The Social Security Act established the Medicare Board of Trustees to oversee the financial operations of the HI and SMI trust funds. The Board has six members. Four members serve by virtue of their positions in the Federal Government: the Secretary of the Treasury, who is the Managing Trustee; the Secretary of Labor; the Secretary of Health and Human Services; and the Commissioner of Social Security. Two other members are public representatives whom the President appoints and the Senate confirms. These positions are currently vacant. The Administrator of the Centers for Medicare & Medicaid Services (CMS) serves as Secretary of the Board.