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Overview:

The Centers for Medicare and Medicaid Services (CMS) is the federal body responsible for administering Medicare and Medicaid programs. CMS also runs the State Children’s Health Insurance Program (SCHIP), which is jointly financed by the Federal and State governments and administered by individual States.

 
more
History:

 

 

 

 

 

 

 

 

Medicare and Medicaid were enacted under the Social Security Act of 1965. Medicare was implemented the following year, extending health coverage to almost all Americans aged 65 or older - only about half of whom had insurance at the time. Medicaid provided health care for low-income children, the elderly, the blind and individuals with other disabilities.
 
In 1972, Medicare was extended to cover people under 65 with permanent disabilities, and Medicaid eligibility for elderly, blind and disabled residents under state care was linked to eligibility for the newly enacted Federal Supplemental Security Income program (SSI).
 
The following year, the HMO Act provided start-up grants and loans for private health maintenance organizations to cover many of the program services provided by the government, and gave them preferential treatment in the marketplace. And in 1982, the Tax Equity and Fiscal Responsibility Act further encouraged HMOs to contract with the Medicare programs.
 
Throughout the 1980s, CMS programs were expanded and improved upon, with Medicare supplemental insurance (Medigap), additional subsidization for hospitals serving low-income patients and for pregnant women and infants through Medicaid state initiatives.
 
The Medicare Catastrophic Coverage Act of 1988 (PDF) included the most significant changes since the enactment of Medicare, including improved hospital and skilled nursing facility benefits, mammography coverage, outpatient prescription drug benefits and limits on patient liability. The Act was repealed a year later in response to protests from higher-income elderly over new premiums, and charge-based payments were replaced with a new service fee schedule.
 
1996 Welfare reforms included the end of entitlement programs for families and children in need - replaced with a block grant for temporary assistance, and the severance of Medicaid from welfare. Also in 1996, the Health Insurance Portability and Accountability Act (HIPAA) (PDF) addressed federal rules regarding “portability” of coverage in various health insurance markets. It amended the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code of 1986. CMS implemented HIPAA provisions affecting small-group and individual markets, and began to competitively contract for program integrity work under the new Medicare Integrity program.
 
The Balanced Budget Act of 1997 created the State Children’s Heath Insurance Program (SCHIP), and made significant changes to Medicare - including expansion of private managed care at the state level, a slowed spending growth rate, new payment systems and expanded services.
 
And in 2003 the Medicare Prescription Drug, Improvement and Modernization Act (MMA) introduced the most significant changes in the history of the program, creating a stand-alone prescription drug option - and significantly enhancing the presence and authority of private providers.
 

Oral History Biographies

(PDF)


CMS Oral History Interviews

(PDF)

 

more
What it Does:

 

 

 

 

 

 

 

 

 
Enacted under Title XXI of the Social Security act, SCHIP is jointly financed by Federal and State governments. Individual states work within broad federal guidelines to determine program design, eligibility, benefits, payment levels - as well as administrative and operating procedures. $24 billion in federal matching funds was provided for FY 1998- FY 2007, and reportedly cover more than 5 million of the nation’s uninsured children.
 
Divisions
 
Regional Offices
 
CMS IT Links
 
Computer and Data Systems
 
Research
 
Statistics, Trends and Reports
 
Criticism
An AARP report raised issues with regard to the agency’s administrative functioning, including the following:
“Ambiguities with respect to the functions of CMS and its regional offices. Medicare is a national program with uniform benefits and eligibility rules, yet CMS's 10 regional offices and contractors have leeway in making decisions about coverage, contract management, and certification of facilities. Regional variations in the practice and delivery of health care mean that Medicare can vary for beneficiaries and providers. Some beneficiaries and providers complain that they often receive conflicting information from the national and regional offices.
 
“Questions remaining about the role of CMS itself. Some analysts question whether CMS should be an agency devoted solely to the management of Medicare or should also have other health policy and program responsibilities (e.g., Medicaid), as it does now.”

