In healthcare, what does CMS oversee?

The Centers for Medicare & Medicaid Services (CMS) is a federal agency that plays a crucial role in overseeing the Medicare and Medicaid programs, which are essential components of the U.S. healthcare system. Medicare provides health coverage primarily to individuals aged 65 and older, as well as to certain younger people with disabilities. Medicaid, on the other hand, offers coverage to eligible low-income individuals and families.

CMS is responsible for establishing guidelines and regulations that govern how these programs operate, including the payment structures for healthcare providers, the eligibility criteria for beneficiaries, and the overall management of services provided under these programs. This oversight helps ensure compliance with federal laws and the maintenance of quality standards in health care delivery for millions of Americans.

The other choices involve different aspects of healthcare regulation that fall outside the primary responsibilities of CMS. State health regulations are managed by individual state governments, private insurance policies are overseen by state insurance departments, and clinical laboratory standards are regulated by a different set of laws and agencies, including the Clinical Laboratory Improvement Amendments (CLIA). Thus, while all options relate to healthcare in some way, the oversight of Medicare and Medicaid programs distinctly identifies the role of CMS.