AHIP Practice Exam

The role of the Centers for Medicare and Medicaid Services (CMS) primarily involves administering the Medicare and Medicaid programs. CMS is a federal agency that oversees these essential health insurance programs, which provide coverage for millions of Americans, particularly those who are elderly, disabled, or low-income.

Through its administration of Medicare, CMS manages healthcare services for those aged 65 and older, as well as certain younger individuals with disabilities. In administering Medicaid, CMS ensures that low-income individuals and families receive necessary health care services, often in partnership with state governments. This involves establishing guidelines, monitoring compliance, and managing funding for both programs.

The other options present functions that do not accurately reflect the core responsibilities of CMS. For instance, while CMS may influence healthcare costs, it does not set premiums for all health insurance plans as this is determined by private insurers and varies significantly. Providing direct healthcare services is also not a role of CMS, as it focuses more on program oversight and operational management rather than being a healthcare provider. Lastly, while controlling pharmaceutical pricing relates to broader healthcare issues, it is not a specific function of CMS, which does not directly regulate drug prices but rather supports programs that can affect affordability and access to medications.