[Federal Register Volume 70, Number 249 (Thursday, December 29, 2005)]
[Notices]
[Pages 77159-77168]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E5-8073]


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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. 62, No. 
85, pp. 24120-24126, dated Friday, May 2, 1997, as amended thereafter) 
is being republished to reflect the current organizational structure of 
CMS in relation to meeting the Department's goal of having no more than 
four management levels in the Agency and to also exercise leadership in 
implementing the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (MMA).
    Part F is described below:
     Section F.10. (Organization) reads as follows:

1. Office of External Affairs (FAC)
2. Center for Beneficiary Choices (FAE)
3. Office of Legislation (FAF)
4. Center for Medicare Management (FAH)
5. Office of Equal Opportunity and Civil Rights (FAJ)
6. Office of Research, Development, and Information (FAK)
7. Office of Clinical Standards and Quality (FAM)
8. Office of the Actuary (FAN)
9. Center for Medicaid and State Operations (FAS)
10. Office of the Boston Regional Administrator (FAU1)
11. Office of the New York Regional Administrator (FAU2)
12. Office of the Philadelphia Regional Administrator (FAU3)
13. Office of the Atlanta Regional Administrator (FAV4)
14. Office of the Chicago Regional Administrator (FAW5)
15. Office of the Dallas Regional Administrator (FAV6)
16. Office of the Kansas City Regional Administrator (FAW7)
17. Office of the Denver Regional Administrator (FAX8)
18. Office of the San Francisco Regional Administrator (FAX9)
19. Office of the Seattle Regional Administrator (FAXX)
20. Office of Operations Management (FAY)
21. Office of Information Services (FBB)
22. Office of Financial Management (FBC)
23. Office of Strategic Operations and Regulatory Affairs (FGA)
24. Office of E-Health Standards and Services (FHA)
25. Office of Acquisition and Grants Management (FKA)
26. Office of Policy (FLA)

     Section F. 20. (Functions) reads as follows:

1. Office of External Affairs (FAC)

     Serves as the focal point for the Agency to the news media 
and provides leadership for the Agency in the area of intergovernmental 
affairs. Advises the Administrator and other Agency components in all 
activities related to the media and on matters that affect other units 
and levels of government.
     Coordinates CMS activities with the Office of the 
Assistant Secretary for Public Affairs and the Secretary's 
intergovernmental affairs officials.
     Serves as senior counsel to the Administrator in all 
activities related to the media. Provides consultation, advice, and 
training to the Agency's

[[Page 77160]]

senior staff with respect to relations with the news media.
     Develops and executes strategies to further the Agency's 
relationship and dealings with the media. Maintains a broad based 
knowledge of the Agency's structure, responsibilities, mission, goals, 
programs, and initiatives in order to provide or arrange for rapid and 
accurate response to news media needs.
     Prepares and edits appropriate materials about the Agency, 
its policies, actions and findings, and provides them to the public 
through the print and broadcast media. Develops and directs media 
relations strategies for the Agency.
     Responds to inquiries from a broad variety of news media, 
including major newspapers, national television and radio networks, 
national news magazines, local newspapers and radio and television 
stations, publications directed toward the Agency's beneficiary 
populations, and newsletters serving the health care industry.
     Manages press inquiries, coordinates sensitive press 
issues, and develops policies and procedures for how press and media 
inquiries are handled.
     Arranges formal interviews for journalists with the 
Agency's Administrator or other appropriate senior Agency staff; 
identifies for interviewees the issues to be addressed, and prepares or 
obtains background materials as needed.
     For significant Agency initiatives, issues media 
advisories and arranges press conferences as appropriate; coordinates 
material and personnel as necessary.
     Serves as liaison with the Department of Health and Human 
Services and White House press offices.

2. Center for Beneficiary Choices (FAE)

     Serves as Medicare Beneficiary Ombudsman, as well as the 
focal point for all Agency interactions with beneficiaries, their 
families, care givers, health care providers, and others operating on 
their behalf concerning improving beneficiary's ability to make 
informed decisions about their health and about program benefits 
administered by the Agency. These activities include strategic and 
implementation planning, execution, assessment and communications.
     Assesses beneficiary and other consumer needs, develops 
and oversees activities targeted to meet these needs, and documents and 
disseminates results of these activities. These activities focus on 
Agency beneficiary service goals and objectives and include: 
Development of baseline and ongoing monitoring information concerning 
populations affected by Agency programs; development of performance 
measures and assessment programs; design and implementation of 
beneficiary services initiatives; development of communications 
channels and feedback mechanisms within the Agency and between the 
Agency and its beneficiaries and their representatives; and close 
collaboration with other Federal and State agencies and other 
stakeholders with a shared interest in better serving our 
beneficiaries.
     Develops national policy for all Medicare Parts A, B, C 
and D beneficiary eligibility, enrollment, entitlement; premium billing 
and collection; coordination of benefits; rights and protections; 
dispute resolution process; as well as policy for managed care 
enrollment and disenrollment to assure the effective administration of 
the Medicare program, including the development of related legislative 
proposals.
     Oversees the development of privacy and confidentiality 
policies pertaining to the collection, use, and release of individually 
identifiable data.
     Coordinates beneficiary-centered information, education, 
and service initiatives.
     Develops and tests new and innovative methods to improve 
beneficiary aspects of health care delivery systems through Title 
XVIII, XIX, and XXI demonstrations and other creative approaches to 
meeting the needs of Agency beneficiaries.
     Assures, in coordination with other Centers and Offices, 
the activities of Medicare contractors, including managed care plans, 
agents, and State Agencies, meet the Agency's requirements on matters 
concerning beneficiaries and other consumers.
     Plans and administers the contracts and grants related to 
beneficiary and customer service, including the State Health Insurance 
Assistance Program grants.
     Formulates strategies to advance overall beneficiary 
communications goals and coordinates the design and publication process 
for all beneficiary-centered information, education, and service 
initiatives.
     Builds a range of partnerships with other national 
organizations for effective consumer outreach, awareness, and education 
efforts in support of Agency programs.
     Serves as the focal point for all Agency interactions with 
managed health care organizations for issues relating to Agency 
programs, policy and operations.
     Develops national policies and procedures related to the 
development, qualification and compliance of health maintenance 
organizations, competitive medical plans and other health care delivery 
systems and purchasing arrangements (such as prospective pay, case 
management, differential payment, selective contracting, etc.) 
necessary to assure the effective administration of the Agency's 
programs, including the development of statutory proposals.
     Handles all phases of contracts with managed health care 
organizations eligible to provide care to Medicare beneficiaries.
     Coordinates the administration of individual benefits to 
assure appropriate focus on long term care, where applicable, and 
assumes responsibility for the operational efforts related to the 
payment aspects of long term care and post-acute care services.
     Serves as the focal point for all Agency interactions with 
employers, employees, retirees and others operating on their behalf 
pertaining to issues related to Agency policies and operations 
concerning employer sponsored prescription drug coverage for retirees.
     Develops national policies and procedures to support and 
assure appropriate State implementation of the rules and processes 
governing group and individual health insurance markets and the sale of 
health insurance policies that supplement Medicare coverage.
     Primarily responsible for all operations related to 
Medicare Prescription Drug Plans and Medicare Advantage Prescription 
Drug (Part D) plans.
     Performs activities related to the Medicare Parts A & B 
processes (42 CFR part 405, subparts G and H), Part C (42 CFR part 422, 
subpart M), Part D (42 CFR part 423, subpart M) and the PACE program 
for claims-related hearings, appeals, grievances and other dispute 
resolution processes that are beneficiary-centered.
     Develops, evaluates, and reviews regulations, guidelines, 
and instructions required for the dissemination of appeals policies to 
Medicare beneficiaries, Medicare contractors, Medicare Advantage plans, 
Prescription Drug Plans, CMS regional offices, beneficiary advocacy 
groups and other interested parties.

