Statement of Organization, Functions, and Delegations of Authority, 14176-14178 [2010-6429]

Agencies

• Centers for Medicare & Medicaid Services
• DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Federal Register Volume 75, Number 56 (Wednesday, March 24, 2010)]
[Notices]
[Pages 14176-14178]
From the Federal Register Online via the Government Printing 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