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Centers for Medicare & Medicaid Services (CMS)

Self Description

August 2004: "The Centers for Medicare & Medicaid Services (CMS) is a Federal agency within the U.S. Department of Health and Human Services. Programs for which CMS is responsible include Medicare, Medicaid, State Children's Health Insurance Program (SCHIP), HIPAA, and CLIA."

Third-Party Descriptions

September 2014: "The distinction between inpatient and outpatient status matters: Seniors must have three consecutive days as admitted patients to qualify for Medicare coverage for follow-up nursing home care, and observation time doesn’t count for that three-day tally. That leaves some observation patients with a tough choice: Pay the nursing home bill themselves – often tens of thousands of dollars – or go home without the care their doctor prescribed and recover as best they can."

March 2014: "For years, efforts to curb fast­rising Medicaid costs centered on welfare mothers and children, even though Medicaid spends more than five times as much on an aged or severely disabled person in long­term care as it does on a poor child."

August 2012: 'To some, HCA successfully pushed the envelope in its interpretation of existing Medicare rules. “If HCA can do it, why can’t we?” asked a hospital consulting firm, the Advisory Board Company, in a presentation to its clients.'

March 2010: 'START WITH THE DATA Every year the Centers for Medicare and Medicaid Services collect data on more than 15,000 nursing homes throughout the country. Health inspection data, staffing and quality measures are combined to come up with an overall ranking of one to five stars. To look up nursing homes in your area, go to and click on the “nursing home compare” tool.'

September 2009: "Despite that heavy investment, federal law limits Medicare reimbursement for the immunosuppressant drugs that transplant recipients must take for life, at costs of $1,000 to $3,000 a month."

June 2009: "It is natural to be skeptical. The largest existing public health programs — Medicare and Medicaid — are the main reason that the government’s long-term finances are in shambles. True, Medicare’s administrative costs are low, but it is easy to keep those costs contained when a system merely writes checks without expending the resources to control wasteful medical spending."

May 2009: "...Medicare has decided not to pay for genetic tests intended to help doctors determine the best dose of the blood thinner warfarin for a particular patient....the Centers for Medicare and Medicaid Services said that there was not enough evidence that use of the tests improved patients’ health."

June 2009: "Proposal 1: Lower the annual rate of pay increases for Medicare"

December 2008: "Medicare is pressing for quality improvements, using as leverage the $155 billion it spends on hospital care annually. But Herb Kuhn, deputy administrator of the Centers for Medicare and Medicaid Services, said hospitals would not make patient safety their top priority until Medicare changed its reimbursement system."

November 2008: "Since Medicaid is an entitlement, not a program everyone pays into like Social Security or Medicare, the Federal government defines eligibility. And Federal law prohibits state Medicaid programs from looking at the finances of anyone other than the applicant or the applicant’s spouse. When the elderly exhaust their assets, individually or as a couple, the government steps in and pays for their long-term care. Adult children are not part of the Medicaid eligibility equation."

November 2008: "Two decades have now passed, and not one of those solutions (which I call smiley-faced) has made much difference. The Medicare program cost $429 billion in 2007 and, with a 7 percent annual cost increase, will rise to $884 billion in 2017. At that point, the Trustees of the program have told us, it will in effect be bankrupt."

August 2008: "Medicare’s top officials said in 2006 that they had reduced the number of fraudulent and improper claims paid by the agency, keeping billions of dollars out of the hands of people trying to game the system."

May 2008: "Government officials have been complaining for two decades that the medical-device lobby has managed to keep reimbursements for that service too high. Last year, the Democratic-controlled House passed a bill that would have slashed oxygen payments, but the Senate did not act. Kerry Weems, acting administrator of the Centers for Medicare and Medicaid Services, said Congress could lower payments sharply and still provide profit to the companies and full service to patients."

December 2007: 'The Bush administration, responding to earlier reports of [private Medicare health plan] deceptive marketing, has tried to crack down on such practices. "There are substantially fewer violations, and those violations are of substantially lower severity than in previous marketing periods,” said Kerry N. Weems, the acting administrator of the Centers for Medicare and Medicaid Services."'