3. Office of Legislation (FAF)

     Provides leadership and executive direction within the 
Agency for legislative planning to address the Administration's agenda.
     Tracks, evaluates and develops provisions of annual 
legislative

[[Page 77161]]

proposals for Medicare, Medicaid, Clinical Laboratory Improvement Act, 
Health Insurance Portability and Accountability Act and related 
statutes affecting health care financing quality and access in concert 
with HCFA 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 the Agency 
in collaboration with the CMS Centers and Offices.
     Participates with other CMS components in the development 
of Agency policy, including implementing regulations and administrative 
actions.
     Manages pro-actively the Agency's response in times of 
heightened congressional oversight of CMS in collaboration with the 
Centers and Offices. 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 ASLs principal 
contact point on legislative and congressional relations.
     In collaboration with CMS Centers and Offices, provides 
technical assistance, consultation and information services to 
congressional committees and individual members of Congress on the 
Medicare and Medicaid programs, new CMS initiatives and pertinent 
legislation.
     In collaboration with the CMS Centers and Offices, 
provides technical, analytical, advisory and information services to 
the Agency's components, the Department, the White House, OMB, other 
government agencies, private organizations and the general public on 
Agency legislation.
     Tracks and reports on legislation relating to CMS programs 
and maintains legislative reference library.
     Coordinates the Agency's participation in congressional 
hearings, including preparation of testimony and briefing materials, 
and covers all other congressional hearings on matters of interest to 
the Agency except Appropriations Committee hearings specifically on the 
appropriation budget.

4. Center for Medicare Management (FAH)

     Serves as the focal point for all Agency interactions with 
health care providers, intermediaries and carriers for issues relating 
to Agency fee-for-service policies and operations.
     Monitors providers' and other entities' conformance with 
quality standards (other than those directly related to survey and 
certification); policies related to scope of benefits; and other 
statutory, regulatory, and contractual provisions.
     Based on program data, develops payment mechanisms, 
administrative mechanisms, and regulations to ensure that CMS is 
purchasing medically necessary services under fee-for-service.
     Writes payment and benefit-related instructions for 
Medicare contractors.
     Defines the scope of Medicare benefits and develops 
national fee-for-service payment policies, as necessary, to assure the 
effective administration of the Agency's programs, including the 
development of related statutory proposals.
     Develops Agency medical coding policies related to fee-
for-service payments.
     Provides administrative support to the Practicing 
Physician Advisory Council.
     Coordinates provider, physician and contractor centered 
information, education, and service initiatives.
     Serves as the CMS lead for Medicare carrier and fiscal 
intermediary management, oversight, budget, and performance issues.
     Functions as CMS liaison for all Medicare carrier and 
fiscal intermediary program issues and, in close collaboration with the 
regional offices and other CMS components, coordinates the agency-wide 
contractor activities.
     Manages contractor instructions, workload, and change 
management process.
     Collaborates with other CMS components to establish 
ongoing performance expectations for Medicare contractors (carriers and 
fiscal intermediaries) consistent with the agency's goals; interprets, 
evaluates, and provides information on Medicare contractors in terms of 
ongoing compliance with performance requirements and expectations; 
evaluates compliance with issued instructions; evaluates contractor-
specific performance and/or integrity issues; and evaluates/monitors 
corrective action, if necessary.
     Manages, monitors, and provides oversight of contractor 
(carriers and fiscal intermediaries) transition activities including 
replacement of departing contractors and the resulting transfer of 
workload, functional realignments, and geographic workload carveouts.
     Maintains and provides accurate contractor specific 
information. Develops and implements long-term fee-for-service 
contractor strategy, tactical plans, and other planning documents.
     Serves as lead on current/proposed legislation in order to 
determine impact on provider and contractor operations.
     Develops national policy and implementation of all 
Medicare Part A, Part B, and Part C premium billing and collection 
activities and coordination of benefits to assure effective 
administration of fee-for-service aspects of the Medicare program.

