Nurses at The Centers for Medicare & Medicaid Services (CMS)

1. Nurses at The Centers for Medicare & Medicaid Services (CMS) Anitra Johnson, DHSc, RN CDR, USPHS Nurse Consultant May 3, 2013

2. Overview • CMS • Experiences at CMS • Current roles and responsibilities • Useful experience/education

3. CMS The Centers for Medicare & Medicaid Services is responsible for administration of several key federal health care programs. These programs include: • Medicare • Medicaid • Children’s Health Insurance Program (CHIP) • Health Insurance Portability and Accountability Act (HIPAA) • Clinical Laboratory Improvement Amendments (CLIA) For additional information please visit www.cms.gov

4. Experiences at CMS • Developed quality measures • Medicaid fraud, waste, and abuse • Ombudsman • Program of All Inclusive Care for the Elderly (PACE)

5. Experiences at CMS (cont’d) • PACE allows nursing home eligible beneficiaries to stay at home and receive comprehensive services and support • Services include: • Primary care • Home care • Physical, occupational, and recreational therapy • Meals and nutritional counseling • Social services • Transportation • Personal care and supportive services

6. Current Roles and Responsibilities • Lead Clinician for PACE • 92 PACE Organizations • Point of contact to all CMS staff, PACE Organizations, and State agencies • Provide consultative and authoritative advice to Agency officials and external stakeholder on clinical and quality improvement issues

7. Current Roles and Responsibilities (cont’d) • Promote collaboration and communication with key stakeholders, both internal and external to CMS • Responsible for writing technical guidance documents and revising federal regulations • Developing quality measures • Monitoring and auditing of PACE Organizations • Represent CMS at National conferences and programs

8. Useful Experience/Education • Preferred and required experience varies across the agency • Nurse Consultant and Health Insurance Specialist are generic titles at CMS • Education progression • Training and certifications

9. Contact Information Anitra Johnson, DHSc, RN CDR, USPHS Nurse Consultant Division of Medicare Advantage Operations (DMAO) 410-786-0609 anitra.johnson@cms.hhs.gov