Any individual or organization, public or private, with whom the Centers for Medicare and Medicaid Services (CMS) has a contractual arrangement to contribute to or participate in the Medicare survey and certification process. The state survey agency is the most common example of a CMS agent as established through the partnership role that the state agency (SA) plays in the survey process under the provisions of §1864 of the Act. A private physician serving a contractual consultant role with the SA or CMS regional office as part of a survey and certification activity is another example of a CMS agent.