5. Office of Equal Opportunity & Civil Rights (FAJ)

     Provides agency-wide leadership and advice on issues of 
diversity, civil rights, and promotion of a supportive work environment 
for Agency employees.
     Develops, implements and manages affirmative employment 
programs. Provides principal advisory, advocacy, and liaison services 
for the Administrator to Agency leadership and employees concerning 
equality in employment related issues to ensure a diverse workforce.
     Develops Equal Employment Opportunity (EEO) and civil 
rights compliance policy for the Agency. Assesses the Agency's 
compliance with applicable civil rights statutes, executive orders, 
regulations, policies, and programs.
     Identifies policy and operational issues and proposes 
solutions for resolving these issues in partnership with management, 
Office of the General Counsel, and other organizational entities.
     Receives and evaluates complaints for procedural 
sufficiency; investigates, adjudicates and resolves such complaints.
     Promotes the representation of minority groups, women, and 
individuals with disabilities through community outreach and other 
activities.
     Resolves informal discrimination complaints by means of 
EEO counseling and/or Alternative Dispute Resolution.
     Develops and analyzes data for internal and external 
reports reflecting the diversity of the Agency workforce and fairness 
in employment related actions. Makes recommendations to management on 
changes needed to ensure equal employment opportunity in every respect.
     Serves as the internal advocate for civil rights and 
related principles. Provides training, seminars, and technical guidance 
to Agency staff.

6. Office of Research, Development & Information (FAK)

     Provides analytic support and information to the 
Administrator and

[[Page 77162]]

the Executive Council needed to establish Agency goals and directions.
     Performs environmental scanning, identifying, evaluating, 
and reporting emerging trends in health care delivery and financing and 
their interactions with Agency programs.
     Manages strategic, crosscutting initiatives.
     Designs and conducts research and evaluations of health 
care programs, studying their impacts on beneficiaries, providers, 
plans, States and other partners and customers, designing and assessing 
potential improvements, and developing new measurement tools.
     Coordinates all Agency demonstration activities, including 
development of the research and demonstration annual plan, evaluation 
of all Agency demonstrations, and assistance to other components in the 
design of demonstrations and studies.
     Manages assigned demonstrations, including Federal review, 
approval, and oversight; coordinates and participates with departmental 
components in experimental health care delivery projects.
     Develops research, demonstration, and other publications 
and papers related to health care issues.
     Designs and conducts payment, purchasing, and benefits 
demonstrations.

7. Office of Clinical Standards & Quality (FAM)

     Serves as the focal point for all quality, clinical and 
medical science issues and policies for the Agency's programs. Provides 
leadership and coordination for the development and implementation of a 
cohesive, agency-wide approach to measuring and promoting quality and 
leads the Agency's priority-setting process for clinical quality 
improvement. Coordinates quality-related activities with outside 
organizations. Monitors quality of Medicare, Medicaid, and 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 and evaluates, adopts and supports 
performance measurement systems (quality indicators) to evaluate care 
provided to CMS beneficiaries except for demonstration projects 
residing in other components.
     Assures that the Agency's 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 (HCQIP) for the Medicare, Medicaid, and CLIA 
programs.
     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 Medicare Peer Review 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 and recommends to the Administrator decisions regarding coverage of 
new and established technologies and services. Coordinates activities 
of the Agency's 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.

8. Office of the Actuary (FAN)

     Conducts and directs the actuarial program for CMS and 
directs the development of and methodologies for macroeconomic analysis 
of health care financing issues.
     Performs actuarial, economic and demographic studies to 
estimate CMS program expenditures under current law and under proposed 
modifications to current law.
     Provides program estimates for use in the President's 
budget and for reports required by Congress.
     Studies questions concerned with financing present and 
future health programs, evaluates operations of the Federal Hospital 
Insurance Trust Fund and Supplementary Medical Insurance Trust Fund and 
performs microanalyses for the purpose of assessing the impact of 
various health care financing factors upon the costs of Federal 
programs.
     Estimates the financial effects of proposals to create 
national health insurance systems or other national or incremental 
health insurance reform.
     Develops and conducts studies to estimate and project 
national and area health expenditures.
     Develops, maintains, and updates provider market basket 
input price indexes and the Medicare Economic Index.
     Analyzes data on physicians' costs and charges to develop 
payment indices and monitors expansion of service and inflation of 
costs in the health care sector.
     Performs actuarial reviews and audits of employee benefit 
expenses charged to Medicare by fiscal intermediaries and carriers.
     Publishes cost projections and economic analyses, and 
provides actuarial, technical advice and consultation to CMS 
components, governmental components, Congress, and outside 
organizations.

9. Center for Medicaid and State Operations (FAS)

     Serves as the focal point for all Centers for Medicare & 
Medicaid Services activities relating to Medicaid, the State Children's 
Health Insurance Program, the Clinical Laboratory Improvement Act, the 
survey and certification of health facilities and all interactions with 
States and local governments (including the Territories).
     Develops national Medicaid policies and procedures which 
support and assure effective State program administration and 
beneficiary protection. In partnership with States, evaluates the 
success of State agencies in carrying out their responsibilities and, 
as necessary, assists States in correcting problems and improving the 
quality of their operations.
     Develops, interprets, and applies specific laws, 
regulations, and policies that directly govern the financial operation 
and management of the Medicaid program and the related interactions 
with States and regional offices.
     In coordination with other components, develops, 
implements, evaluates and refines standardized provider performance 
measures used within provider certification programs.