Administrative Challenges in Managing the Medicare Program

(by Michael E. Gluck, Ph.D., and Richard Sorian, AARP Public Policy Institute) (PDF)

 

more
Controversies:

 

 

 

 

 

 

 

 

Medicare Funding Cuts
 
Bush SCHIP Guidelines
In April 2008 the Government Accountability Office (GAO) challenged new guidelines handed down by the Bush Administration regarding the State Children’s Health Insurance Plan (SCHIP). In a letter issued directly to states, the new rules prohibit states from using federal funds to cover children in families 250% or more above the poverty line ($53,000 for a family of four) until 95% of children under 200% of poverty ($43,000) are covered. The GAO says the administration illegally bypassed Congress to issue the rules, which they claim constitute a policy change—but the Bush administration can ignore the watchdog’s opinion, and CMS has stated it intends to do just that. The conflict springs from a long-standing debate between an administration that wants to cut federal healthcare spending and push towards privatization, and a Democratic Congress seeking to increase spending in response to rising medical costs and diminishing benefits coverage.
 
 
GAO: CMS Funds Spent on “Questionable Contracts”
In 2007 the Government Accountability Office (GAO) reported that 9 percent (or about $90 million) of the $1 billion Congress appropriated to the agency during implementation of the 2003 Medicare Modernization Act was spent on “numerous questionable payments,” and raised questions regarding contractor oversight, wasteful contracting practices, contract terms, internal control deficiencies and backlogs.
 
DHHR Settlement
“The DHHR is being questioned by the CMS over the handling of a $10 million settlement between Attorney General Darrell McGraw and Purdue Pharma, the maker of prescription drug OxyContin. McGraw claimed the drug's addiction capabilities put a strain on the state's Medicaid budget, but never handed the money to the DHHR or Legislature, preventing the CMS from seizing its share of it.”
DHHR response coming in McGraw controversy (by John O'Brien, Legal Newsline)
 
CMS and HSAs: Crticism
 
Medicare Drug Plan Deadline Extension
 
Nuclear Medicine
Nuclear Medicine to Become a Stark Designated Health Service (By Robert G. Homchick and Edwin Rauzi, Davis Wright Tremaine)
 
CMS Chief Actuary Controversy
Medicare actuary details threats over estimates (by Emily Heil, CongressDaily)
 
2003 Legislation: Drug Price Negotiation

CMS Joins Those Saying Negotiating Drug Prices for Medicare Will Not Work: Cites weakness not allowing establishment of preferred list of drugs

(Senior Journal)

 

more
Suggested Reforms:

 

 

 

 

 

 

 

 

Medicare Contracting Reform: CMS’s Plan Has Gaps and Its Anticipated Savings Are Uncertain (GAO Report) (PDF)

 

