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Q: Healthcare ( Answered,   0 Comments )
Question  
Subject: Healthcare
Category: Reference, Education and News > General Reference
Asked by: tinkertoy-ga
List Price: $50.00
Posted: 20 Jul 2006 06:04 PDT
Expires: 19 Aug 2006 06:04 PDT
Question ID: 747980
What are the different regulatory agencies involved in and influencing
Medicare A, B, C, and prescription drugs? Please provide references. I
would like this information ASAP.
Answer  
Subject: Re: Healthcare
Answered By: pafalafa-ga on 20 Jul 2006 10:52 PDT
 
tinkertoy-ga,


Hello, and thanks for bringing your question to Google Answers.

Since you need the information ASAP, I have prepared a quick overview
of the government agencies involved in both Medicare and prescriptions
drugs.

If you find you need any additional information, just post a Request
for Clarification to let me know, and I'll be happy to continue
working on this for you.

All the best,

pafalafa-ga


====================

Medicare is run by a federal government organization, the Centers for
Medicare and Medicaid Services, which is housed in the Department of
Health of Human Services.  The Social Security Administration also has
a large role in administering the Medicaid program.

Here are some links to the key government organizations involved:



http://www.cms.hhs.gov/
Centers for Medicare & Medicaid Services
Department of Health & Human Services



http://www.cms.hhs.gov/History/

...The Medicare and Medicaid programs were signed into law on July 30,
1965. President LBJ is pictured at the signing ceremony in
Independence, Missouri at the Truman Library. Former President Truman
is seated beside him. LBJ held the ceremony there to honor President
Truman's leadership on health insurance, which he first proposed in
1945. You can read LBJ's speech at the signing ceremony and listen to
his taped conversations relating to CMS programs. Key speeches and
press conference excerpts from other President's are also available.
See the links in the Downloads section below.

...The most significant legislative change to Medicare‚??called the
Medicare Modernization Act or MMA‚??was signed into law by another
President from Texas, George W. Bush, on December 8, 2003. This
historic legislation adds an outpatient prescription drug benefit to
Medicare and makes many other important changes. You can read his
speech at the signing ceremony and see pictures of the event at the
White House web site.



http://www.cms.hhs.gov/History/downloads/CMSProgramKeyMilestones.pdf
Key Milestones in CMS Programs
...Below are some of the key legislative milestones that have shaped
our programs?Medicare, Medicaid, CLIA, HIPAA and SCHIP



http://www.cms.hhs.gov/MedicareGenInfo/
Medicare Program - General Information

Medicare is a health insurance program for:

--people age 65 or older,
--people under age 65 with certain disabilities, and
--people of all ages with End-Stage Renal Disease (permanent kidney
failure requiring dialysis or a kidney transplant).




The site below is a government-run portal for the general public to
access information on their Medicare benefits:
 

http://www.medicare.gov/
Welcome to My.Medicare.gov  

...Welcome to Medicare's free, secure online service for accessing
your Medicare information.



Information on prescription drug coverage under Medicare can be found here:

http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/
Prescription Drug Coverage - General Information


and state-government agencies and contacts that assist in
administering the program can be found here;


http://www.medicare.gov/Contacts/Include/DataSection/Questions/SearchCriteria.asp?version=default&browser=IE%7C6%7CWinXP&language=English&defaultstatus=0&pagelist=Home
Welcome to Helpful Contacts 
...This tool will provide you with contact information for specific
organizations or help you get answers to your Medicare related
questions.



The Social Security Administration also has a large role in the
overall Medicare program:


http://www.ssa.gov/pubs/10043.html
Medicare 
SSA Publication No. 05-10043, January 2006

...The Centers for Medicare & Medicaid Services is the agency in
charge of the Medicare program. But you apply for Medicare at Social
Security, and we can give you general information about the Medicare
program.

Medicare has four parts

...Hospital insurance (Part A) that helps pay for inpatient care in a
hospital or skilled nursing facility (following a hospital stay), some
home health care and hospice care.

...Medical insurance (Part B) that helps pay for doctors? services and
many other medical services and supplies that are not covered by
hospital insurance.

...Medicare Advantage (Part C) formerly known as Medicare + Choice
plans are available in many areas. People with Medicare Parts A and B
can choose to receive all of their health care services through one of
these provider organizations under Part C.

...Prescription drug coverage (Part D) that helps pay for medications
doctors prescribe for treatment.



A useful overall explanation of the Medicare program can be found here:


http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf
Medicare and You




MEDPAC is a governmental commission that advises on the Medicare program:


http://www.medpac.gov/
...The Medicare Payment Advisory Commission (MedPAC) is an independent
federal body established by the Balanced Budget Act of 1997 (P.L.
105-33) to advise the U.S. Congress on issues affecting the Medicare
program.



Finally, the Food and Drug Administration is the key federal agency
with oversight for the approval and safe distribution of prescription
drugs:


http://www.fda.gov/cder/index.html
FDA/Center for Drug Evaluation and Research



http://www.fda.gov/cder/about/history/default.htm
...The Center for Drug Evaluation and Research (CDER), which assures
that safe and effective drugs are available to the American people,
has gone through a functional and organizational metamorphosis since
it began as a one-man operation to assess significant drug problems in
the  marketplace on the eve of the 1906 Pure Food and Drugs Act...



