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<title>About the Health Care Financing Administration (HCFA)</title>
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<a HREF="about.htm"><img SRC="/images/nbtm1.gif" border="0" ALT="About HCFA"></a><br>
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<td valign="top"><br>
<p align="center"><img SRC="../../images/infoclhs/icbanabt.gif" alt="About HCFA"
border="0"> <br>
7500 Security Boulevard, Baltimore, Maryland 21244, USA. <br>
Phone 410/786-3000</p>
<hr SIZE="2">
<p>Welcome to HCFA, the Health Care Financing Administration, which administers the
Medicare, Medicaid, and Child Health Insurance Programs. HCFA helps pay the medical bills
for more than 75 million beneficiaries. </p>
<hr SIZE="2">
<ul>
<li>HCFA at a Glance <ul>
<li><a HREF="#whatis">Description</a> of agency </li>
<li><a HREF="/pccdir/sp_final.htm">Strategic Plan</a> (also available in <a
HREF="/pccdir/sp_final.pdf">PDF</a> format) <br>
<a HREF="#Mission">Mission</a>, <a HREF="#Vision">Vision</a>, and <a HREF="#Goals">Goals</a>
</li>
</ul>
</li>
<li>Remarks by the Administrator/Deputy Administrator at the All-Staff Meetings on the
Strategic Plan <a href="/pccdir/remarks.htm">Remarks</a> (also available in )<a
href="/pccdir/remarks.pdf"> PDF format</a></li>
<li>HCFA's Central and Regional Leadership <a href="leader.htm">Leadership Listing</a></li>
<li>HCFA Employment <a href="employ.htm">Information</a> </li>
<li>HCFA Employee <a HREF="http://directory.psc.gov/employee.htm"> Phone Numbers</a>
</li>
<li>HCFA <a HREF="/about/alumnihp.htm">Alumni</a> Association <img
src="/images/animated/newbox.gif" border="0" alt="HCFA Alumni Association"> </li>
<li><a href="what.htm">What's New</a> </li>
</ul>
<hr>
<font color="#FF0000"><h2 align="center">HCFA At a Glance</font> </h2>
<a NAME="whatis"><p>The Health Care Financing Administration (HCFA) is a federal agency
within the U.S. Department of Health and Human Services. HCFA runs the Medicare and
Medicaid programs &#151; two national health care programs that benefit about 75 million
Americans. And with the Health Resources and Services Administration, HCFA runs the
Children&#146;s Health Insurance Program, a program that is expected to cover many of the
approximately 10 million uninsured children in the United States. </p>
<h2>Additional Responsibilities</h2>
<p>HCFA also regulates all laboratory testing (except research) performed on humans in the
United States. Approximately 158,000 laboratory entities fall within HCFA&#146;s
regulatory responsibility. And HCFA, with the Departments of Labor and Treasury, helps
millions of Americans and small companies get and keep health insurance coverage and helps
eliminate discrimination based on health status for people buying health insurance. </p>
<h2>Running the Programs</h2>
<p>HCFA spends over $360 billion a year buying health care services for beneficiaries of
Medicare, Medicaid and the Children&#146;s Health Insurance Program. HCFA: <ul>
<li>assures that the Medicaid, Medicare and Children&#146;s Health Insurance programs are
properly run by its contractors and state agencies; </li>
<li>establishes policies for paying health care providers; </li>
<li>conducts research on the effectiveness of various methods of health care management,
treatment, and financing; and </li>
<li>assesses the quality of health care facilities and services and taking enforcement
actions as appropriate. </li>
</ul>
<h2>Areas of Special Focus</h2>
<h3>Fighting Fraud and Abuse</h3>
<p>HCFA has a comprehensive program to combat fraud and abuse. Working with other federal
departments and state and local governments, HCFA takes strong enforcement action against
those who commit fraud and abuse, protects taxpayer dollars, and guarantees security for
the Medicare, Medicaid and Child Health programs. </p>
<h3>Quality Assessment and Performance Improvement</h3>
<p>HCFA is improving the quality of health care provided to Medicare, Medicaid and Child
Health Insurance Program beneficiaries. Quality improvement is based on: <ul>
<li>developing and enforcing standards through surveillance; </li>
<li>measuring and improving outcomes of care; </li>
<li>educating health care providers about quality improvement opportunities; and </li>
<li>educating beneficiaries to make good health care choices. </li>
</ul>
<h2>Agency </a><a href="leader.htm">Structure</a></h2>
<p>Agency staff working in the Baltimore, Maryland headquarters and in 10 regional offices
nationwide oversee HCFA programs. The headquarters staff are responsible for national
program direction. The regional office staff provide HCFA with the local presence
necessary for quality customer service and oversight. </p>
<p>A brief outline of the three major HCFA programs follows: </p>
<h2><strong>Medicare</strong></h2>
<h3>Who Qualifies?</h3>
<p>HCFA runs Medicare, the nation&#146;s largest health insurance program, covering over
38 million Americans at a cost of just under $200 billion. Medicare provides health
insurance to: <ul>
<li>people who are at least 65 years old; </li>
<li>people who are disabled; and </li>
<li>people with permanent kidney failure. </li>
