Final answer:
The Centers for Medicare & Medicaid Services (CMS) is the administrative agency responsible for establishing rules for Medicare claims processing. They play a critical role in overseeing healthcare programs and implementing the ACA's cost-controlling regulations, including the adoption of electronic medical records.
Step-by-step explanation:
The administrative agency responsible for establishing rules for Medicare claims processing is known as the Centers for Medicare & Medicaid Services (CMS). CMS oversees various healthcare programs, including Medicare and Medicaid. Established via the Social Security Act of 1965, Medicare is a vital federal health insurance plan for individuals eligible for Social Security. The Patient Protection and Affordable Care Act (ACA or Obamacare) introduced regulations to help control increasing healthcare costs, including a cap on administrative expenses and a shift to electronic medical records (EMRs), to streamline the healthcare process and reduce administrative burdens.
Medicare itself includes multiple parts, such as Part A, which pays hospital charges and is funded by payroll deductions. Furthermore, Part B covers doctor services and is financed through premiums and general revenues. The program has adapted over time to changes in healthcare delivery and policy to ensure sustainable service provision.
Due to the ACA, healthcare providers are incentivized to transition to EMRs to reduce administrative costs and improve overall efficiency. With ongoing reforms and technological advancements, the role of CMS in regulating Medicare is crucial to maintaining the program's integrity and sustainability while ensuring that administrative costs do not detract from the quality of care provided to beneficiaries.