CMS Responsibilities

30.1 - CMS Responsibilities (Rev. 1, 09-11-02) The CMS is responsible for policy formulation. The central and regional offices are responsible for the general management and operation of the program. In brief, CMS's responsibilities include the following: • Determining an individual's entitlement to benefits in consultation with the Social Security Administration (SSA); • Determining the nature and duration of services for which a beneficiary's benefits may be paid; • Establishing, maintaining, and administering agreements with State agencies, providers of services, and A/B MACs (A) and (HHH); • Establishing operational policy for contractors; • Developing operational instructions and official interpretations of policy for contractors; • Formulating major policies regarding conditions of participation for providers in consultation with the Public Health Service; • Developing and maintaining statistical research and actuarial programs; and • Managing general finances of the program; and • Managing the Medicare Premium Collection Operation. The regional offices are responsible for assuring that contractors meet applicable Federal requirements under the provisions of their contracts. They also: • Provide liaison, direction, and technical assistance to contractors in the day-to-day management of their operations; • Interpret CMS guidelines, policies, and procedures applicable to contractor activities; • Analyze contractor budgets and spending patterns to assure that funds are economically and appropriately utilized; • Conduct assessments of contractor operations; • Review contractor actions; and • Provide feedback to each contractor.