more

Comments

Patricia Shulko 5 months ago
October 31st 2016 I discovered an error and reported it to the local SSA office here in Bradenton, FL. A simple error to start with - incorrect income reported from somewhere!!!!!! This could have been corrected the first of November if there were people who wanted to do their job and not have to go thru the red tape of the Government. I am being charged for the government's error on my MCR (Medicare). WHY????? Patricia Shulko, last digits from SS 3201, Bradenton, FL. I know no one in Government will respond to this, but someone should. It is 8 1/2 months without resolution.
Rhonda L Koenig 1 year ago
It is so vague as to whom is responsible for the operations and running of Medicare. It seems to be the poorest run operation we have ever dealt with- if other companies were run this badly they would surely be out of business very quickly. My husband called in January to get the process going for April. Along with phone calls and forms etc between January and March. Still on July 1st all is not finished! There seems to be so many "steps" and nobody who works at the SS office has a "full picture" so "the people" can complete everything in an orderly and timely fashion. So come on President of the US... get someone in charge who can manage this size of a project by putting people in charge who are competent, helpful and friendly.
James R Babcock 1 year ago
I was told by Medicare that you are the entity who decides what may be added to Medicare's approved list of medicines and medical supplies. I am very new to Medicare and I am a type 1 diabetic on an insulin pump and sensor. Medicare has approved the supplies for my insulin pump with the exception being the very important part: the sensor. The sensor is an integral part of my Medtronic MiniMed system and is essential for my best glucose control and health. Please, consider adding my sensor to the approved Medicare list of medical supplies. This would be the best ethical and financial choice for Medicare, for with the sensor my diabetes health issues are kept controlled and actually less money in the big picture will be spent on my health care. Pleas let me know the progress of this process. At present, I have 42 days of sensors on hand and will need some soon to continue my good diabetes control. If a letter from my endocrinologist would help you make this decision, let me know, and I'll arrange it. Thank you.
Chibi 4 years ago
I am very disappointed in our Congress the very pelope who's main concern is to protect their constituents have failed the American pelope by passing the heallth care bill without knowing what it actually contains. It is also irresponsible of them to lower medicare fees which are already to low ,it would nice however if the goverment would pay 21.3% of the Doctors overhead expenses.
Hollie White 5 years ago
I need to find somebody to help, my son has P.T.S.D. and A.D.H.D. I went to health and human services and he applied, and was denied. I have called the Idaho disability rights agency,no help. Even though I have evidence of a doctor violating my sons rights. As well as lieing to S.S.I. NAMI is of no help either. This is very serious and there is no help in Idaho for people with mental health issues.He even got turned away from a hospital( county ) for a injury he had. The ER doctor said we couldn't pay for it, so go! We are 6th in the united states for suicide and last for any help. I am on disability and I have been treated so badly at the hospital we have pictures of the soiled sheet I had to lay in. This isn't all. Please call me at 208-713-4905 anytime. Thank you Hollie White
Without Respite in Arizona 6 years ago
i am the parent of a child with developmental disabilities in the state of arizona. we the parents are being told that the fate of our children rests in the hands of cms. the state is proposing a 15% reduction in respite services for individuals with developmental disabilities or a total of 600 hours per year. i ask that you consider how you would use only 600 hours per year, 600 hours per year. this is the time you would be allowed per year to spend with your friends, run errands, ...
Edna Parola 6 years ago
to whom it may concern hello, i would like to have the curent operating rules on msa scheduling fees please. i am not aware if the msa is base on pravite pay rates(original charges from physicians) and not medicare schedule fees. please email to me any document that states that the calculation needs to be based on private pay rate. thank you ms. parola

Leave a comment

Founded: 1965
Annual Budget: $3.2 billion
Employees:
Official Website: http://www.cms.hhs.gov/
Centers for Medicare & Medicaid Services (CMS)
Slavitt, Andrew
Acting Head

Andrew Slavitt, who worked in the healthcare industry for much of his career, was named in February 2015 as the acting head of the Centers for Medicare & Medicaid Services (CMS). On July 9 of that year, President Barack Obama nominated Slavitt to be administrator of CMS.

 

Slavitt is from Evanston, Illinois, where his father Earl was an attorney. Slavitt graduated from Evanston High School in 1984 and followed in his father’s footsteps to the University of Pennsylvania. He graduated from Penn in 1988 with degrees from the College of Arts and Science and the Wharton School and went on to earn an MBA from Harvard.

 

Slavitt initially went into investment banking, working for Goldman Sachs. Beginning in 1993, he was an associate at management consulting firm McKinsey & Co. He left in 1995 to become chief operating officer of Paula Financial, an insurance underwriter.

 

Slavitt switched gears in his career as a result of a tragedy. A college roommate died of a brain tumor and his widow was left with substantial medical bills despite the family having health insurance. Slavitt founded HealthAllies, a health-care shopping company, getting health-care providers to offer their services to patients for the same prices they did to insurance companies. UnitedHealth Group acquired HealthAllies in 2004 by and Slavitt began climbing the ladder there. In 2005 he moved over to Ingenix, now OptumInsight, the UnitedHealth division that provides IT services to the health-care industry, and became its CEO in 2006. In 2011 he became group executive vice president for Optum. He took time out to help fix Healthcare.gov after its shaky rollout. (He personally tried to create an account during the rollout, but it didn’t work for him—he never got a confirmation email.)

 

Slavitt joined CMS in 2014 as Principal Deputy Administrator, having to get an “ethics waiver” from the Obama administration policy of industry executives not working for government. As he awaits confirmation, Slavitt has taken criticism from some in Congress, particularly Sen. Orrin Hatch (R-Utah) for conflicts of interest that his appointment would create. The liberal group Public Citizen also has questioned the appropriateness of the nomination.