The National Institutes of Health also plays a large role in
researching and evaluating the effectiveness of medicines:


http://www.nih.gov/
National Institutes of Health 


in particular, the NIH role in clinical trials of drugs is a key function:


http://clinicaltrials.gov/
...ClinicalTrials.gov provides regularly updated information about
federally and privately supported clinical research in human
volunteers. ClinicalTrials.gov gives you information about a trial's
purpose, who may participate, locations, and phone numbers for more
details.



====================


I trust that's the information you were seeking, but again, if there's
anything more you need, just let me know.


paf


search strategy -- Google search on [ medicare OR "prescription drugs" site:gov ]

Request for Answer Clarification by tinkertoy-ga on 21 Jul 2006 08:50 PDT
I am sorry for not getting back sooner. Hectic day yesterday.

I did come up with the same regulatory agencies that you found. For
some reason, I thought there might be others such as Health Care
Financing Administration (HCFA), HMO Medicare may fall under a state's
Department of Insurance, and what about Joint Commission on
Accreditation of Healthcare?

I just may be over thinking, but I think there may be more than what
you provided. I do need this information by Saturday 07/22/06 12:00 pm
noon at the latest.

Thanks,

Tinkertoy

Clarification of Answer by pafalafa-ga on 21 Jul 2006 18:42 PDT
tinkertoy-ga,

Thanks for getting back to me.

Sure...there are plenty of other agencies that get into the Medicare
policy mix...I didn't really know what your baseline was in terms of
the information you had already, and I wanted to get you a fast reply,
as you requested.

But with a bit more time, now, I'm able to provide the following additional links:




http://www.aoa.gov/smp/
The Administration on Aging 
...The Administration on Aging (AoA) is dedicated to promoting
consumer awareness, preventing elder victimization, and working to
implement community partnerships to prevent Medicare and Medicaid
fraud, error, and abuse



[NCI generates much of the medical statistical data used in many of
the policy studies for Medicare]
http://healthservices.cancer.gov/seermedicare/aboutdata/
National Cancer Institute
...The current SEER-Medicare linkage includes all Medicare eligible
persons appearing in the SEER data through 2002 and their Medicare
claims through 2003



[GAO holds all government program's feet to the fire, so to speak]
http://www.gao.gov/new.items/d06278r.pdf
United States Government Accountability Office
...Medicare: Contingency Plans to Address Potential Problems with the
Transition of Dual-Eligible Beneficiaries from Medicaid to Medicare
Drug Coverage



[Similarly, CBO does a lot of investigative work that contributes to policy]
http://www.cbo.gov/showdoc.cfm?index=6332&sequence=0
Congressional Budget Office 
...High-Cost Medicare Beneficiaries



[The IRS collects the taxes that fund Medicare, and has a role to play as well] 
http://www.irs.gov/businesses/small/international/article/0,,id=129427,00.html
The Internal Revenue Service 
...Liability for Social Security and Medicare Taxes



[AHRQ is involved in all aspects of national healthcare policy]
http://www.ahrq.gov/clinic/epcsums/telemedsum.htm
Agency for Healthcare Research and Quality 
....Telemedicine for the Medicare Population



[Treasury heads up the rapidly-going-broke Medicare fund]
http://www.treasury.gov/offices/economic-policy/social_security.shtml
Treasury
...The Secretary of Treasury is the Chairman of the Boards of Trustees
of the Social Security and Medicare trust funds....Each year the
trustees provide Congress with a detailed accounting of the current
and projected financial status of the Social Security and Medicare
trust funds. Two reports are issued, one for Social Security and one
for Medicare.


[DOJ goes after Medicare fraud]
http://www.usdoj.gov/usao/eousa/foia_reading_room/usam/title4/civ00085.htm
Department of Justice
...Medicare Overpayment Cases


[The Joint Commission that you mentioned is not a government agency,
but it certainly gets involved in policy issues]
http://www.jointcommission.org/AccreditationPrograms/LongTermCare/AccreditationOptions/faqs.htm
Joint Commission on Accreditation of Healthcare Organizations 
Medicare/Medicaid Certification Based Long Term Care Accreditation
Option Frequently Asked Questions



[You asked about the HCFA, which, as you can see, has been
bureaucratically transmogrified into the CMS, which I linked to in my
original answer]
http://www.cms.hhs.gov/apps/acronyms/results.asp?Acronym=hcfa
...HCFA  Health Care Financing Administration (renamed CMS effective July 1, 2001) 


===============


The states are heavily involved in Medicare as well, of course, but
largely from an administrative perspective.  Here are a few examples:


Wisconsin
dhfs.wisconsin.gov/Medicaid1/recpubs/part_d/partd.htm 
Medicare Part D Information


Ohio
www.ohioinsurance.gov/ConsumServ/Ocs/CompleteGuides/CompleteMedSup.pdf 
Medicare Supplement Insurance, Medicare Options & New Part D


Missouri
insurance.mo.gov/consumer/senior/medsupp/index.htm
Medicare Supplement Insurance


Kentucky
chfs.ky.gov/dhss/das/prescriptiondrugs.htm
Kentucky: Cabinet for Health and Family Services - Prescription ...



Hope that's everything you need, but as always, if there's more I can
do for you, just give me a holler.


paf
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