Who administers the Medicare program?

The Centers for Medicare and Medicaid Services (CMS) is the organization responsible for administering the Medicare program. CMS plays a crucial role in overseeing the day-to-day operations, policy development, and implementation of Medicare parts A, B, C, and D, which together provide health insurance to millions of Americans aged 65 and over, as well as certain younger individuals with disabilities.

CMS establishes regulations, oversees Medicare Advantage plans and prescription drug coverage, and ensures compliance with federal laws related to Medicare. This includes managing provider relationships and the management of Medicare claims process, as well as promoting effective healthcare delivery.

While the U.S. Department of Health and Human Services encompasses all federal health programs, including CMS, it does not administer Medicare directly. The Social Security Administration (SSA) is involved in processing Medicare applications and related functions, but it does not manage the program itself. The National Institute of Health (NIH) focuses on medical research and is not involved in Medicare administration. Understanding the distinct roles of these organizations is vital for anyone studying the healthcare system and Medicare.