Research Paper on "Centers for Medicare and Medicaid"

Research Paper 4 pages (1289 words) Sources: 4

[EXCERPT] . . . .

Centre for Medicare and Medicaid Services (CMS)

The CMS is a federal agency that falls within the United States Department f Health and Human Services (DHHS). It is charged with the administering Medicare and also works with the state governments in providing Medicaid. The Medicare includes involves the federal health insurance for the seniors while the Medicaid basically deals with the needs-based programs. The CMS is also charged with overseeing the Health Insurance Portability and Accountability Act otherwise known as (HIPAA) the Children's Health Insurance Program also known as (CHIP) as well as the Clinical Laboratory Improvement Amendments (CLIA) as the main areas of concentration among several other areas of commitments (Techtarget, 2011).

It is also worth noting that CMS has also been charged with the responsibility of advancing health IT which includes the implementation of the EHR or electronic health record program. It was also entrusted to come up with definition for the meaningful use of the HER technology asn well as the determining of the standards for the certification of the electronic health record technology and the security and privacy of the technology under the HIPAA.

CMS through its Medicare also caters for the insurance of the elderly people who are of the age 65 years and beyond and people with certain disabilities.

The CMS and the programs that it runs have proven to be quite expensive in the recent years and are projected to continue in the same trend over the next few years. Currently, the numbers of citizens who require medical care from the program get far much more form the program than they contribute through taxes. This is in sight of the baby-boomer generation that is now retiring in drives. An instance at hand is the case of a wage earner who paid his taxes from 1966 and retired in 1998 will have contributed on average $16, 800 yet the present value of future Part A benefits is estimated at $109,000 which outstrips by far the contribution that the individual made.

The main point of worry for the program has to do with the financial solvency that is occasioned by the baby Boomer generation maturation towards retirement age. According to financial analysts if the health insurance programs coordinated by CMS fail to change with the prevailing trend it is possible that they will end financial solvency hence seeing an end to Medicare and Medicaid. It is projected that the Medicare program could possibly consume more than half of the federal income tax by the year 2042, this will also drive up the real cost of drugs. The main reason behind the continued rise in the Medicare cost is the fact that the medical insurances has vastly expanded over the last 40 years as observed in Congressional Budget Office (2011). People will adopt the new technology freely with the thought that insurance will pay for it.

Despite the fact that CMS has widely succeeded in ensuring that the Medicare and Medicaid are implemented effectively in a manner that benefits Americans, it is faced with quite a number of challenges. One very significant concern was raised by AARP regarding the administrative functioning of the agency. There were some ambiguities noted between the CMS and it regional offices. Bearing that Medicare is a national program that issues uniform benefits, there should be uniform information issued throughout the system. There has been however cases of CMS's ten regional offices and the contractors making decisions about contract management, coverage and certification of facilities. This has led to some providers and beneficiaries complaining that they have severally received conflicting information from national and regional offices.

The other inefficiency of the CMS has to do with the areas that it leaves out in the health coverage yet very significant. It is worth noting that with both Part A and B. Of the policy of the CMS… READ MORE

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