CMS Leadership

Office of Financial Management

Megan Worstell

Director & CMS Chief Financial Officer

Megan Worstell is the Director of the Office of Financial Management (OFM). As one of CMS’s senior financial management executives, she is accountable and responsible for planning, directing, analyzing and coordinating the Agency’s comprehensive financial management functions, including the release of the CMS Annual Financial Report and the CMS Budget to Congress. Megan also helps lead the implementation of all CMS financial management systems, debt collection activities, travel, error rate measurement, and other financial management functions.

Megan served as the Acting Chief Financial Officer (CFO) and Acting Director of OFM from May 2015 – August 2016. During her tenure, CMS achieved its 17th consecutive unqualified audit opinion for the 2015 CFO Audit. CMS implemented Phase 1 of the Enterprise Contract Initiative to achieve a risk based approach to better align the Marketplace contracting vehicles with the program requirements, better manage cost overruns, and reduce contract costs by $40-$50 million. Megan has also served as the Director of the Budget and Analysis Group (BAG) for over four years. BAG is responsible for formulating and executing the entire budget for CMS consisting of close to $1 trillion in outlays every year and served as the Agency liaison with the Appropriations Committees. Megan also served as the Deputy Director of BAG.

Megan graduated with honors with a Bachelor of Arts degree in Elementary Education from Flagler College.


Larry Young

Deputy Director

Larry Young is the Deputy Director of the Office of Financial Management (OFM). Working in concert with the Director of OFM, he is accountable and responsible for planning, directing, analyzing and coordinating the Agency’s comprehensive financial management functions, including the CMS Budget to Congress.  Larry also helps lead the implementation of all CMS financial management systems, debt collection activities, travel, error rate measurement, and other financial management functions.  

Prior to joining OFM in the fall of 2023, Larry was the Director of the Medicare Contractor Management Group in the Center for Medicare. In this role, held permanently since November 2014, he provided executive leadership and direction ensuring continuity of operations for overall Medicare fee-for-service (FFS) operations which served over 33 million beneficiaries.  His primary responsibilities were focused on the procurement, management, coordination, and oversight of 16 Medicare Administrative Contracts (MACs) with contract values that exceed $11.1 billion and which employed approximately 9,000 employees across the country forming the backbone of the traditional FFS Medicare program. The MACs are responsible for a myriad of different administrative functions including claim payment, financial management, provider enrollment, appeal adjudication, provider education, provider call center, medical review, and provider audit and reimbursement.  The most critical MAC function is comprised of processing about 1.1 billion claims and paying out over $440 billion in claim benefits annually to over 1.7 million Medicare providers of service nationwide, including hospitals and other institutional facilities, physicians, non-physician practitioners, and durable medical equipment suppliers.  

Larry joined the then designated HCFA Dallas Regional Office under the Outstanding Scholar program in 1988, working on different assignments in operations, policy, program integrity, managed care, and contracting in CMS, and at a Medicare claims processing contractor. After a brief three-year stint as a Medicare Compliance Officer for Kaiser Permanente, he returned to CMS in the fall of 1999 where he has held positions of increasing scope and responsibility, providing critical contributions to the MAC program and operational environment of the FFS Medicare program. Larry holds a B.A. from Austin College and M.A. from T.C.U.




OFM Functional Statement

  • Serves as the Chief Financial Officer and Comptroller for the Centers for Medicare & Medicaid Services (CMS).  Manages the preparation and audit of CMS financial statements, and issues the annual Agency Financial Report, in accordance with the requirements of the Chief Financial Officers (CFO) Act.
  • Formulates, presents and executes all CMS budget accounts, develops outlay plans and tracks contract and grant award amounts; acts as liaison with the Congressional Budget Office (CBO) on budget estimates; reviews demonstration waivers (except 1115) for revenue neutrality.  Is responsible for ensuring that the budget is formulated in accordance with CMS' strategic plan and the Government Performance and Results Act (GPRA) goals and performance measures.
  • Acts as liaison to the Department of Health and Human Services (HHS), Assistant Secretary for Financial Resources, Office of Management and Budget (OMB), and the Congressional appropriations committees for all matters concerning CMS' operating budget.
  • Manages the Medicare financial management system, the Medicare contractors' budget, Quality Improvement Organizations' budgets, research budgets, managed care payments, the issuance of State Medicaid grants, and the funding of the State survey certification and the Clinical Laboratory and Improvement Act programs.  Is responsible for all CMS disbursements.
  • Maintains CMS financial data and prepares external reports to other agencies such as HHS, Treasury, OMB, Internal Revenue Service, General Services Administration, related to CMS' obligations, expenditures, prompt payment activities, debt and cash management, and other administrative functions.
  • Performs cash management activities and establishes and maintains systems to control the obligation of funds and ensure that the Anti-Deficiency Act is not violated.
  • Manages the Medicare Secondary Payer Program and Medicare Debt Resolution activities.
  • Develops CMS policies governing both Medicare Secondary Payer and Medicaid Third Party Liability.
  • Oversees the Medicare fee-for-service and the Medicaid and the Children's Health Insurance Program improper payment measurement programs to measure payment accuracy.
  • Develops and publishes the Medicare Fee-For-Service, Medicaid, and Children's Health Insurance Error Rate.  Develops improper payment measurement methodologies to report related Marketplaces and related programs.
  • Manages, develops, and enhances CMS' core financial management system, the Healthcare Integrated General Ledger Accounting System (HIGLAS), which tracks the financial activity and transactions of all CMS' programs.
  • Manages the development to maintain information technology program systems that support accounting operations, for the Medicare Benefits, Medicare Secondary Payer (MSP), Marketplace, Medicaid, Children Health Insurance Program (CHIP) Grants, and Administrative Program Accounting (APA) lines of business.
  • Coordinates the development and monitoring of all audit corrective action plans (CAPs) and the Office of the Inspector General (OIG) clearance documents that address each OIG and the Government Accountability Office agreed upon recommendations.
  • Develops an enterprise risk assessment program to better support CMS programs.
  • Works collaboratively with components and contracting officials to review contract language and contract cost estimates in order to develop contract-specific performance and financial information.
  • Coordinates performance management and promotes the use of Agency performance measures to foster a more results-orientated performance culture through CMS.
  • Ensures compliance with a number of agency performance requirements such as the Government Performance and Results Act of 1983 (GPRA) and the GPRA Modernization Act, OMB program analysis and the Department strategic plan priorities.
Page Last Modified:
04/24/2024 02:28 PM