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[Federal Register Volume 76, Number 203 (Thursday, October 20, 2011)]
[Notices]
[Pages 65197-65199]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-27169]

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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. 70, No. 
249, pp. 77160-77161, dated December 29, 2005; Vol. 75, No. 56, pp. 
14176--14178, dated March 24, 2010; and Vol. 76, No. 144, pp. 44933-
44934, dated July 27, 2011) are amended to: (1) Realign the survey and 
certification function from the Center for Medicaid, CHIP and Survey & 
Certification to the Office of Clinical Standards and Quality (OCSQ) 
and to change the organizational title for the Center for Medicaid, 
CHIP and Survey & Certification to the Center for Medicaid and CHIP 
Services (CMCS), and (2) realign the governmental relations function 
from the Office of Legislation (OL) to CMCS. Part F, Sections FC.10 
(Organization) and FC.20 (Functions) is revised as follows:
     Section FC. 10 (Organization):

Office of the Administrator (FC)
Office of Equal Opportunity and Civil Rights (FCA)
Office of Legislation (FCC)
Office of the Actuary (FCE)
Office of Strategic Operations and Regulatory Affairs (FCF)
Office of Clinical Standards and Quality (FCG)
Center for Medicare (FCH)
Center for Medicaid and CHIP Services (FCJ)
Center for Strategic Planning (FCK)
Center for Program Integrity (FCL)
Chief Operating Officer (FCM)
Office of Minority Health (FCN)
Center for Medicare and Medicaid Innovation (FCP)
Federal Coordinated Health Care Office (FCQ)
Center for Consumer Information and Insurance Oversight (FCR)
Office of Public Engagement (FCS)
Office of Communications (FCT)

     Section FC.20 (Functions):

Center for Medicaid and CHIP Services (FCJ)

     Serves as CMS' focal point for the formulation, 
coordination, integration, implementation, and evaluation of all 
national program policies and operations relating to the Medicaid and 
Children's Health Insurance Program (CHIP).
     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

[[Page 65198]]

in the health care industry, program objectives, and the needs of 
Medicaid beneficiaries. Collaborates with OL on the development and 
advancement of new legislative initiatives and improvements.
     Serves as CMS' lead for management, oversight, budget and 
performance issues relating to Medicaid, CHIP, 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 Public Engagement, 
oversees all CMS interactions and collaboration relating to Medicaid 
and CHIP with beneficiaries, States and territories and key 
stakeholders (e.g., 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 and CHIP programs.

Office of Clinical Standards and Quality (FCG)

     Serves as the focal point for all quality, clinical, 
medical science issues, survey and certification, and policies for CMS' 
programs. Provides leadership and coordination for the development and 
implementation of a cohesive, CMS-wide approach to measuring and 
promoting quality and leads CMS' priority-setting process for clinical 
quality improvement. Coordinates quality-related activities with 
outside organizations. Monitors quality of Medicare, Medicaid, and the 
Clinical Laboratory and Improvement Amendments (CLIA). Evaluates the 
success of interventions.
     Identifies and develops best practices and techniques in 
quality improvement; implementation of these techniques will be 
overseen by appropriate components. Develops and collaborates on 
demonstration projects to test and promote quality measurement and 
improvement.
     Develops, tests, evaluates, adopts and supports 
performance measurement systems (i.e., quality measures) to evaluate 
care provided to CMS beneficiaries except for demonstration projects 
residing in other components.
     Assures that CMS' quality-related activities (survey and 
certification, technical assistance, beneficiary information, payment 
policies and provider/plan incentives) are fully and effectively 
integrated. Carries out the Health Care Quality Improvement Program for 
the Medicare, Medicaid, and CLIA programs.
     Oversees the planning, policy, 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 the survey and certification program and 
the related interactions with the States.
     Leads in the specification and operational refinement of 
an integrated CMS quality information system, which includes tools for 
measuring the coordination of care between health care settings; 
analyzes data supplied by that system to identify opportunities to 
improve care and assess success of improvement interventions.
     Develops requirements of participation for providers and 
plans in the Medicare, Medicaid, and CLIA programs. Revises 
requirements based on statutory change and input from other components.
     Operates the Quality Improvement Organization and End-
Stage Renal Disease Network program in conjunction with Regional 
Offices, providing policies and procedures, contract design, program 
coordination, and leadership in selected projects.
     Identifies, prioritizes and develops content for clinical 
and health related aspects of CMS' Consumer Information Strategy; 
collaborates with other components to develop comparative provider and 
plan performance information for consumer choices.
     Prepares the scientific, clinical, and procedural basis 
for coverage of new and established technologies and services and 
provides coverage recommendations to the CMS Administrator. Coordinates 
activities of CMS' Technology Advisory Committee and maintains liaison 
with other departmental components regarding the safety and 
effectiveness of technologies and services; prepares the scientific and 
clinical basis for, and recommends approaches to, quality-related 
medical review activities of carriers and payment policies.

Office of Legislation (FCC)

     Provides leadership and executive direction within CMS for 
legislative planning to address the Administration's agenda.
     Tracks, evaluates and develops provisions of annual 
legislative proposals for Medicare, Medicaid, CHIP, private health 
insurance programs, CLIA, Health Insurance Portability and 
Accountability Act and related statutes affecting health care 
financing, health insurance, quality, and access in concert with CMS 
components, the Department and the Office of Management and Budget.
     Advances the legislative policy process through analysis, 
review and development of health care initiatives and issues.
     Develops the long-range legislative plans for CMS in 
collaboration with the CMS Centers, Offices, and the Chief Operating 
Officer (COO).
     Participates with other CMS components in the development 
of CMS policy, including implementing regulations and administrative 
actions.
     Manages pro-actively CMS' response in times of heightened 
congressional oversight of CMS in collaboration with the Centers, 
Offices, and COO. Manages, coordinates and develops policies for 
responding to congressional inquiries.
     Coordinates activities with the Office of the Assistant 
Secretary for Legislation (ASL) and serves as the ASL's principal 
contact point on legislative and congressional relations.
     In collaboration with CMS Centers, Offices, and the COO, 
provides technical assistance, consultation and information services to 
congressional committees and individual members of Congress on the 
Medicare, Medicaid, CHIP, and private health insurance programs, new 
CMS initiatives, and pertinent legislation.
     In collaboration with the CMS Centers, Offices, and COO, 
provides technical, analytical, advisory, and information services to 
CMS' components, the Department, the White House, OMB, other government 
agencies, private organizations and the general public on CMS 
legislation.
     Tracks and reports on legislation relating to CMS programs 
and maintains legislative reference library.
     Coordinates CMS' participation in congressional hearings, 
including preparation of testimony and briefing materials, and covers 
all other congressional hearings on matters of interest to CMS except 
Appropriations Committee hearings specifically on the appropriation 
budget.

[[Page 65199]]

    Authority: 44 U.S.C. 3101.

    Dated: October 13, 2011.
Michelle Snyder,
Deputy Chief Operating Officer, Centers for Medicare & Medicaid 
Services.
[FR Doc. 2011-27169 Filed 10-19-11; 8:45 am]
BILLING CODE 4120-01-P
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