Medicare is a national government-sponsored health insurance program in the United States of America. On July 30, 1965, President Lyndon B. Johnson signed Medicare into law in Independence, Missouri. Medicare offers health insurance for Americans aged 65 and older. It also provides health insurance to younger people with disabilities, end-stage renal disease, and ALS. Medicare is the primary insurer for 54 million Americans. Medicare is a single-payer health care program, covering all eligible beneficiaries under a single, publicly financed insurance plan. Government spending on Medicare in 2013 was $583 billion, or 14 percent of the federal budget (Centers for Medicare and Medicaid Services, 2014).
Hospitals, healthcare providers, and suppliers participating in the Medicare program must meet minimum health and safety standards. The standards are defined in the Code of Federal Regulations, Title 42. The Centers for Medicare & Medicaid Services (CMS) defines Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) that set the standards that health care organizations must meet to begin, and continue participating in Medicare. CMS currently has approved seven accrediting organizations that can accredit a heath care organization as having “deemed status”. The national accrediting organization surveys a health care organization and certifies that they satisfy the health and safety standards component of the Medicare certification (Centers for Medicare & Medicaid Services, 2015).
The State Survey Agency (SA) does not routinely conduct a certification survey for survey a health care facility that has established accreditation from an Accrediting Organization, and received the “deemed status”. These facilities are overseen by the Accrediting Organization, instead, which ensures compliance with the specific Medicare CoPs and CfCs. However, CMS can direct the