November 2007: "Herb B. Kuhn, the deputy director of the Center for Medicare and Medicaid Services, said that finding was attracting attention at the center, which is eager to keep the hospice care benefit from morphing into a long-term care entitlement. “Well over nine out of 10 hospices seem to be managing well, including the ones in higher-wage areas, so it does raise an issue of management,” Mr. Kuhn said. Mr. Kuhn said it remained a question whether hospice care saved money, but called it “a wonderful benefit” that “probably needs refinement” after nearly 25 years."

October 2007: An additional 22,110 poor children had not received dental care in at least two years, according to a review of dental records requested from United Healthcare, a managed-care organization serving Maryland Medicaid beneficiaries. The congressional subcommittee requested billing and service records from United as part of an investigation into gaps in Medicaid care for poor children.

October 2007: Tens of thousands of Medicare recipients have been victims of deceptive sales tactics and had claims improperly denied by private insurers that run the system’s huge new drug benefit program and offer other private insurance options encouraged by the Bush administration, a review of scores of federal audits has found.

October 2007: The New Jersey lawsuit, filed yesterday in U.S. District Court, contends that the federal Centers for Medicare and Medicaid Services (CMS) violated the law by not going through a formal rulemaking process when it announced the new regulations. That process would require CMS to publish a notice in the Federal Register and provide the public an opportunity to comment.

July 2007: The site,, now rates the level of cardiac care provided by more than 4,000 hospitals nationwide based on mortality statistics, the first time the federal Centers for Medicare & Medicaid Services (CMS) has posted hospital information based on outcomes.

April 2007: “Some of these homes repeatedly harmed residents over a six-year period and yet remain in the Medicare and Medicaid programs,” said the report, to be issued next week by the Government Accountability Office, an investigative arm of Congress.

January 2007: Leavitt and other Republicans countered that the year-old program is working, with the Centers for Medicare and Medicaid Services (CMS) reporting overall costs coming in billions of dollars lower than expected and average plan premiums being lower this year than in 2006. Moreover, polls conducted last fall by the Henry J. Kaiser Family Foundation and other nonpartisan groups found that the overwhelming majority of seniors were satisfied with their drug plans.

December 2006: States base their programs on a 1993 federal law mandating that they recover what Medicaid spends on a beneficiary's long-term care. Congress approved the law to prevent states from forcing the sale of beneficiaries' homes while they were still living, in case their conditions improve and they can return home, says Mary Kahn, spokeswoman for the Centers for Medicare and Medicaid Services.

November 2006: WASHINGTON, Nov. 2 — Under a new federal policy, children born in the United States to illegal immigrants with low incomes will no longer be automatically entitled to health insurance through Medicaid, Bush administration officials said Thursday.

May 2006: The Bush administration, which has argued strenuously for keeping both the deadline and the late fees, refused to respond yesterday to the Republicans' concern about the penalties. 'We've not been focused on it. We've really been focused on getting to May 15,' said Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services (CMS), who was stumping through New England yesterday encouraging older people to sign up. He said he planned to hit five more states before the end of the weekend.

July 2006: Among the groups exempted will be seniors and people with disabilities who have Medicare or SSI, as Supplemental Security Income is commonly called. Because they have provided documentation as required in those programs, the Centers for Medicare and Medicaid Services agreed that they should be excluded from a new citizenship rule.

June 2006: The U.S. Centers for Medicare and Medicaid Services has allowed 48 heart, liver and lung transplant centers to continue operating despite sometimes glaring and repeated lapses, the newspaper's review found. There are 236 approved centers nationwide.,1,4034696.story

February 2006: The mentally ill are nearly a third of the 'dual eligibles' who qualify for both Medicare and Medicaid because of income and disability or age. Mark B. McClellan, head of the Centers for Medicare and Medicaid Services, told a Senate committee hearing Thursday that a prime focus is resolving the 'remaining transition issues' for this extremely vulnerable population.

January 2006: Administration officials, already racing to fix other glitches in the new drug program, yesterday pointed the finger back at drugmakers, saying there are a variety of legal ways to assist low-income patients. If a drug company's patient assistance program ends, 'that's the manufacturer's decision,' said Mark McClellan, administrator of the Centers for Medicare and Medicaid Services. He said drugmakers could continue their patient assistance programs as long as they remain separate from Medicare or contribute money to charities that help poor patients.

January 2006: Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said on Saturday that he was working closely with states to address their concerns and to help individual patients. 'We are filling close to a million prescriptions a day, including hundreds of thousands for low-income beneficiaries,' Dr. McClellan said. 'Many, many people are getting the prescriptions they need.'

