Office of Clinical Standards and Quality

Patrick Conway, M.D., Director and Chief Medical Officer

Wesley Perich, Deputy Director

Shari Ling, M.D., Deputy Chief Medical Officer

Business Operations Staff - Rachael Weinstein, Director

Clinical Standards Group - John Thomas, Director
Division of Institutional Quality Standards - Lisa Parker, Director
Division of Non-Institutional Quality Standards - Maria Hammel, Director

Coverage & Analysis Group - Louis Jacques, M.D., Director
Division of Items and Devices - James Rollins, M.D., Director
Division of Medical & Surgical Services - Jyme Schafer, M.D.,  Director
Division of Operations & Information Management - Janet Brock, Director

Information System Group - Debbie Hattery, Director
Division of Quality Systems and Operations Support - Quentin Tyson, Director
Division of Quality Systems Engineering and Development - Michael Blake, Director
Division of Quality Program Management and Contract Administration - Ming Zhu, Director
Division of Quality Modeling and Requirements - Anne Weinstein Director

Quality Improvement Group - Jean Moody-Williams, Director
Division of ESRD, Population and Community Health - Teresa Casey, Director
Division of Beneficiary Healthcare Improvement and Safety - Vacant, Director
Division of Program Management, Communications and Evaluation - Alfreda Staton, Director
Division of  Value, Incentives and Quality Reporting - James Poyer, Director
 

Quality Measurement and Health Assessment Group - Michael Rapp, M.D., Director
Division of Chronic & Post Acute Care - Mary Pratt, Director
Division of Hospitals & Medication Measurement - Shaheen Halim, Director
Division of Ambulatory Care - Aucha Prachanronarong, Director
Division of Health Information Technology - Douglas Brown, Director
Division of Program and Measurement Support - Fatima Millar, Director

Survey and Certification Group - Thomas Hamilton, Director
Division of Acute Care Services - Marilyn Dahl, Director
Division of Laboratory Services - Judith Yost, Director
Division of Nursing Homes - Alice Bonner, Director
Division of Continuing Care Providers - Martin Kennedy

 

Functional Statement

  • Serves as the focal point for all quality, clinical, medical science issues, survey and certification, and policies for CMS' programs. Provides leadership and coordination for the development and implementation of a cohesive, CMS-wide approach to measuring and promoting quality and leads CMS' priority-setting process for clinical quality improvement. Coordinates quality-related activities with outside organizations. Monitors quality of Medicare, Medicaid, and the Clinical Laboratory and Improvement Amendments (CLIA). Evaluates the success of interventions.
  • Identifies and develops best practices and techniques in quality improvement; implementation of these techniques will be overseen by appropriate components. Develops and collaborates on demonstration projects to test and promote quality measurement and improvement.
  • Develops, tests, evaluates, adopts and supports performance measurement systems (i.e., quality measures) to evaluate care provided to CMS beneficiaries except for demonstration projects residing in other components.
  • Assures that CMS' quality-related activities (survey and certification, technical assistance, beneficiary information, payment policies and provider/plan incentives) are fully and effectively integrated. Carries out the Health Care Quality Improvement Program for the Medicare, Medicaid, and CLIA programs.
  • Oversees the planning, policy, coordination and implementation of the survey, certification and enforcement programs for all Medicare and Medicaid providers and suppliers, and for laboratories under the auspices of CLIA.
  • Serves as CMS' lead for management, oversight, budget, and performance issues relating to the survey and certification program and the related interactions with the States.
  • Leads in the specification and operational refinement of an integrated CMS quality information system, which includes tools for measuring the coordination of care between health care settings; analyzes data supplied by that system to identify opportunities to improve care and assess success of improvement interventions.
  • Develops requirements of participation for providers and plans in the Medicare, Medicaid, and CLIA programs. Revises requirements based on statutory change and input from other components.
  • Operates the Quality Improvement Organization and End-Stage Renal Disease Network program in conjunction with Regional Offices, providing policies and procedures, contract design, program coordination, and leadership in selected projects.
  • Identifies, prioritizes and develops content for clinical and health related aspects of CMS' Consumer Information Strategy; collaborates with other components to develop comparative provider and plan performance information for consumer choices.
  • Prepares the scientific, clinical, and procedural basis for coverage of new and established technologies and services and provides coverage recommendations to the CMS Administrator. Coordinates activities of CMS' Technology Advisory Committee and maintains liaison with other departmental components regarding the safety and effectiveness of technologies and services; prepares the scientific and clinical basis for, and recommends approaches to, quality related medical review activities of carriers and payment policies.
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