No Confirmation Necessary: Berwick to Head CMS

WASHINGTON — Late Tuesday, the White House announced that
President Obama will use a recess appointment to put Dr. Donald
Berwick in the administrator’s seat at the Centers for Medicare and
Medicaid Services.

Obama nominated the Harvard professor and pediatrician for the
post in April, but in recent weeks, increasingly sharp attacks on
Berwick’s views over Medicare cost control had threatened to turn
his confirmation hearing into a replay of the health reform debate.
The recess appointment, good until the end of the 111th Congress,
will sidestep that battle, the Wall Street Journal
reported.

According to a blog posted by White House Communications
Director Dan Pfeiffer, “Many Republicans in Congress have made it
clear in recent weeks that they were going to stall the nomination
as long as they could, solely to score political points. But with
the agency facing new responsibilities to protect seniors’ care
under the Affordable Care Act, there’s no time to waste with
Washington game-playing.”

Pfeiffer said that’s why the president will install Berwick “at
the agency’s helm and provide strong leadership for the Medicare
program without delay.”

CMS has been without a permanent administrator for four years
since Mark McClellan, who served in the agency’s top post from
2004-2006, stepped down. McClellan supports Berwick for the job, as
do the AARP and the American Medical Association.

While there is scant information about his views on specific HME
issues, some industry associations believe Berwick could be
good for home
care.

Following Berwick’s nomination, the American Association for
Homecare’s Michael Reinemer, vice president of communications and
policy, pointed out that Berwick has at least seen home care up
close.

“Berwick personally witnessed problems related to the delay of
appropriate durable medical equipment and care when his own father
(also a physician) was recovering from a fall more than a dozen
years ago,” Reinemer noted. “He knows about the role of home care
in more than an academic sense.”

Reinemer characterized Berwick as an ardent advocate for quality
patient care who appreciates the inherent dangers of allowing
Medicare patients to slip through cracks in the system.

Wayne Stanfield called Berwick a true “policy person” who earned
a Masters in Public Policy (MPP) from Harvard’s John F. Kennedy
School of Government, in addition to a medical degree.

“I believe he will be good for home care and DME, and that he is
committed to care that is safe, effective, patient-centered,
timely, efficient, and equitable,” said Stanfield, president and
CEO of the National Association of Independent Medical Equipment
Suppliers. “He is committed to prevention, which will favor the
home care model.”

“There’s no question that Don Berwick is the right choice to be
our next CMS administrator,” Pfeiffer wrote.  ”He’s the
founder of the Institute for Healthcare Improvement and has spent
decades as a practicing physician and a Harvard professor. He’s
dedicated his career to finding ways to make our health care system
work better for patients and cost less for taxpayers.”

But some legislators see it differently.

As reported in Politico, Sen. Pat Roberts, R-Kan.,
said, “Once again, the Obama administration is going behind closed
doors out of fear the American people will learn that Dr. Berwick
plans to use rationing as a cost cutting tool to achieve the
billions of dollars in cuts to Medicare called for in the health
care reform bill.”

For more on Berwick’s background, see Obama to Nominate
Berwick as CMS Chief, March 29.