March 2005: Mr. Grassley, the chairman of the Finance Committee, which has authority over Medicaid, said: 'The drug program has been badly mismanaged. The Centers for Medicare and Medicaid Services, which administers the program, has been negligent. For 15 years, drug companies have been profiting from a system that costs taxpayers untold hundreds of millions, if not billions, of dollars annually.'

January 2005: So it was that in May the GAO said the Centers for Medicare Centers for Medicare & Medicaid Services Medicaid Services violated "publicity and propaganda" prohibitions by producing a "video news release" regarding changes to Medicare benefits. The video package, complete with lead-in scripts, did not identify CMS as the source, resembled a television news story and was used by some TV stations as if it were independently reported news.


RoleNameTypeLast Updated
Owner of (partial or full, past or present) Center for Consumer Information and Insurance Oversight (CCIIO) Organization Jul 9, 2012
Owned by (partial or full, past or present) Department of Health and Human Services (HHS) Organization Aug 5, 2004
Owned by (partial or full, past or present) US Federal Government - Independent Agencies Organization May 4, 2005
Organization Executive (past or present) Prof. Cindy Mann Esq. Person Jul 1, 2006
Organization Head/Leader (past or present) Dr. Mark B. McClellan Person Jan 8, 2006
Organization Head/Leader (past or present) Organization Executive (past or present) Leslie V. Norwalk Esq. Person Nov 6, 2006
Organization Head/Leader (past or present) Marilyn B. Tavenner Person Aug 15, 2012
Organization Head/Leader (past or present) Kerry Weems Person Jun 5, 2008

Articles and Resources

103 Articles and Resources. Go to:  [Beginning] [Previous 20]

Date Resource Read it at:
Feb 06, 2006 Stability of Mentally Ill Shaken By Medicare Drug Plan Problems: Some Prescription Denials Have Heightened Distress

QUOTE: Since the prescription program made its debut Jan. 1, some of the estimated 2 million mentally ill Americans covered because they receive both Medicare and Medicaid have gone without the drugs that keep their delusions, paranoia, anxieties or stress in check. Mental health service providers and advocacy organizations nationwide say they worry that scores are at high risk of relapse. Numerous people have been hospitalized.

Washington Post
Jan 27, 2006 Drugmakers to Cut Off Some Free Prescriptions: Seniors, Disabled Face Big Financial Crunch

QUOTE: Several of the nation's largest drug manufacturers say they will no longer provide free or discounted medications to low-income elderly and disabled patients because they should be covered by the new Medicare drug benefit.

Washington Post
Jan 08, 2006 States Intervene After Drug Plan Hits Early Snags

QUOTE: Low-income Medicare beneficiaries around the country were often overcharged, and some were turned away from pharmacies without getting their medications, in the first week of Medicare's new drug benefit. The problems have prompted emergency action by some states to protect their citizens.

New York Times
Jan 06, 2006 Medicare Officials' Attendance at Lavish Contractor Meetings Probed

QUOTE: Medicare officials responsible for overseeing $300 million awarded annually to private contractors regularly attended conferences sponsored by the groups at lavish beach and mountain resorts..."appeared to be more of a party than a diligent working meeting."

Washington Post
Nov 27, 2005 Insurers' Tactics in Marketing Drug Plan Draw Complaints

QUOTE: ...officials say they have received scores of complaints about the aggressive tactics used by some insurance companies and agents to market Medicare's new prescription drug benefit.

New York Times
Nov 23, 2005 New Drug Benefit Questioned: Democrats' Report Cites Lower Prices From VA and in Canada

QUOTE: ...average prices of 10 popular drugs being offered to Medicare recipients through 10 well-known insurance plans were 80 percent higher than prices negotiated for the government by Veterans Affairs.

Washington Post
Aug 13, 2005 Grassley Seeks Medicare Data On Response To Complaints: Overseers of Quality Control Criticized for Laxity, Secrecy

QUOTE: ...when complaints are reviewed... patients have less than a 1-in-4 chance of having them confirmed. Many of Medicare's decades-old rules governing QIO investigations are shrouded in secrecy and appear to favor physicians.