 

Slavitt was based in Minnesota before his government appointment and still lives there, going home on weekends when he can. He and his wife, Lana, have two sons, Caleb and Zachary. Slavitt also serves as a director of the Special Olympics.

-Steve Straehley

more
Tavenner, Marilyn
Previous Acting Administrator

President Barack Obama has turned to a former health care executive to serve as the next Director of the Centers for Medicare and Medicaid Services (CMS) the federal body responsible for administering the Medicare and Medicaid programs, as well as the State Children’s Health Insurance Program (SCHIP). The previous director, Donald Berwick, had to resign because of stiff opposition from Senate Republicans, who never allowed his nomination to come to a vote. The new Director, Marilyn Tavenner, is a nurse who worked her way through the health care ranks.

 
Born May 31, 1951, in Martinsville, Virginia, Tavenner studied Nursing at Roanoke Memorial Hospital, and earned both her B.S. in Nursing (1972) and a Masters in Health Administration (1989) from Virginia Commonwealth University. She started her career in 1972 as a staff nurse, joining the for-profit Hospital Corporation of America (HCA) in 1981 as a Nursing Supervisor at Johnston-Willis Hospital (later renamed Chippenham Johnston-Willis Hospital) in Richmond, Virginia. After serving in a number of supervisory positions, Tavenner was named CEO of the hospital in April 1993. From February 1996 to January 2001, she was President of HCA’s Richmond Division. She was made President of HCA’s Central Atlantic Division in February 2001, with operational responsibility for the division’s 18 hospitals in Virginia, West Virginia and New Hampshire. In January 2004, Tavenner was promoted to President of HCA’s Outpatient Services Group, where she was responsible for freestanding outpatient facilities, including ambulatory surgery and diagnostic centers.
 
Tavenner left the private sector for public service in January 2006, when Virginia Governor Tim Kaine appointed her Secretary of Health and Human Resources. In that position, she oversaw 12 agencies, employing more than 18,000 people, including the Departments of Health, Mental Health, Social Services, Health Professions and Medical Assistance Services. She left Virginia government for federal service in February 2010, when she was appointed Principal Deputy Administrator of CMS.
 
Tavenner has served on the Boards of several organizations, including the American Hospital Association, Meals on Wheels Association of America, United Way, The Greater Richmond Partnership, which attracts business to the city and its surrounding counties, and the YMCA. She also served as president of both the Virginia Hospital Association and the Chesterfield Business Council.
Tavenner is married to Robert Tavenner, who is a Virginia State Police Captain. They have three children.
 
Tavenner has contributed more than $27,000 to political campaigns and causes since 1998, much of it to health care-related political action committees (PACs), including $9,500 to the Federation of American Hospitals between 1998 and 2005, $2,000 to the American Hospital Association in 2004, and $1,000 to the HCA Healthcare PAC in 1998 and 1999. She also contributed $2,025 to Rep. Eric Cantor (R-Virginia) in the 2003-2004 election cycle, $1,000 to George W. Bush in 2003, and $1,000 to the Republican-affiliated Committee for the Preservation of Capitalism in 2005. As she left the private sector, however, Tavenner shifted her contributions from industry-owned PACs to Democratic Party candidates and causes. Thus, in 2006 she contributed $500 to the Democratic Party of Virginia and $1,000 to the Democratic-leaning Forward Together PAC. She also contributed $6,000 to the Democratic Party of Virginia in 2007 and 2008, $1,000 to Rep. Jim Moran (D-Virginia) in 2007, $1,750 to Senator Mark Warner (D-Virginia) in 2007 and 2008, $250 to Barack Obama in 2011, and $250 to former Governor Tim Kaine, who is running for the Senate from Virginia in 2012.
 
