[Federal Register Volume 75, Number 56 (Wednesday, March 24, 2010)]
[Notices]
[Pages 14176-14178]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-6429]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Statement of Organization, Functions, and Delegations of
Authority
Part F of the Statement of Organization, Functions, and Delegations
of Authority for the Department of Health and Human Services, Centers
for Medicare & Medicaid Services (CMS), (Federal Register, Vol. 72, No.
248, pp. 73847-73850, dated Friday, December 28, 2007) is amended to
reflect changes to the current structure of CMS.
In an effort to improve the value and service that CMS provides to
the Nation, the CMS has modified its structure to align similar
functions under common executive leadership and allow CMS to establish
a Center for Program Integrity and to strengthen its focus on
beneficiary services and strategic planning.
The structure includes the following, which all report to the
Administrator, CMS: (1) Center for Medicare, (2) Center for Medicaid,
CHIP and Survey & Certification, (3) Center for Strategic Planning, (4)
Center for Program Integrity, and (5) Office of External Affairs and
Beneficiary Services. In addition, the current role of the Chief
Operating Officer (COO) has been formalized and remains responsible for
operations, information systems, contracts, finance, E-health standards
and services, and the Consortia. The COO continues to report to the
Administrator, CMS. The following organizations remain substantively
unchanged and continue to report to the Administrator, CMS: Office of
Equal Opportunity and Civil Rights, Office of Legislation, Office of
the Actuary, Office of Clinical Standards and Quality, and the Office
of Strategic Operations and Regulatory Affairs (will be renamed the
Office of Executive Operations and Regulatory Affairs to more
accurately reflect the work of the organization). New administrative
codes were assigned to all organizations, including the immediate
office of the Administrator.
Given the complexity and importance of CMS' programs, this
realignment of existing functions positions CMS to consistently excel
in serving our beneficiaries and strategically positions CMS for the
future. Additionally, this effort ensures common core functions are
under common executive leadership and share a consistent vision.
The specific amendments to Part F are described below:
I. Under Part F, CMS, Office of the Administrator, FA.10
Organization is deleted in its entirety and replaced with the
following:
FC.10 Organization. CMS is headed by the Administrator, CMS, and
includes the following organizational components:
Office of the Administrator (FC)
Office of Equal Opportunity and Civil Rights (FCA)
[[Page 14177]]
Office of External Affairs and Beneficiary Services (FCB)
Office of Legislation (FCC)
Office of the Actuary (FCE)
Office of Executive Operations and Regulatory Affairs (FCF)
Office of Clinical Standards and Quality (FCG)
Center for Medicare (FCH)
Center for Medicaid, CHIP and Survey & Certification (FCJ)
Center for Strategic Planning (FCK)
Center for Program Integrity (FCL)
Chief Operating Officer (FCM)
II. Under Part F, CMS, Office of the Administrator, FA.20 Functions
is replaced with FC.20 Functions. The functions of the new
organizations read as follows:
Office of External Affairs and Beneficiary Services (FCB)
Serves as CMS' focal point for beneficiary communications
and services, provides leadership for CMS in the areas of
intergovernmental affairs, and media relations. Advises the
Administrator and other CMS components in all activities related to
these functions and on matters that affect other units and levels of
government.
Contributes to the formulation of policies, programs, and
systems as well as oversees beneficiary services, intergovernmental
affairs, media relations, and tribal affairs, including CMS' Ombudsman
program, call center operations, web sites, and Medicare contractor
communications. Coordinates with the Office of Legislation on the
development and advancement of new legislative initiatives and
improvements.
Oversees the analysis and evaluation of customer data for
the purpose of improving beneficiary communication tools (including but
not limited to brochures, program/media campaigns, handbooks, websites,
reports, presentations/briefings) and identifying best practices for
the benefit of beneficiaries and other CMS customers. Coordinates this
data with other CMS components to resolve customer and beneficiary
issues through continuous quality improvement.
Oversees all CMS interactions and collaboration with key
stakeholders relating to beneficiary communications and services, media
relations, and intergovernmental affairs (e.g., external advocacy
groups, Medicare beneficiary customer service, the media, contractors,
Native American and Alaskan Native tribes, HHS, the White House, other
CMS components, and other Federal government entities).
Formulates and implements a customer service plan that
serves as a roadmap for the effective treatment and advocacy of
customers and the quality of information provided to them.
Coordinates communications, messaging, media relations,
partner relations and Tribal Affairs outreach with the CMS Regional
Offices.
Serves as senior advisor to the Administrator in all
activities related to the media. Provides consultation, advice, and
training to CMS' senior staff with respect to relations with the news
media.
Serves as liaison between CMS and State and local
officials, and individuals representing State and local officials and
advocacy groups.
Serves as coordinator of tribal affairs issues and liaison
between CMS and State and local officials representing tribal affairs
groups.
Center for Medicare (FCH)
Serves as CMS' focal point for the formulation,
coordination, integration, implementation, and evaluation of national
Medicare program policies and operations.
Identifies and proposes modifications to Medicare programs
and policies to reflect changes or trends in the health care industry,
program objectives, and the needs of Medicare beneficiaries.
Coordinates with the Office of Legislation on the development and
advancement of new legislative initiatives and improvements.
Serves as CMS' lead for management, oversight, budget and
performance issues relating to Medicare Advantage and prescription drug
plans, Medicare fee-for-service providers and contractors.
Oversees all CMS interactions and collaboration with key
stakeholders relating to Medicare (e.g., plans, providers, other
government entities, advocacy groups, Consortia) and communication and
dissemination of policies, guidance and materials to same to understand
their perspectives and to drive best practices in the health care
industry.