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Supports States in their use of standardized measures for provider 
feedback and quality improvement activities. Develops, implements and 
supports the data collection and analysis systems needed by States to 
administer the certification program.
     Reviews, approves and conducts oversight of Medicaid 
managed care waiver programs. Provides assistance to States and 
external customers on all Medicaid managed care issues.
     Develops national policies and procedures on Medicaid 
automated claims/encounter processing and information retrieval systems 
such as the Medicaid Management Information System (MMIS) and 
integrated eligibility determination systems.
     In coordination with the Office of Financial Management 
(OFM), directs, coordinates, and monitors program integrity efforts and 
activities by States and regions. Works with OFM to provide input in 
the development of program integrity policy.
     Through administration of the home and community-based 
services program and policy collaboration with other Agency components 
and the States, promotes the appropriate choice and continuity of 
quality services available to frail elderly, disabled and chronically 
ill beneficiaries.
     Develops and tests new and innovative methods to improve 
the Medicaid program through demonstrations and best practices 
including managing review, approval, and oversight of the Section 1115 
demonstrations.
     Directs 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 the Clinical Laboratory Improvement Act (CLIA). Reviews and 
approves applications by States for ``exemption'' from CLIA and 
applications from private accreditation organizations for deeming 
authority. Develops assessment techniques and protocols for 
periodically evaluating the performance of these entities. Monitors the 
performance of proficiency testing programs under the auspices of CLIA.

10. Office of the Boston Regional Administrator (FAU1)

     Assures the effective administration of CMS programs and 
implements national policy at the regional level.
     Develops policy, participates in the formulation of new 
policy and recommends changes in existing national policy for CMS 
programs.
     Monitors the regional administrative budget, including 
oversight of the regional travel funding allocation.
     Manages procurement and contracting activities, and 
personnel administration for the region.
     Serves as principal CMS contact for professional and 
provider/supplier organizations in the region's service area.
     Oversees workplanning, facilities and property management, 
labor-management relations, and staff training for the region.
     Initiates and directs the implementation of special 
regional and national projects.
     Assures effective relationships within the region with 
State and local governments, beneficiaries and their representatives, 
and the media.
     Coordinates with the DHHS Regional Director to assure 
effective relationships with Congressional representatives and State 
and local governments.

11. Office of the New York Regional Administrator (FAU2)

     Assures the effective administration of CMS programs and 
implements national policy at the regional level.
     Develops policy, participates in the formulation of new 
policy and recommends changes in existing national policy for CMS 
programs.
     Monitors the regional administrative budget, including 
oversight of the regional travel funding allocation.
     Manages procurement and contracting activities, automated 
data processing/local area network systems, and personnel 
administration for the region.
     Serves as principal CMS contact for professional and 
provider/supplier organizations in the region's service area.
     Oversees workplanning, facilities and property management, 
labor-management relations, and staff training for the region.
     Initiates and directs the implementation of special 
regional and national projects.
     Assures effective relationships within the region with 
State and local governments, beneficiaries and their representatives, 
and the media.
     Coordinates with the Department of Health and Human 
Services' Regional Director to assure effective relationships with 
Congressional representatives and State and local governments.

12. Office of the Philadelphia Regional Administrator (FAU3)

     Assures the effective administration of CMS programs and 
implements national policy at the regional level.
     Develops new policies and recommends changes in existing 
national policies for CMS programs.
     Monitors the regional administrative budget, including 
oversight of the regional travel funding allocation.
     Manages procurement and contracting activities and 
personnel administration for the region.
     Serves as principal CMS contact for professional and 
provider/supplier organizations in the region's service area.
     Oversees work planning, facilities and property 
management, labor-management relations, and staff training for the 
region.
     Initiates and directs the implementation of special 
regional and national projects. Assures effective relationships within 
the region with State and local governments, beneficiaries and their 
representatives, and the media.
     Coordinates with the Department of Health and Human 
Services' Regional Director to ensure effective relationships with 
elected officials as well as State and local governments.

13. Office of the Atlanta Regional Administrator (FAV4)

     Directs the planning, coordination, and implementation of 
the programs under Titles XI, XVIII, and XIX of the Social Security Act 
and related statutes within the Agency's regional/field offices that 
comprise the Atlanta and Dallas Regional Offices.
     Provides executive leadership and direction to the 
Agency's Regional Administrator(s) in the Atlanta and Dallas Regional 
Offices.
     Assures that the Agency's programs are carried out in the 
most effective and efficient manner within the Atlanta and Dallas 
Regional Offices, and that they are coordinated both at the Atlanta and 
Dallas level and with the Agency's headquarters' offices.
     Provides an Atlanta and Dallas perspective to the Agency's 
Administrator and other members of the Executive Council in such 
activities as strategic planning, determining the effectiveness of the 
Agency's programs and policies, budget formulation and execution, 
legislation, and administrative management.
     Assures that the Agency's national policies, programs and 
special initiatives are implemented effectively throughout the Atlanta 
and Dallas Regional Offices. Conducts local projects to improve the 
quality of medical care provided to beneficiaries and to control fraud, 
abuse and waste in the Agency's programs.

[[Page 77164]]