Who is New CMS Administrator Marilyn Tavenner? (by Karen M. Cheung, Fierce HealthCare)
Tavenner To Replace Berwick As Medicare Chief (by Mary Agnes Carey and Phil Galewitz, NPR)
more
Bookmark and Share
Overview:

The Centers for Medicare and Medicaid Services (CMS) is the federal body responsible for administering Medicare and Medicaid programs. CMS also runs the State Children’s Health Insurance Program (SCHIP), which is jointly financed by the Federal and State governments and administered by individual States.

 
more
History:

 

 

 

 

 

 

 

 

Medicare and Medicaid were enacted under the Social Security Act of 1965. Medicare was implemented the following year, extending health coverage to almost all Americans aged 65 or older - only about half of whom had insurance at the time. Medicaid provided health care for low-income children, the elderly, the blind and individuals with other disabilities.
 
In 1972, Medicare was extended to cover people under 65 with permanent disabilities, and Medicaid eligibility for elderly, blind and disabled residents under state care was linked to eligibility for the newly enacted Federal Supplemental Security Income program (SSI).
 
The following year, the HMO Act provided start-up grants and loans for private health maintenance organizations to cover many of the program services provided by the government, and gave them preferential treatment in the marketplace. And in 1982, the Tax Equity and Fiscal Responsibility Act further encouraged HMOs to contract with the Medicare programs.
 
Throughout the 1980s, CMS programs were expanded and improved upon, with Medicare supplemental insurance (Medigap), additional subsidization for hospitals serving low-income patients and for pregnant women and infants through Medicaid state initiatives.
 
The Medicare Catastrophic Coverage Act of 1988 (PDF) included the most significant changes since the enactment of Medicare, including improved hospital and skilled nursing facility benefits, mammography coverage, outpatient prescription drug benefits and limits on patient liability. The Act was repealed a year later in response to protests from higher-income elderly over new premiums, and charge-based payments were replaced with a new service fee schedule.
 
1996 Welfare reforms included the end of entitlement programs for families and children in need - replaced with a block grant for temporary assistance, and the severance of Medicaid from welfare. Also in 1996, the Health Insurance Portability and Accountability Act (HIPAA) (PDF) addressed federal rules regarding “portability” of coverage in various health insurance markets. It amended the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code of 1986. CMS implemented HIPAA provisions affecting small-group and individual markets, and began to competitively contract for program integrity work under the new Medicare Integrity program.
 
The Balanced Budget Act of 1997 created the State Children’s Heath Insurance Program (SCHIP), and made significant changes to Medicare - including expansion of private managed care at the state level, a slowed spending growth rate, new payment systems and expanded services.
 
And in 2003 the Medicare Prescription Drug, Improvement and Modernization Act (MMA) introduced the most significant changes in the history of the program, creating a stand-alone prescription drug option - and significantly enhancing the presence and authority of private providers.
 

Oral History Biographies

(PDF)


CMS Oral History Interviews

(PDF)

 

more
What it Does:

 

 

 

 

 

 

 

 

 
Enacted under Title XXI of the Social Security act, SCHIP is jointly financed by Federal and State governments. Individual states work within broad federal guidelines to determine program design, eligibility, benefits, payment levels - as well as administrative and operating procedures. $24 billion in federal matching funds was provided for FY 1998- FY 2007, and reportedly cover more than 5 million of the nation’s uninsured children.
 
Divisions
 
Regional Offices
 
CMS IT Links
 
Computer and Data Systems
 
Research
 
Statistics, Trends and Reports
 
Criticism
An AARP report raised issues with regard to the agency’s administrative functioning, including the following:
“Ambiguities with respect to the functions of CMS and its regional offices. Medicare is a national program with uniform benefits and eligibility rules, yet CMS's 10 regional offices and contractors have leeway in making decisions about coverage, contract management, and certification of facilities. Regional variations in the practice and delivery of health care mean that Medicare can vary for beneficiaries and providers. Some beneficiaries and providers complain that they often receive conflicting information from the national and regional offices.
 
“Questions remaining about the role of CMS itself. Some analysts question whether CMS should be an agency devoted solely to the management of Medicare or should also have other health policy and program responsibilities (e.g., Medicaid), as it does now.”

