Medicare
Medicare is the federal health program primarily for people aged 65 and over and some younger people with disabilities, administered by CMS.
Who it serves
People aged 65+, and some younger people with qualifying disabilities or conditions.
Key points
What providers should know about Medicare.
Supporting Medicare providers
Keep Conditions of Participation evidence inspection-ready
Track quality and staffing signals tied to payment
Maintain a compliance audit trail across services
Sectors, agencies & frameworks
The care sectors, federal agencies and regulatory frameworks most connected to Medicare. Applicability varies by provider type, program and jurisdiction.
Regulatory frameworks
- CoPs — Federal standards providers must meet to participate in Medicare/Medicaid.
- Stark — Restrictions on physician referral relationships.
- AKS — Prohibits remuneration for referrals of federally funded care.
- FCA — Liability for false or fraudulent federal healthcare claims.
Many programmes — Medicaid and CHIP especially — vary state by state. CareFocusIQ is designed to reflect state licensing, staffing and programme requirements across all 50 states. Explore the 50-state directory for state-level intelligence.
Explore other federal programs
One platform, from federal program to the front line
CareFocusIQ connects agencies, programs, states and sectors into a single intelligent platform for US care.
CareFocusIQ provides technology and intelligence to support care operations and compliance. It is not a medical device and does not provide legal advice. Regulatory requirements vary by provider type, program and jurisdiction, and remain the responsibility of each provider.