Topics on this page: CMS Budget Overview | CMS Programs and Services | Budgetary Request
Centers for Medicare & Medicaid Services (CMS): Overview
The Centers for Medicare & Medicaid Services ensures availability of effective, up-to-date health care coverage and promotes quality care for beneficiaries.
CMS Budget Overview
(Dollars in millions)
| Current Law | 2014 | 2015 | 2016 | 2016 +/- 2015 |
|---|---|---|---|---|
| Medicare /1 | 511,693 | 530,451 | 583,519 | +53,068 |
| Medicaid | 301,472 | 328,595 | 344,447 | +15,852 |
| CHIP | 9,319 | 10,608 | 14,010 | +3,402 |
| State Grants and Demonstrations | 508 | 572 | 593 | +21 |
| Private Health Insurance Programs | 2,689 | 15,252 | 13,254 | +11,692 |
| Center for Medicare and Medicaid Innovation | 997 | 1,291 | 1,590 | +299 |
| Total Net Outlays, Current Law | 826,678 | 886,768 | 957,413 | +70,645 |
| Adjusted Baseline | 2014 | 2015 | 2016 | 2016 +/- 2015 |
|---|---|---|---|---|
| Prevent Reduction in Medicare Physician Payments | — | 5,337 | 8,786 | +3,449 |
| Total Net Outlays, Adjusted Baseline | 826,678 | 886,768 | 957,413 | +70,645 |
| Proposed Law | 2014 | 2015 | 2016 | 2016 +/- 2015 |
|---|---|---|---|---|
| Medicare | — | 630 | -2,413 | -3,043 |
| Medicaid | — | 4,485 | 6,617 | +2,132 |
| CHIP | — | — | 560 | +560 |
| State Grants and Demonstrations | — | — | 25 | +25 |
| Private Health Insurance Programs | — | — | — | — |
| Program Management | — | — | 656 | +656 |
| Total Proposed Law | — | 5,115 | 5,445 | +330 |
| Total Net Outlays, Proposed Law /2 | 826,678 | 897,221 | 971,664 | +74,423 |
| Savings from Program Integrity Investments /3 | — | — | -870 | -870 |
| Total Net Outlays, Proposed Policy | 826,678 | 897,221 | 970,774 | +73,553 |
Table Footnotes
1/ Current law Medicare outlays net of offsetting receipts.
2/ Total net proposed law outlays equal current law outlays plus the impact of proposed legislation and offsetting receipts.
3/ Includes savings not subject to PAYGO from additional program integrity investments above savings already assumed in current law.
CMS Programs and Services
The FY 2016 Budget estimate for the Centers for Medicare & Medicaid Services (CMS) is $970.8 billion in mandatory and discretionary outlays, a net increase of $74 billion above the FY 2015 level. This request finances Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), private health insurance programs and oversight, program integrity efforts, and operating costs. The Budget continues CMS’s work to implement the Affordable Care Act by improving health care for tens of millions of Americans through comprehensive insurance reforms, policies to enhance quality, and providing access to health insurance coverage. The Budget proposes targeted reforms to improve the long term sustainability of Medicare and Medicaid by increasing the efficiency of health care delivery without compromising the quality of care for the elderly, children, low income families, and people with disabilities.
Budgetary Request
Medicare: The Budget includes net projected Medicare savings of $423 billion over 10 years. Most notably, the Budget invests $44 billion above the President’s Budget adjusted baseline to reform the Medicare physician payment system to accelerate physician participation in high quality and efficient healthcare delivery systems. Other proposals improve payment efficiency across providers and increase the value of the care that is provided to Americans.
Medicaid: The Budget includes legislative proposals in Medicaid which have an impact of $3.7 billion on net federal spending over 10 years , including $26.7 billion in Medicaid investments, to make the program more flexible, efficient, and accountable. The Budget, as part of the Workforce Initiative, extends and refocuses the rate increase for Medicaid primary care providers. The Budget also extends free preventive care services to all Medicaid beneficiaries, creates a new state plan option to provide continuous Medicaid coverage and limit churning, expands access to home and community-based long-term care services and supports and provides permanent flexibility to facilitate enrollment of children into Medicaid.
CHIP: The Budget extends CHIP funding for four additional years, through 2019, to ensure continued comprehensive and affordable coverage for CHIP children. The proposal is paid for through an increase in tobacco taxes that will help reduce youth smoking and save lives. The Budget includes an additional $490 million in CHIP investments to permanently extend express lane eligibility.
Program Integrity: The Budget includes $201 million in new program integrity investments in FY 2016, as part of a multi-year strategy to enable HHS and the Department of Justice to detect, prevent, and prosecute health care fraud. Additionally, the Budget proposes $25 million in discretionary funding to support program integrity activities in private insurance, including the Health Insurance Marketplaces. These investments, plus new legislative authorities to strengthen program integrity oversight, yield $21.7 billion in savings over 10 years.
Discretionary Program Management: The Budget for Program Management enables reforms in health care delivery while supporting the ongoing administration of the Medicare, Medicaid, and CHIP programs, as well as the Health Insurance Marketplaces. The request invests of $36.2 million to address growing Medicare appeals workloads and $50 million for a multiyear process of removing Social Security Numbers from Medicare beneficiary identification cards.
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