Administrative Challenges in Managing the Medicare Program

(by Michael E. Gluck, Ph.D., and Richard Sorian, AARP Public Policy Institute) (PDF)

 

more
Controversies:

 

 

 

 

 

 

 

 

Medicare Funding Cuts
 
Bush SCHIP Guidelines
In April 2008 the Government Accountability Office (GAO) challenged new guidelines handed down by the Bush Administration regarding the State Children’s Health Insurance Plan (SCHIP). In a letter issued directly to states, the new rules prohibit states from using federal funds to cover children in families 250% or more above the poverty line ($53,000 for a family of four) until 95% of children under 200% of poverty ($43,000) are covered. The GAO says the administration illegally bypassed Congress to issue the rules, which they claim constitute a policy change—but the Bush administration can ignore the watchdog’s opinion, and CMS has stated it intends to do just that. The conflict springs from a long-standing debate between an administration that wants to cut federal healthcare spending and push towards privatization, and a Democratic Congress seeking to increase spending in response to rising medical costs and diminishing benefits coverage.
 
 
GAO: CMS Funds Spent on “Questionable Contracts”
In 2007 the Government Accountability Office (GAO) reported that 9 percent (or about $90 million) of the $1 billion Congress appropriated to the agency during implementation of the 2003 Medicare Modernization Act was spent on “numerous questionable payments,” and raised questions regarding contractor oversight, wasteful contracting practices, contract terms, internal control deficiencies and backlogs.
 
DHHR Settlement
“The DHHR is being questioned by the CMS over the handling of a $10 million settlement between Attorney General Darrell McGraw and Purdue Pharma, the maker of prescription drug OxyContin. McGraw claimed the drug's addiction capabilities put a strain on the state's Medicaid budget, but never handed the money to the DHHR or Legislature, preventing the CMS from seizing its share of it.”
DHHR response coming in McGraw controversy (by John O'Brien, Legal Newsline)
 
CMS and HSAs: Crticism
 
Medicare Drug Plan Deadline Extension
 
Nuclear Medicine
Nuclear Medicine to Become a Stark Designated Health Service (By Robert G. Homchick and Edwin Rauzi, Davis Wright Tremaine)
 
CMS Chief Actuary Controversy
Medicare actuary details threats over estimates (by Emily Heil, CongressDaily)
 
2003 Legislation: Drug Price Negotiation

CMS Joins Those Saying Negotiating Drug Prices for Medicare Will Not Work: Cites weakness not allowing establishment of preferred list of drugs

(Senior Journal)

 

more
Suggested Reforms:

 

 

 

 

 

 

 

 

Medicare Contracting Reform: CMS’s Plan Has Gaps and Its Anticipated Savings Are Uncertain (GAO Report) (PDF)

 

