By: Taylor

Congress created Medicare in 1965 under Title XVIII of the Social Security Act. Medicare, at its inception was to provide health insurance coverage to any United States citizen over the age of 65, regardless of their medical history or income level. At that time, only half of older adults in the United States had health insurance and the other half found it unavailable, due to preexisting medical conditions, or insurance was just not affordable on their limited income. A little known fact is the creation of Medicare also came with a stipulation stating that any medical practice or facility must be completely desegregated in order to receive payment from Medicare. Thus Medicare played a key role in the desegregation of hospitals and doctorís offices.

Medicare Administration

The Centers for Medicare and Medicaid (CMS) administers Medicare. CMS falls under the Department of Health and Human Services. They also oversee the State Childrenís Health Insurance Program (CHIP) and the Clinical Laboratory Improvement Amendments. CMS, along with the Department of Labor and Treasury, also implement the insurance reform provisions of the Health Insurance Portability and Accountability Act of 1996 Ė otherwise known as HIPPA. The responsibility of determining a personís Medicare Eligibility and processing payments for the Medicare Program falls to the Social Security Administration.

Changes to Medicare over the Years

Since Medicare began in 1965, it has undergone several changes. Initially it consisted only of Part A (covers hospital and other inpatient services) and Part B (covers outpatient care, doctorís visits and other medically necessary services.

In 1972, Medicare was expanded to include benefits for chiropractic therapy, physical therapy and speech therapy as well as adding the option of payments to health maintenance organizations (HMOís). Additional changes made to Medicare in 1972 included eligibility to people under the age of 65 who were permanently disabled and receive Social Security Disability Insurance (SSDI) as well as patients who had end-stage rental disease.

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