Develops and implements a comprehensive strategic plan,
objectives and measures to carry out CMS' Medicare program mission and
goals and position the organization to meet future challenges with the
Medicare program and its beneficiaries.
Coordinates with the Center for Program Integrity on the
identification of program vulnerabilities and implementation of
strategies to eliminate fraud, waste, and abuse.
Center for Medicaid, CHIP and Survey & Certification (FCJ)
Serves as CMS' focal point for the formulation,
coordination, integration, implementation, and evaluation of all
national program policies and operations relating to Medicaid, CHIP,
Survey & Certification, and the Clinical Laboratory Improvement Act
(CLIA).
In partnership with States, evaluates the success of State
agencies in carrying out their responsibilities for effective State
program administration and beneficiary protection, and, as necessary,
assists States in correcting problems and improving the quality of
their operations.
Identifies and proposes modifications to Medicaid and CHIP
program measures, regulations, laws and policies to reflect changes or
trends in the health care industry, program objectives, and the needs
of Medicaid and CHIP beneficiaries. Collaborates with the Office of
Legislation on the development and advancement of new legislative
initiatives and improvements.
Oversees the planning, coordination and implementation of
the survey, certification and enforcement programs for all Medicare and
Medicaid providers and suppliers, and for laboratories under the
auspices of CLIA.
Serves as CMS' lead for management, oversight, budget and
performance issues relating to Medicaid, CHIP and Survey and
Certification, and the related interactions with the States.
Coordinates with the Center for Program Integrity on the
identification of program vulnerabilities and implementation of
strategies to eliminate fraud, waste, and abuse.
In conjunction with the Office of External Affairs,
oversees all CMS interactions and collaboration relating to Medicaid
and CHIP with beneficiaries, States and territories and key
stakeholders (i.e., health facilities and other health care providers,
other Federal government entities, local governments) and communication
and dissemination of policies, guidance and materials to same to
understand their perspectives, support their efforts, and to drive best
practices for beneficiaries, in States and throughout the health care
industry.
Develops and implements a comprehensive strategic plan,
objectives and measures to carry out CMS' Medicaid and CHIP mission and
goals and position the organization to meet future challenges with the
Medicaid, CHIP and Survey & Certification, and CLIA programs.
[[Page 14178]]
Center for Strategic Planning (FCK)
Serves as CMS' focal point for the planning, formulation
and coordination of long-term strategic plans, and future program
policy and proposals for CMS.
Collaborates with the Office of Legislation on the
development and advancement of new legislative initiatives and
improvements.
Conducts environmental scanning, identifying, evaluating
and reporting emerging trends in health care delivery and financing and
their interactions with CMS programs and implications for future policy
development and planning.
Oversees strategic, cross-cutting initiatives in
coordination with other CMS components and external stakeholders.
In collaboration with other CMS components, designs,
coordinates, conducts research, demonstrations, analyses and special
studies, and evaluates the results for impacts on beneficiaries,
providers, plans, health care programs and financing, States and other
partners, designing and assessing potential improvements, and
developing new measurement tools.
Oversees the development and dissemination of
publications, data analyses, graphics, and briefing materials related
to health care issues.
Center for Program Integrity (FCL)
Serves as CMS' focal point for all national and State-wide
Medicare and Medicaid programs and CHIP integrity fraud and abuse
issues.
Promotes the integrity of the Medicare and Medicaid
programs and CHIP through provider/contractor audits and policy
reviews, identification and monitoring of program vulnerabilities, and
providing support and assistance to States. Recommends modifications to
programs and operations as necessary and works with CMS Centers and
Offices to affect changes as appropriate. Collaborates with the Office
of Legislation on the development and advancement of new legislative
initiatives and improvements to deter, reduce, and eliminate fraud,
waste and abuse.
Oversees all CMS interactions and collaboration with key
stakeholders relating to program integrity (i.e., U.S. Department of
Justice, HHS Office of Inspector General, State law enforcement
agencies, other Federal entities, CMS components) for the purposes of
detecting, deterring, monitoring and combating fraud and abuse, as well
as taking action against those that commit or participate in fraudulent
or other unlawful activities.
In collaboration with other CMS Centers and Offices,
develops and implements a comprehensive strategic plan, objectives and
measures to carry out CMS' Medicare, Medicaid and CHIP program
integrity mission and goals, and ensure program vulnerabilities are
identified and resolved.
Chief Operating Officer (FCM)
Overall responsibility for facilitating the coordination,
integration and execution of CMS policies and activities across CMS
components, including new program initiatives.
Promotes accountability, communication, coordination, and
facilitation of cooperative corporate decision-making among CMS senior
leadership on management, operational and programmatic cross-cutting
issues.
Tracks and monitors CMS performance and intervenes, as
appropriate, to ensure key milestones/deliverables are successfully
achieved. Keeps the Administrator and Principal Deputy Administrator
advised of the status of significant national initiatives and programs
that affect beneficiaries and/or the health care industry and makes
recommendations regarding necessary corrective actions.
Provides executive leadership to CMS' Consortia
operations, including facilitating all required interaction and
coordination between Consortia and other CMS components.
Oversees all planning, implementation and evaluation of
administrative and operational activities for CMS, including
enterprise-wide information systems and services, acquisition and
grants, financial management, electronic health standards, facilities,
and human resources.
Delegations of Authority
All delegations and re-delegations of authority made to officials
and employees of affected organizational components will continue in
them or their successor organization pending further re-delegation,
provided they are consistent with this realignment.
(Authority: 44 U.S.C. 3101)
Dated: March 18, 2010.
Kathleen Sebelius,
Secretary.
[FR Doc. 2010-6429 Filed 3-23-10; 8:45 am]
BILLING CODE 4120-01-P