Executive Agencies Implementation Responsibilities

Agencies such as the Department of Health and Human Services (DHHS) (www.dhhs.gov) and the Department of Justice (DOJ) (www.usdoj.gov) (as well as subdivisions of those departments) and a number of independent federal agencies such as the Environmental Protection Agency (EPA) (www.epa .gov), the Consumer Product Safety Commission (CPSC) (www.cpsc.gov), and the Food and Drug Administration (FDA) (fda.gov) bear direct responsibility for implementing laws enacted by the legislative branch. These and many other executive branch organizations exist to implement the laws formulated by the legislative branch.

The Centers for Medicare & Medicaid Services (CMS) (www.cms.gov) is a good example of an implementing organization. CMS is a federal agency located organizationally within DHHS, as shown in Figure 7.2. It was created in 1977 specifically to administer the Medicare and Medicaid programs and is the primary federal implementing agent for the public laws that established and now continue these programs. Figure 7.3 is an organization chart of CMS. The agency is organized around the following three centers to support its key functions:

1. The Center for Medicare Management focuses on management of the traditional fee-for-service Medicare program. This includes development of payment policy and management of the Medicare fee-for-service contractors.

2. The Center for Beneficiary Choices focuses on the management of the Medicare Advantage and Medicare Prescription Drug plans and the support and coordination of beneficiary services. This center also

Figure 7.2 Organization Chart of the Department of Health and Human Services

Figure 7.2 Organization Chart of the Department of Health and Human Services

Medicare Organizational Chart

Figure 7.3 Organization Chart of the Centers for Medicare & Medicaid Services

DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR MEDICARE & MEDICAID SERVICES

Figure 7.3 Organization Chart of the Centers for Medicare & Medicaid Services

DEPARTMENT OF HEALTH AND HUMAN SERVICES

CENTERS FOR MEDICARE & MEDICAID SERVICES

responds to the information and assistance needs of Medicare beneficiaries and their families, handles appeals, develops and publishes reference materials for beneficiaries, conducts consumer research, and ensures that CMS protects the privacy of individuals and the confidentiality of health records under the Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Act. 3. The Center for Medicaid and State Operations focuses on programs administered by states. This includes Medicaid, the State Children's Health Insurance Program (SCHIP), insurance regulation functions, survey and certification, and the Clinical Laboratory Improvements Act (CLIA).

CMS staff works in the organization's Baltimore headquarters and in ten regional offices nationwide. The regional offices provide a more decentralized presence, which can contribute to customer service and program oversight. Information about the mission and activities of the agency can be seen at http://www.cms.hhs.gov/about/mission.asp.

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