</ul>
<h3>What are the benefits?</h3>
<p>Medicare has two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). </p>
<p>Medicare Part A helps pay for inpatient hospital services, skilled nursing facility
services, home health services, and hospice care. </p>
<p>Medicare Part B helps pay for doctor services, outpatient hospital services, medical
equipment and supplies, and other health services and supplies. </p>
<h3>Many Choices for Getting Benefits</h3>
<p>Many Medicare beneficiaries choose to enroll in managed care plans like Health
Maintenance Organizations (HMOs). They can get both Part A and Part B benefits in most
managed care plans. In addition to the typical HMO, other options are available, including
Preferred Provider Organizations. </p>
<p>Beginning in 1999, Medicare beneficiaries will have more choices. New choices include
HMOs with or without point-of-service options; provider sponsored organizations (closed
networks operated by providers); private fee-for-service plans; and medical savings
accounts. </p>
<h3>Where to Apply</h3>
<p>People who are already getting Social Security or Railroad Retirement benefits are
automatically enrolled when they become eligible for Medicare. Others must go to their <a
href="http://s3abaca.ssa.gov/pro/fol/fol-home.html">local Social Security office</a> and
apply. </p>
<h2>Medicaid</h2>
<p>Medicaid is a health insurance program for certain low-income people. It is funded and
administered through a state-federal partnership. Although there are broad federal
requirements for Medicaid, states have a wide degree of flexibility to design their
program. States have authority to: <ul>
<li>establish eligibility standards; </li>
<li>determine what benefits and services to cover; </li>
<li>set payment rates. </li>
</ul>
<h3>Who Qualifies?</h3>
<p>On any given day, there are about 33 million people who are eligible for Medicaid.
These people include: certain low-income families with children; aged, blind or disabled
people on Supplemental Security Income; certain low-income pregnant women and children;
and people who have very high medical bills. </p>
<h3>What are the Benefits?</h3>
<p>Because states have flexibility in structuring their Medicaid programs, there are
variations from state to state. All states, however, must cover these basic services:
inpatient and outpatient hospital services; laboratory and X-ray services, skilled nursing
and home health services, doctors&#146; services; family planning; and periodic health
checkups, diagnosis and treatment for children. </p>
<h3>Where to apply?</h3>
<p>People can generally apply for Medicaid at local welfare or social service offices.
Many states have now made it possible to apply in other locations, such as hospitals and
public health clinics, or in some cases by mail. </p>
<h2>Children&#146;s Health Insurance Program</h2>
<p>HCFA, along with the Health Resources and Services Administration, runs the
Children&#146;s Health Insurance Program. Program benefits became available October 1,
1997, and will provide $24 billion in federal matching funds over 5 years to help states
expand health care coverage to as many as 5 million of the nation&#146;s uninsured
children. </p>
<h3>Who Qualifies?</h3>
<p>States set eligibility and coverage, following broad federal guidelines. States also
have flexibility in the way they provide services. Recipients in all states must have low
incomes, be otherwise ineligible for Medicaid, and be uninsured. </p>
<h3>What are the Benefits?</h3>
<p>State programs differ, but all states must cover at least these services: inpatient and
outpatient hospital services, doctors&#146; surgical and medical services, laboratory and
X-ray services, and well baby/child care, including immunizations. Some states may provide
additional benefits. Benefits are not yet available in all States. </p>
<h3>Where to Apply?</h3>
<p>People can apply for Children&#146;s Health Insurance Program benefits at state welfare
offices, state public health departments, and state social service agencies. </p>
<p>See the <a HREF="http://www.hcfa.gov/facts/f9702b.htm">Fact Sheet</a> on HCFA for more
information.<br>
</p>
<hr>
<h3><a NAME="Mission">HCFA's Mission</a></h3>
<p>We assure health care security for beneficiaries. </p>
<h3><a NAME="Vision">HCFA's Vision</a></h3>
<p>In the stewardship of our programs, we lead the Nation's health care system toward
improved health for all. </p>
<h3><a NAME="Goals">Goals</a></h3>
<ul>
<li>Protect and improve beneficiary health and satisfaction. </li>
<li>Promote the fiscal integrity of HCFA programs. </li>
<li>Purchase the best value health care for beneficiaries. </li>
<li>Promote beneficiary and public understanding of HCFA and its programs. </li>
<li>Foster excellence in the design and administration of HCFA's proograms. </li>
<li>Provide leadership in the broader public interest to improve health. </li>
</ul>
<hr>
<p><br>
<a HREF="pubforms/pubforms.htm"><img SRC="/images/arrowbac.gif" alt="Return Arrow"
BORDER="0"> Return to Information Clearinghouse</a><br>
</p>
<p><font SIZE="-1">Last Updated April 12, 1999</font> </td>
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