Health Care Financing Administration

[For the Health Care Financing Administration statement of organization, see the Federal Register of March 25, 1991, 56 FR 12374]

The Health Care Financing Administration (HCFA) was created as a principal operating component of the Department by the Secretary on March 8, 1977, to combine under one administration the oversight of the Medicare program, the Federal portion of the Medicaid program, and related quality assurance activities. Today, HCFA serves 67 million people, or one in four elderly, disabled, and poor Americans through Medicare and Medicaid. In fiscal year 1993, HCFA will spend an estimated $230 billion to provide health care services.

Medicare. The Medicare Program provides health insurance coverage for people age 65 and over, younger people who are receiving social security disability benefits, and persons who need dialysis or kidney transplants for treatment of end-stage kidney disease. As a Medicare beneficiary, one can choose how to receive hospital, doctor, and other health care services covered by Medicare. Beneficiaries can receive care either through the traditional fee-for-service delivery system or through coordinated care plans, such as health maintenance organizations and competitive medical plans, which have contracts with Medicare.

Medicaid. The Medicaid Program is a medical assistance program jointly financed by State and Federal governments for eligible low-income individuals. Medicaid covers health care expenses for all recipients of Aid to Families with Dependent Children, and most States also cover the needy elderly, blind, and disabled who receive cash assistance under the Supplemental Security Income Program. Coverage also is extended to certain infants and low-income pregnant women and, at the option of the State, other low-income individuals with medical bills that qualify them as categorically or medically needy.

Quality Assurance. The Medicare/Medicaid programs include a quality assurance focal point to carry out the quality assurance provisions of the Medicare and Medicaid programs; the development and implementation of health and safety standards of care providers in Federal health programs; and the implementation of the End Stage Renal Disease Program and the Peer Review provisions.

For further information, contact the Administrator, Health Care Financing Administration, Department of Health and Human Services, 200 Independence Avenue SW., Washington, DC 20201. Phone, 410-786-3000.

Last revised: November 25, 2003

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