Operations and Local Engagement".
35. "Office of Program Operations and Local Engagement".
36. Young, Jeffrey. (September 7, 2007). "Weems may hold CMS top post through 2008 without confirmation". [[The Hill (newspaper).
37. (July 7, 2010). "Donald Berwick, M.D., Sworn in as CMS Administrator". American Society of Anesthesiologists.
38. "Andy Slavitt Bio". America’s Physician Groups.
39. (March 13, 2017). "Trump pick Seema Verma sworn in to head Medicare and Medicaid". [[PBS]].
40. Spanko, Alex. (January 20, 2021). "Richter to Lead CMS on Acting Basis Under New Biden Administration". Skilled Nursing News.
41. King, Robert. (May 27, 2021). "Obama admin veteran Brooks-LaSure sworn in as new CMS administrator". Fierce Healthcare.
42. (January 22, 2025). "Administrator {{!}} CMS".
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45. (May 5, 2025). "Dr. Mehmet Oz Sworn in as CMS Administrator". [[American Association of Colleges of Osteopathic Medicine]].