more

Comments

Patricia Shulko 5 months ago
October 31st 2016 I discovered an error and reported it to the local SSA office here in Bradenton, FL. A simple error to start with - incorrect income reported from somewhere!!!!!! This could have been corrected the first of November if there were people who wanted to do their job and not have to go thru the red tape of the Government. I am being charged for the government's error on my MCR (Medicare). WHY????? Patricia Shulko, last digits from SS 3201, Bradenton, FL. I know no one in Government will respond to this, but someone should. It is 8 1/2 months without resolution.
Rhonda L Koenig 1 year ago
It is so vague as to whom is responsible for the operations and running of Medicare. It seems to be the poorest run operation we have ever dealt with- if other companies were run this badly they would surely be out of business very quickly. My husband called in January to get the process going for April. Along with phone calls and forms etc between January and March. Still on July 1st all is not finished! There seems to be so many "steps" and nobody who works at the SS office has a "full picture" so "the people" can complete everything in an orderly and timely fashion. So come on President of the US... get someone in charge who can manage this size of a project by putting people in charge who are competent, helpful and friendly.
James R Babcock 1 year ago
I was told by Medicare that you are the entity who decides what may be added to Medicare's approved list of medicines and medical supplies. I am very new to Medicare and I am a type 1 diabetic on an insulin pump and sensor. Medicare has approved the supplies for my insulin pump with the exception being the very important part: the sensor. The sensor is an integral part of my Medtronic MiniMed system and is essential for my best glucose control and health. Please, consider adding my sensor to the approved Medicare list of medical supplies. This would be the best ethical and financial choice for Medicare, for with the sensor my diabetes health issues are kept controlled and actually less money in the big picture will be spent on my health care. Pleas let me know the progress of this process. At present, I have 42 days of sensors on hand and will need some soon to continue my good diabetes control. If a letter from my endocrinologist would help you make this decision, let me know, and I'll arrange it. Thank you.
Chibi 4 years ago
I am very disappointed in our Congress the very pelope who's main concern is to protect their constituents have failed the American pelope by passing the heallth care bill without knowing what it actually contains. It is also irresponsible of them to lower medicare fees which are already to low ,it would nice however if the goverment would pay 21.3% of the Doctors overhead expenses.
Hollie White 5 years ago
I need to find somebody to help, my son has P.T.S.D. and A.D.H.D. I went to health and human services and he applied, and was denied. I have called the Idaho disability rights agency,no help. Even though I have evidence of a doctor violating my sons rights. As well as lieing to S.S.I. NAMI is of no help either. This is very serious and there is no help in Idaho for people with mental health issues.He even got turned away from a hospital( county ) for a injury he had. The ER doctor said we couldn't pay for it, so go! We are 6th in the united states for suicide and last for any help. I am on disability and I have been treated so badly at the hospital we have pictures of the soiled sheet I had to lay in. This isn't all. Please call me at 208-713-4905 anytime. Thank you Hollie White
Without Respite in Arizona 6 years ago
i am the parent of a child with developmental disabilities in the state of arizona. we the parents are being told that the fate of our children rests in the hands of cms. the state is proposing a 15% reduction in respite services for individuals with developmental disabilities or a total of 600 hours per year. i ask that you consider how you would use only 600 hours per year, 600 hours per year. this is the time you would be allowed per year to spend with your friends, run errands, ...
Edna Parola 6 years ago
to whom it may concern hello, i would like to have the curent operating rules on msa scheduling fees please. i am not aware if the msa is base on pravite pay rates(original charges from physicians) and not medicare schedule fees. please email to me any document that states that the calculation needs to be based on private pay rate. thank you ms. parola

Leave a comment

Founded: 1965
Annual Budget: $3.2 billion
Employees:
Official Website: http://www.cms.hhs.gov/
Centers for Medicare & Medicaid Services (CMS)
Slavitt, Andrew
Acting Head

Andrew Slavitt, who worked in the healthcare industry for much of his career, was named in February 2015 as the acting head of the Centers for Medicare & Medicaid Services (CMS). On July 9 of that year, President Barack Obama nominated Slavitt to be administrator of CMS.

 

Slavitt is from Evanston, Illinois, where his father Earl was an attorney. Slavitt graduated from Evanston High School in 1984 and followed in his father’s footsteps to the University of Pennsylvania. He graduated from Penn in 1988 with degrees from the College of Arts and Science and the Wharton School and went on to earn an MBA from Harvard.

 

Slavitt initially went into investment banking, working for Goldman Sachs. Beginning in 1993, he was an associate at management consulting firm McKinsey & Co. He left in 1995 to become chief operating officer of Paula Financial, an insurance underwriter.

 

Slavitt switched gears in his career as a result of a tragedy. A college roommate died of a brain tumor and his widow was left with substantial medical bills despite the family having health insurance. Slavitt founded HealthAllies, a health-care shopping company, getting health-care providers to offer their services to patients for the same prices they did to insurance companies. UnitedHealth Group acquired HealthAllies in 2004 by and Slavitt began climbing the ladder there. In 2005 he moved over to Ingenix, now OptumInsight, the UnitedHealth division that provides IT services to the health-care industry, and became its CEO in 2006. In 2011 he became group executive vice president for Optum. He took time out to help fix Healthcare.gov after its shaky rollout. (He personally tried to create an account during the rollout, but it didn’t work for him—he never got a confirmation email.)

 

Slavitt joined CMS in 2014 as Principal Deputy Administrator, having to get an “ethics waiver” from the Obama administration policy of industry executives not working for government. As he awaits confirmation, Slavitt has taken criticism from some in Congress, particularly Sen. Orrin Hatch (R-Utah) for conflicts of interest that his appointment would create. The liberal group Public Citizen also has questioned the appropriateness of the nomination.