     Evaluates progress in the administration of the Agency's 
programs in the Atlanta and Dallas Regional Offices, ensuring that 
required actions are taken to direct or redirect efforts and/or 
resources to achieve program objectives.
     Working with the Regional Administrator(s) in the Atlanta 
and Dallas Regional Offices and the Agency's headquarters' leadership, 
assures that the information needs of the Medicare and Medicaid 
beneficiaries are fully understood and met, to the maximum degree 
possible. In association with other Agency components, maintains an 
understanding of the health care market that is operating in the 
Atlanta and Dallas Regional Offices in order to allow the Agency to 
adapt to changes in that market when appropriate.
     Assures that the Regional Administrator(s) in the Atlanta 
and Dallas Regional Offices fully coordinate the Agency's programs with 
other Health and Human Services' components, other Federal agencies, 
the Agency's contractors, State and local governments, professional 
associations, other interested groups, and the Agency's beneficiaries 
and/or representatives in their respective region.
     Working with the Agency's headquarters, manages the 
Atlanta and Dallas' administrative budget, to include the planning and 
allocation of resources to the regional offices comprising the Atlanta 
and Dallas Regional Offices.
     Provides executive leadership and guidance on behalf of 
the Atlanta and Dallas Regional Administrator to CMS components at the 
regional level.
     Serves on the Atlanta and Dallas Leadership Council, which 
sets the overall direction for the Atlanta and Dallas Regional Offices, 
and implements the Council's directions within the Region's service 
area.
     Effectively implements national policy, programs, and 
special initiatives at the regional level. Conducts local projects to 
improve the quality of medical care provided to beneficiaries and to 
control fraud, abuse, and waste in the Agency's programs.
     Assures that the information needs of the Medicare and 
Medicaid beneficiaries are fully understood and met, to the maximum 
degree possible. In association with other Agency components, maintains 
an understanding of the health care market that is operating in the 
Region in order to allow the Agency to adapt to changes in that market 
when appropriate.
     Participates in the formulation of new policy and 
recommends changes in existing national policy for CMS programs.
     Develops and implements a professional relations program 
within the Region for all CMS programs and serves as the principal CMS 
contact for all professional organizations such as hospital and medical 
associations.
     Fully coordinates the Agency's programs with other Health 
and Human Services' components including the Department's Regional 
Director, other Federal agencies, the Agency's contractors, State and 
local governments, professional associations, other interested groups, 
and the Agency's beneficiaries and/or representatives in the Region.
     Manages procurement and contracting activities, ADP/LAN 
systems, and personnel actions for the Region.
     Provides regional perspective to the Administrator and the 
Executive Council.
     Monitors the regional administrative budget, including 
oversight of the regional travel funding allocation.

14. Office of the Chicago Regional Administrator (FAW5)

     Serves as the principal office for Regional operations of 
CMS.
     Directs the administration of all CMS programs within the 
region.
     Sets the overall direction for the Chicago and Kansas City 
Regional Offices through the Midwest Consortium Advisory Board, and 
implements Board directions within the Region's service area.
     Monitors the Regional administrative budget, including 
oversight of the Regional travel funding allocation.
     Manages procurement and contracting activities, ADP/LAN 
systems, and personnel actions for the Region.
     Serves as principal CMS contact for professional and 
provider/supplier organizations in the Region's service area.
     Oversees work planning, facilities and property 
management, labor-management relations, merit promotion principles, 
EEO, and staff training for the Region.
     Coordinates environmental scanning and strategic planning 
for the Region. Pursues activities which enable the Regional staff to 
become knowledgeable regarding developments and trends in health care 
delivery within the States they serve.
     Serves as focal point among Regional Office components for 
special initiatives and broad cross-cutting issues.

15. Office of the Dallas Regional Administrator (FAV6)

     Provides executive leadership and guidance on behalf of 
the Atlanta and Dallas Regional Administrators to CMS components at the 
regional level.
     Serves on the Atlanta and Dallas Leadership Council, which 
sets the overall direction for the Regions, and implements the 
Council's directions within the Region's service area.
     Effectively implements national policy, programs, and 
special initiatives at the regional level. Conducts local projects to 
improve the quality of medical care provided to beneficiaries and to 
control fraud, abuse, and waste in the Agency's programs.
     Assures that the information needs of the Medicare and 
Medicaid beneficiaries are fully understood and met, to the maximum 
degree possible. In association with other Agency components, maintains 
an understanding of the health care market that is operating in the 
Region in order to allow the Agency to adapt to changes in that market 
when appropriate.
     Participates in the formulation of new policy and 
recommends changes in existing national policy for CMS programs.
     Develops and implements a professional relations program 
within the Region for all CMS programs and serves as the principal CMS 
contact for all professional organizations such as hospital and medical 
associations.
     Fully coordinates the Agency's programs with other Health 
and Human Services' components including the Department's Regional 
Director, other Federal agencies, the Agency's contractors, State and 
local governments, professional associations, other interested groups, 
and the Agency's beneficiaries and/or representatives in the Region.
     Manages procurement and contracting activities, ADP/LAN 
systems, and personnel actions for the Region.
     Provides regional perspective to the Administrator and the 
Executive Council.
     Monitors the regional administrative budget, including 
oversight of the regional travel funding allocation.

16. Office of the Kansas City Regional Administrator (FAW7)

     Serves as the principal official for regional operations 
of CMS and directs the administration of all CMS programs within the 
region.

[[Page 77165]]

     Directs the Consortium Survey and Certification and 
Consortium Contractor Management organizations.
     Monitors the regional administrative budget, including 
oversight of the regional travel funding allocation.
     Develops and implements a media relations plan to market 
CMS programs to the diverse populations of the region.
     Manages procurement and contracting activities, ADP/LAN 
systems, and personnel actions for the Region.
     Oversees work planning, facilities and property 
management, labor-management relations, merit promotion principles, EEO 
and staff training for the region.
     Coordinates environmental scanning and strategic planning 
for the region. Pursues activities which enable the Chicago and Kansas 
City regional staff to become knowledgeable regarding developments and 
trends in health care delivery within the states they serve.
     Serves as the focal point among regional office components 
for special initiatives and broad cross-cutting issues.
     Manages and executes the Health Insurance Portability and 
Accountability Act's insurance portability enforcement process for the 
nation.

17. Office of the Denver Regional Administrator (FAX8)

     The Office of the Regional Administrator directs the 
operations of programs administered by the CMS, including Medicare, 
Medicaid, Clinical Laboratory Improvement Act, and Health Insurance 
Portability and Accountability Act, in a distinct geographic area and 
provides executive leadership to regional office staff on behalf of the 
CMS Administrator.
     Develops and implements an outreach plan which includes 
media relations, community participation, speeches and presentations, 
and local Congressional office liaison, to market CMS programs to the 
diverse populations of the region.
     Manages the human and dollar resources of the regional 
office in an efficient and effective manner including work planning, 
facilities and property management, human resource management 
(recruitment, retention, training, development and performance 
management), and labor-management relations.
     Coordinates with the Department's Regional Director to 
assure effective relations with State and local governments and with 
other Departmental programs and offices.
     Evaluates diverse needs of constituents in the region and 
advises policy makers so that such needs are considered by CMS in 
national policy development.
     Develops expert opinion to advise national policy makers 
on concerns of American Indians and Alaska Natives as they relate to 
programs administered by HHS.

