The U.S. government serves a protective purpose, and all laws are intended to safeguard the public from harm. Regulations are authorized specifically in legislation creating the law. Enforcement of the law and related regulations is accomplished by regulatory agencies. For this week’s assignment, you will research 2 federal agencies that play a prominent role in regulating different segments of the health care industry in our country.
A. The Centers for Medicare & Medicaid Services (CMS):
The Centers for Medicare & Medicaid Services (CMS) is the government agency responsible for administering the Medicare and Medicaid programs, as well as providing health insurance oversight to state governments and private insurers. CMS sets standards of care, including regulations that providers must meet in order to be eligible for reimbursement from these programs. Additionally, CMS works with states to establish rules related to licensing and certification of healthcare facilities and providers. It also enforces regulations related to fraud prevention in both public and private insurance plans.