Which entity administers the Medicare and Medicaid laws outlined in the Social Security Act?

Study for the HCCA Certified in Healthcare Compliance (CHC) Exam. Practice with interactive questions and detailed explanations. Get ready to excel in your field!

The Centers for Medicare and Medicaid Services (CMS) is the entity primarily responsible for administering the Medicare and Medicaid programs as outlined in the Social Security Act. CMS oversees the implementation of these laws, ensuring compliance, managing enrollments, and overseeing the funding and operation of Medicare, which provides health coverage primarily for individuals aged 65 and older, and Medicaid, which offers assistance to low-income individuals and families.

CMS operates under the Department of Health and Human Services (HHS), which is a broader department responsible for public health, welfare programs, and various health-related initiatives. While HHS provides the overarching framework and support for health-related policies and programs, CMS specifically focuses on the day-to-day administration of Medicare and Medicaid, making it the correct choice.

The Office of Inspector General (OIG) plays a role in promoting efficiency and preventing fraud within these programs but does not administer them directly. Similarly, the Department of Justice (DOJ) may become involved in legal matters involving Medicare and Medicaid, particularly regarding enforcement against fraud and abuse, but it does not handle the administration of the programs themselves. Thus, CMS is clearly identified with the specific duties and roles associated with managing Medicare and Medicaid, directly tying it to the laws established in the Social Security Act

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