18. Office of the San Francisco Regional Administrator (FAX9)

     The Office of the Regional Administrator directs the 
operations of programs administered by the CMS, including Medicare, 
Medicaid, Clinical Laboratory Improvement Act, and Health Insurance 
Portability and Accountability Act, in a distinct geographic area and 
provides executive leadership to regional office staff on behalf of the 
CMS Administrator.
     Develops and implements an outreach plan which includes 
media relations, community participation, speeches and presentations, 
and local Congressional office liaison, to market CMS programs to the 
diverse populations of the region.
     Manages the human and dollar resources of the regional 
office in an efficient and effective manner including work planning, 
facilities and property management, human resource management 
(recruitment, retention, training, development and performance 
management), and labor-management relations.
     Coordinates with the Department's Regional Director to 
assure effective relations with State and local governments and with 
other Departmental programs and offices.
     Evaluates diverse needs of constituents in the region and 
advises policy makers so that such needs are considered by CMS in 
national policy development.

19. Office of the Seattle Regional Administrator (FAXX)

     The Office of the Regional Administrator directs the 
operations of programs administered by the CMS, including Medicare, 
Medicaid, Clinical Laboratory Improvement Act, and Health Insurance 
Portability and Accountability Act, in a distinct geographic area and 
provides executive leadership to regional office staff on behalf of the 
CMS Administrator.
     Develops and implements an outreach plan which includes 
media relations, community participation, speeches and presentations, 
and local Congressional office liaison, to market CMS programs to the 
diverse populations of the region.
     Manages the human and dollar resources of the regional 
office in an efficient and effective manner including work planning, 
facilities and property management, human resource management 
(recruitment, retention, training, development and performance 
management), and labor-management relations.
     Coordinates with the Department's Regional Director to 
assure effective relations with State and local governments and with 
other Departmental programs and offices.
     Evaluates diverse needs of constituents in the region and 
advises policy makers so that such needs are considered by CMS in 
national policy development.
     Designs and implements health care quality improvement 
projects and manages contracts of peer review organizations to improve 
health care quality in 13 Western States.

20. Office of Operations Management (FAY)

     Prepares and presents recommendations to the 
Administrator, Deputy Administrator, Chief Operating Officer and other 
high-level CMS and Department officials on planning, leadership, 
implementation and policy issues concerning modifications to existing 
and proposed operating policies that will improve the administration 
and operations of programs and the Agency as a whole.
     Provides consulting services internally to Agency 
management and staff to identify processes that need improvement, to 
develop improvement strategies, and to monitor processes and 
improvements over time. Participates in agency-wide initiatives to 
streamline operations, improve accountability and performance, and 
implement management best practices.
     Promotes project planning principles throughout the Agency 
and provides technical guidance to the Agency on project planning and 
management techniques. Prepares and presents recommendations to senior 
officials regarding major projects.
     Promotes and teaches risk assessment methods to business 
owners throughout CMS. Promotes awareness of the importance of risk 
analysis as a component of business planning and trains CMS staff in 
specific techniques and their applicability in particular situations.
     Identifies operational vulnerabilities within CMS and 
develops and executes an operational review plan for each fiscal year, 
subject to approval by the Deputy

[[Page 77166]]

Administrator, Chief Operating Officer and other senior leadership of 
CMS.
     Plans and conducts targeted internal audits and makes 
recommendations to strengthen internal audits and improve the 
operations of the Agency.
     Serves as the Agency focal point for emergency 
preparedness.
     Provides the Agency's internal customers (employees) with 
support in human resource management, procurement management, and 
logistics. Includes planning, organizing, coordinating, and evaluating 
needed activities in each area.
     Manages and directs the Agency's ethics and management 
programs; provides policy direction, coordination and support for 
administrative services including space, property, records, printing 
and facilities management, safety and security, and a centralized 
customer service desk.
     Provides administrative support functions for the 
Commissioned Corps.
     Develops and maintains administrative systems for ethics, 
awards, procurement, and property management.
     Provides staff support to the Provider Reimbursement 
Review Board (PRRB) and the Medicare Geographic Review Board (MGCRB).
     Conducts Medicare and Medicaid Hearings on behalf of the 
Secretary or the Administrator that are not within the jurisdiction of 
the Department Appeals Board, the Social Security Administration's 
Office of Hearings and Appeals, the PRRB, the MGCRB, or the States.

21. Office of Information Services (FBB)

     Serves as the focal point for the responsibilities of the 
Agency's Chief Information Officer in planning, organizing, and 
coordinating the activities required to maintain an agency-wide 
Information Resources Management (IRM) program.
     Ensures the effective management of the Agency's 
information technology, and information systems and resources (e.g., 
implementation and administration of a change management process).
     Provides workstation, server, and local area network 
support for CMS-wide activities. Works with customer components to 
develop requirements, needs and cost benefit analysis in support of the 
LAN infrastructure including hardware, software and office automation 
services.
     Serves as the lead for developing and enforcing the 
Agency's information architecture, policies, standards, and practices 
in all areas of information technology.
     Develops and maintains enterprise-wide central databases, 
statistical files, and general access paths, ensuring the quality of 
information maintained in these data sources.
     Directs Medicare claims payment systems activities, 
including CWF operation, as well as systems conversion activities.
     Develops ADP standards and policies for use by internal 
CMS staff and contractor agents in such areas as applications 
development and use of the infrastructure resources.
     Manages and directs the operation of CMS hardware 
infrastructure, including the Agency's Data Center, data communications 
networks, enterprise infrastructure, voice/data switch, audio 
conferencing and other data centers supporting CMS programs.
     Leads the coordination, development, implementation and 
maintenance of health care information standards in the health care 
industry.
     Provides Medicare and Medicaid information to the public, 
within the parameters imposed by the Privacy Act.
     Performs information collection analyses as necessary to 
satisfy the requirements of the Paperwork Reduction Act.
     Directs CMS' ADP systems security program with respect to 
data, hardware, and software.
     Directs and advises the Administrator, senior staff, and 
components on the requirements, policies, and administration of the 
Privacy Act.

