CMS, Centers for Medicare & Medicaid Services , Say Hello

CMS, The Centers for Medicare & Medicaid Services oversees many federal healthcare programs, including those that involve health information technology such as the meaningful use incentive program for electronic health records (EHR).

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CMS: Reimbursement and regulatory functions

In addition to Medicare (the federal health insurance program for the elderly) and Medicaid (the federal needs-based program that helps with medical costs), CMS administers the Children’s Health Insurance Program (CHIP). In addition, they also administer the Health Insurance Portability and Accountability Act (HIPAA).  Key portions of the 2015 Medicare Access and CHIP Reauthorization Act (MACRA) law are also under their jurisdiction.

MACRA includes programs such as Merit-Based Incentive Payment System (MIPS) in which physicians and healthcare organizations are reimbursed based on their scores on healthcare quality and patient satisfaction. CMS also administers alternative payment models (APMs) for healthcare providers which are reimbursed based on positive medical outcomes.

Since passage of the Health Information Technology for Economic and Clinical Health Act in 2009, CMS  runs the meaningful use program. Indeed, $30 billion of incentive funds having been paid out to healthcare providers.

CMS also determines whether healthcare providers have successfully used health IT systems, and sets Medicare and Medicaid reimbursement rates for healthcare providers that use federally certified health IT systems.

 

CMS: ONC-affiliated agency

The Office of the National Coordinator for Health Information Technology (ONC), is responsible for approving certified health IT systems. In addition, they update health information privacy and security regulations under HIPAA.

Meaningful use has been credited for driving the widespread adoption of EHRs among hospitals and physicians. As of 2015, ONC reported that 96% of nonfederal acute care hospitals were using certified EHR systems. At the end of 2015, 56% of office-based physicians were using certified EHRs.

 

CMS History

After Medicare and Medicaid were established in 1965, the Social Security Administration administered federal health programs. In 1977, the former Health Care Financing Administration (HCFA) took over administration of Medicare and Medicaid. In 2001, HCFA became CMS.

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