 

Slavitt was based in Minnesota before his government appointment and still lives there, going home on weekends when he can. He and his wife, Lana, have two sons, Caleb and Zachary. Slavitt also serves as a director of the Special Olympics.

-Steve Straehley

more
Tavenner, Marilyn
Previous Acting Administrator

President Barack Obama has turned to a former health care executive to serve as the next Director of the Centers for Medicare and Medicaid Services (CMS) the federal body responsible for administering the Medicare and Medicaid programs, as well as the State Children’s Health Insurance Program (SCHIP). The previous director, Donald Berwick, had to resign because of stiff opposition from Senate Republicans, who never allowed his nomination to come to a vote. The new Director, Marilyn Tavenner, is a nurse who worked her way through the health care ranks.

 
Born May 31, 1951, in Martinsville, Virginia, Tavenner studied Nursing at Roanoke Memorial Hospital, and earned both her B.S. in Nursing (1972) and a Masters in Health Administration (1989) from Virginia Commonwealth University. She started her career in 1972 as a staff nurse, joining the for-profit Hospital Corporation of America (HCA) in 1981 as a Nursing Supervisor at Johnston-Willis Hospital (later renamed Chippenham Johnston-Willis Hospital) in Richmond, Virginia. After serving in a number of supervisory positions, Tavenner was named CEO of the hospital in April 1993. From February 1996 to January 2001, she was President of HCA’s Richmond Division. She was made President of HCA’s Central Atlantic Division in February 2001, with operational responsibility for the division’s 18 hospitals in Virginia, West Virginia and New Hampshire. In January 2004, Tavenner was promoted to President of HCA’s Outpatient Services Group, where she was responsible for freestanding outpatient facilities, including ambulatory surgery and diagnostic centers.
 
Tavenner left the private sector for public service in January 2006, when Virginia Governor Tim Kaine appointed her Secretary of Health and Human Resources. In that position, she oversaw 12 agencies, employing more than 18,000 people, including the Departments of Health, Mental Health, Social Services, Health Professions and Medical Assistance Services. She left Virginia government for federal service in February 2010, when she was appointed Principal Deputy Administrator of CMS.
 
Tavenner has served on the Boards of several organizations, including the American Hospital Association, Meals on Wheels Association of America, United Way, The Greater Richmond Partnership, which attracts business to the city and its surrounding counties, and the YMCA. She also served as president of both the Virginia Hospital Association and the Chesterfield Business Council.
Tavenner is married to Robert Tavenner, who is a Virginia State Police Captain. They have three children.
 
Tavenner has contributed more than $27,000 to political campaigns and causes since 1998, much of it to health care-related political action committees (PACs), including $9,500 to the Federation of American Hospitals between 1998 and 2005, $2,000 to the American Hospital Association in 2004, and $1,000 to the HCA Healthcare PAC in 1998 and 1999. She also contributed $2,025 to Rep. Eric Cantor (R-Virginia) in the 2003-2004 election cycle, $1,000 to George W. Bush in 2003, and $1,000 to the Republican-affiliated Committee for the Preservation of Capitalism in 2005. As she left the private sector, however, Tavenner shifted her contributions from industry-owned PACs to Democratic Party candidates and causes. Thus, in 2006 she contributed $500 to the Democratic Party of Virginia and $1,000 to the Democratic-leaning Forward Together PAC. She also contributed $6,000 to the Democratic Party of Virginia in 2007 and 2008, $1,000 to Rep. Jim Moran (D-Virginia) in 2007, $1,750 to Senator Mark Warner (D-Virginia) in 2007 and 2008, $250 to Barack Obama in 2011, and $250 to former Governor Tim Kaine, who is running for the Senate from Virginia in 2012.
 
Who is New CMS Administrator Marilyn Tavenner? (by Karen M. Cheung, Fierce HealthCare)
Tavenner To Replace Berwick As Medicare Chief (by Mary Agnes Carey and Phil Galewitz, NPR)
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