22. Office of Financial Management (FBC)

     Serves as the Chief Financial Officer and Comptroller for 
the Agency.
     Formulates, presents and executes all Agency budget 
accounts; develops outlay plans and tracks contract and grant award 
amounts; acts as liaison with the Congressional Budget Office (CBO) on 
budget estimates; reviews demonstration waivers (except 1115) for 
revenue neutrality. Is responsible for ensuring that the budget is 
formulated in accordance with the Agency's strategic plan and the GPRA 
goals and performance measures.
     Acts as liaison with ASMB, OMB, and the Congressional 
appropriations committees for all matters concerning the Agency's 
operating budget.
     Manages the Medicare financial management system, the 
Medicare contractors' budgets, Peer Review Organizations' budgets, 
research budgets, managed care payments, the issuance of State Medicaid 
grants, and the funding of the State survey/certification and the CLIA 
programs. Is responsible for all Agency disbursements.
     Performs cash management activities and establishes and 
maintains systems to control the obligation of funds and ensure that 
the Anti-Deficiency Act is not violated.
     Performs the Agency's debt management activities (e.g., 
accounts receivable, user fees, penalties, disallowances).
     Reconciles all Agency financial data and prepares external 
reports to other agencies such as HHS, Treasury, OMB, Internal Revenue 
Service, General Services Administration, related to the Agency's 
obligations, expenditures, prompt payment activities, debt and cash 
management, and other administrative functions.
     Has overall responsibility for the fiscal integrity of all 
Agency programs. Develops and performs all benefit integrity policy and 
operations in coordination with other Agency components. Manages the 
Medicare program integrity contractors authorized by the HIPAA and 
managed care financial audit and enforcement functions. In coordination 
with the Center for Medicaid and State Operations, develops Medicaid 
program integrity policy; and monitors Medicaid program integrity 
activities.
     Working with other CMS components, develops Agency 
policies governing both Medicare Secondary Payer and Medicaid Third 
Party Liability.
     Develops and implements all civil money penalty policies 
in all programs.
     Prepares financial statements for Federal Managers 
Financial Integrity Act and GPRA.

23. Office of Strategic Operations & Regulatory Affairs (FGA)

     Manages the Agency's decision-making and regulatory 
process.
     Serves in a neutral broker coordination role which 
includes: Scheduling meetings and briefings for the Administrator and 
coordinating communications between and among central and regional 
offices to ensure that emerging issues are identified early, all 
concerned components are directly and fully involved in policy 
development/decision making, and that all points of view are presented.
     Provides leadership, direction, and advocacy, on behalf of 
top CMS officials in connection with official policy matters for 
presentation to the Administrator and Deputy Administrator/ Chief 
Operating Officer to insure that all points of view and

[[Page 77167]]

program interests of concern to the Administrator and Deputy 
Administrator/Chief Operating Officer are developed and properly 
presented for consideration. Reviews policy statements by component 
Directors and others to anticipate potential problems or 
inconsistencies with views of the Administrator, Deputy Administrator/
Chief Operating Officer, and the Administration. Assists in resolving 
these matters to the satisfaction of the Agency and top management.
     Manages meeting requests for or on behalf of the 
Administrator, and Deputy Administrator/Chief Operating Officer. 
Coordinates the preparation of briefing materials for the 
Administrator, Deputy Administrator/Chief Operating Officer, and the 
Department in advance of the Administrator and Deputy Administrator/
Chief Operating Officer's participation in meetings, appointments with 
major groups, etc. Works with CMS components to assure that appropriate 
briefing materials are presented to Senior Leadership. Senior officials 
in CMS and the Department, as well as officials of other Federal 
agencies, State and local governments, and outside interest groups 
attend these meetings.
     Coordinates the preparation of manuals and other policy 
instructions to ensure accurate and consistent implementation of the 
Agency's programs.
     Manages the Agency's system for developing, clearing and 
tracking regulations, setting regulation priorities and corresponding 
work agendas; coordinates the review of regulations received for 
concurrence from departmental and other government agencies, and 
develops routine and special reports on the Agency's regulatory 
activities.
     Manages the regulations development process to ensure 
timely decision making by the Administrator and Deputy Administrator/
Chief Operating Officer on CMS regulations.
     Provides leadership and management of the Agency's 
Executive Correspondence system. Operates the agency-wide 
correspondence tracking and control system and provides guidance and 
technical assistance on standards for content of correspondence and 
memoranda.
     Manages the agency-wide clearance system to ensure 
appropriate involvement from Agency components and serves as a primary 
focal point for liaison with the Executive Secretariat in the Office of 
the Secretary.
     Provides management and administrative support to the 
Office of the Attorney Advisor and staff.
     Acts as audit liaison with the General Accounting Office 
(GAO) and the HHS Office of Inspector General (OIG).
     Monitors and coordinates major CMS legislative initiatives 
such as tracking the status of the Agency's implementation of Balance 
Budget Act, Balanced Budget Refinement Act, and the Benefits 
Improvement and Protection Act provisions.
     Coordinates and prepares the advance planning reports for 
the Secretary and the Administrator (Secretary's Forecast Report).
     Acts as the liaison with the Office of the Secretary for 
Reports to the Congress and maintains a tracking system to monitor 
status. Also serves as the CMS liaison with the Small Business 
Administration's Office of the National Ombudsman.
     Develops standard processes for all CMS FACA committees 
and provides operational and logistical support to CMS components for 
conferences and on all matters relating to Federal Advisory Committees.
     Conducts activities necessary to the receipt, management, 
response, and reporting requirements of the Department under the 
Freedom of Information Act (FOIA) regarding all requests received by 
CMS.
     Maintains a log of all FOIA requests received by the 
central office, refers requests to the appropriate components within 
headquarters, the regions or among carriers and intermediaries for the 
collection of the documents requested. Makes recommendations and 
prepares replies to requesters, including denials of information as 
permitted under FOIA, and drafts briefing materials and responses in 
connection with appeals of denial decisions.
     Directs the maintaining and amending of CMS-wide records 
for confidentiality and disclosure to the Privacy Act to include: 
Planning, organizing, initiating and controlling privacy matching 
assignments.
     Provides direct services and develops policy, standards, 
and procedures for CMS' records, management and vital records program 
for all CMS Central and Regional Offices.