Washington Post
Jul 31, 2005 To disabled, wait for aid can be fatal

QUOTE: Goodlow is among millions of disabled adults who find themselves acutely vulnerable when their health fails. Ejected from the workforce, stripped of health benefits, snared in the bureaucracy of government programs, they are least able to get help at the time they most need it.

Chicago Tribune
Jul 25, 2005 Accreditors Blamed for Overlooking Problems: Conflict of Interest Cited Between Health Facilities, Group That Assesses Conditions

QUOTE: ...the joint commission's practices raise questions about potential conflicts of interest and the rigor of its hospital surveys... About 99 percent of the hospitals reviewed by the joint commission win accreditation, and in recent years it has missed glaring examples of poor care in which patients have been injured or killed...

Washington Post
Jul 24, 2005 Early Deals Set the Stage for Today's Problems

QUOTE: 'By law, Medicare was prohibited from explicitly considering cost when deciding whether to pay for a new treatment or machine, an edict that remains in place today. "Essentially, they were paying claims," Feder said. "They were simply turning over the keys to the Treasury to the providers."'

Washington Post
Jun 20, 2005 Rx For Fraud

QUOTE: The government is about to spend $720 billion over the next decade on medicines for old people... It won't be long before bad guys start helping themselves to the giant honeypot created by the new Medicare drug benefit...they're already busy going after the much smaller drug program...

May 07, 2005 Critics Fault Medicare Handbook: Draft Explanation of Drug Plan Sows Confusion, They Say

QUOTE: Though it was one of the most contentious elements of legislation creating the new benefit, the draft makes no attempt to inform retirees that in most cases coverage will stop once they have spent $3,600 of their own money and will not resume until those out-of-pocket costs reach $5,100.

Washington Post
Mar 08, 2005 Report Says Medicaid Overpays for Drugs

QUOTE: Federal health officials are not enforcing a law that requires drug companies to cut their prices on drugs bought for poor people under Medicaid...

New York Times
Jan 31, 2005 Law Cautions Against Outside PR Spending -- Sort Of: Rarely Applied Provision Has Been Interpreted in a Way That Condones Many Agency Public Relations Efforts

QUOTE: The outcry over the Education Department contract -- coming on the heels of the CMS flap and a similar violation involving prepackaged news reports at the Office of National Drug Control Policy -- has stoked interest in Congress for reviewing all federal agencies' PR efforts.

Washington Post
Sep 19, 2004 OMB Says Medicare Drug Law Could Cost Still More: White House Estimates Show a $42 Billion Increase Over 10 Years, but Administration Officials Dispute That

QUOTE: President Bush promised Congress that his Medicare prescription drug benefit would cost no more than $400 billion over 10 years...projections indicate that the cost could be considerably higher....once considered a political asset for Bush in his bid for reelection, the Medicare drug package has become a source of controversy...

Washington Post
Aug 20, 2004 Cover These Treatments

QUOTE: The recent announcement by Medicare that it will slash reimbursement for cancer drugs has caused dismay among physicians...This delay is detrimental to the survival and health of the roughly 1 million seniors whose cancers will be diagnosed in the interim.

Washington Post
Aug 18, 2004 Union Seeks a Rehearing After Administration Panel Rules Against It

QUOTE: ...AFGE contends that the panel failed to provide constitutional due process in the case because it did not hold a hearing, take testimony or subpoena any documents.

Washington Post
Aug 06, 2004 Penalties for Nursing Homes Show a Drop in Last 4 Years

QUOTE: ...statistics show a significant decline in the number of penalties imposed on nursing homes for violations of federal health and safety standards...federal officials and independent experts agree that many homes still have serious deficiencies in the quality of care.

New York Times
Jul 27, 2004 Checking Up on Hospitals: New Web Site Rates Facilities' Performance in Heart, Pregnancy, Pneumonia Care

QUOTE: The nation's largest health care accrediting organization has launched a Web site that lets consumers compare patient care at hospitals statewide and nationally.

Washington Post
Nov 25, 2001 Administration Revising Its Drug Discount Proposal

QUOTE: The lawsuit against the administration was filed by the National Association of Chain Drug Stores and the National Community Pharmacists Association. The organizations said their members would suffer financial harm because most of the discounts would be extracted from them. In addition, drugstores said they would lose Medicare customers if they did not cut prices to the levels specified in the federal program.

New York Times

103 Articles and Resources. Go to:  [Beginning] [Previous 20]