Which entity is responsible for the regulations surrounding Medicare and Medicaid services?

The Centers for Medicare and Medicaid Services (CMS) is the primary federal agency responsible for administering the nation’s major healthcare programs, including Medicare and Medicaid. CMS plays a critical role in overseeing and enforcing regulations that govern these programs, ensuring that they operate efficiently and serve the public effectively.

The agency's responsibilities include setting health care policy, updating the coding and billing guidelines that providers must follow, and overseeing compliance with various quality and payment standards. By establishing rules and oversight mechanisms, CMS ensures that beneficiaries receive appropriate care while also governing how services are funded and delivered by healthcare providers.

This understanding of CMS's role is essential for revenue cycle management professionals, as they must navigate these regulations to ensure compliance and optimize billing processes effectively.