24. Office of E-Health Standards and Services (FHA)

     Develops and coordinates implementation of a comprehensive 
e-health strategy for CMS. Coordinates and supports internal and 
external technical activities related to e-health services and ensures 
that individual initiatives tie to the overall agency and Federal e-
health goals strategies.
     Promotes and leverages innovative component initiatives. 
Facilitates cross-component awareness of various e-health projects.
     Develops regulations and guidance materials, and provides 
technical assistance on the Administrative Simplification provisions of 
the Health Insurance Portability and Accountability Act of 1996 
(HIPAA), including transactions, code sets, identifiers, and security.
     Develops and implements the enforcement program for HIPAA 
Administrative Simplification provisions.
     Develops and implements an outreach program for HIPAA 
Administrative Simplification provisions. Formulates and coordinates a 
public relations campaign, prepares and delivers presentations and 
speeches, responds to inquiries on HIPAA issues, and maintains liaison 
with industry representatives.
     Adopts and maintains messaging and vocabulary standards 
supporting electronic prescribing under Medicare Part D.
     Serves as agency point of reference on Federal and private 
sector e-Health initiatives. Works with Federal departments and 
agencies to identify and adopt universal messaging and clinical health 
data standards, and represents CMS and HHS in national projects 
supporting the national health enterprise architecture and the national 
health information infrastructure.
     Coordinates and provides guidance on legislative and 
regulatory issues related to e-health standards and services.
     Collaborates with HHS on policy issues related to e-health 
standards, and serves as the central point of contact for the Office of 
the National Coordinator for Health Information Technology.

25. Office of Acquisition & Grants Management (FKA)

     Serves as the Agency's Head of the Contracting Activity. 
Plans, organizes, coordinates and manages the activities required to 
maintain an agency-wide acquisition program.
     Serves as the Agency's Chief Grants Management Official, 
with responsibility for all CMS discretionary grants.
     Ensures the effective management of the Agency's 
acquisition and grant resources.
     Serves as the lead for developing and overseeing the 
Agency's acquisition planning efforts.
     Develops policy and procedures for use by acquisition 
staff and internal CMS staff necessary to maintain

[[Page 77168]]

efficient and effective acquisition and grant programs.
     Advises and assists the Administrator, senior staff, and 
Agency components on acquisition and grant related issues.
     Plans, develops, and interprets comprehensive policies, 
procedures, regulations, and directives for CMS acquisition functions.
     Represents CMS at departmental acquisition and grant 
forums and functions, such as the Executive Council on Acquisition and 
the Executive Council for Grants Administration Policy.
     Serves as the CMS contact point with HHS and other Federal 
agencies relative to grant and cooperative agreement policy matters.
     Coordinates and/or conducts training for contracts and 
grant personnel, as well as project officers in CMS components.
     Develops agency-specific procurement guidelines for the 
utilization of small and disadvantaged business concerns in achieving 
an equitable percentage of CMS' contracting requirements.
     Provides cost/price analyses and evaluations required for 
the review, negotiation, award, administration, and closeout of grants 
and contracts. Provides support for field audit capability during the 
pre-award and closeout phases of contract and grant activities.
     Develops and maintains the OAGM automated procurement 
management system. Manages procurement information activities (i.e., 
collecting, reporting, and analyzing procurement data).

26. Office of Policy (FLA)

     Assists the Policy Council with immediate/rapid response 
on timely issues and transform concepts into institutionalized 
processes.
     Assists the MMA Council as requested to develop, 
implement, and coordinate a policy process for the agency for key major 
cross-cutting and policy issues resulting from MMA legislation and 
subsequent issues.
     Advises the Administrator on medical technical innovation 
and health information technology matters.
     Plans and develops future CMS program policy. Assists OL 
in the development of legislative strategies by providing analytic 
support for legislative options and proposals. Conducts legislative, 
economic, and policy analyses related to the overall structure of 
health care financing. Translates research findings into policy 
applications.
     Performs environmental scanning, identifying, evaluating, 
and reporting emerging trends to health care delivery and financing. 
Works with Agency components and outside organizations to obtain 
relevant information on emerging trends. Analyzes trends for their 
interactions with Agency programs and implications for future policy 
development and planning. Identifies emerging trends and policy issues 
that would benefit the Office of Research, Development, and 
Information's research, evaluation, and survey enterprises.
     Conducts management and development of the long-term 
strategic plan for the Agency. Provides analytic support and 
information to the Administrator and Senior Leadership needed to 
establish the Agency's goals and directions. Conducts special studies 
and analyses concerning Agency-wide planning issues.
     Provides data analyses, graphics presentations, briefing 
materials, and analyses on short notice to support the immediate needs 
of the Administrator and Senior Leadership.
     Manages strategic, cross-cutting initiatives as assigned 
by the Office of the Administrator.
     Facilitates policy development by providing analytic 
liaison with other components in HHS and elsewhere in the 
Administration.
     Serves as CMS' contact for international visitors. 
Responds to requests from intergovernmental agencies and the 
international community for information related to the United States 
health care system.

    Dated: December 20, 2005.
Karen Pelham O'Steen,
Director, Office of Operations Management, Centers for Medicare & 
Medicaid Services.
 [FR Doc. E5-8073 Filed 12-28-05; 8:45 am]
BILLING CODE 4120-01-P