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Tag Archive | "CMS Administrator"

President to Nominate Marilyn Tavenner as CMS Administrator

Later today, the President is expected to nominate Marilyn Tavenner to succeed CMS Administrator Donald Berwick when his recess appointment expires on December 31, 2011. Marilyn Tavenner currently serves as the Principal Deputy Administrator and Chief Operating Officer of CMS. She will serve as Acting Administrator of CMS during her confirmation process.

Marilyn Tavenner was Secretary of the Virginia Health and Human Resources Department during Governor Tim Kaine’s (D) administration from 2006-2010. Previously, she was a nurse and an executive at the Hospital Corporation of America. She was Chairwoman of the Virginia Hospital Association and a trustee at the American Hospital Association.

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Capital Thinking Podcast

Congress Extends SGR Fix

The sustainable growth rate physician payment formula faced a roller coaster ride to the finish line. The Senate adjourned for spring recess without passing an extension of the Medicare physician fee fix to prevent a 21 percent payment cut from going into effect on April 1.  Upon return from recess, after much debate regarding the degree to which the legislation would increase the deficit, the Senate passed H.R. 4851 as amended by a vote of 59-38 to extend the physician fee fix through May 31. On April 15, the House agreed to the Senate-amended legislation by a vote of 289-112, and the President signed the bill into law.

The House and Senate are expected to use the “Tax Extenders Act of 2009” (H.R. 4213) as the basis for continuing negotiations about how to extend the physician fee fix and benefits through 2010. The House and Senate both passed different versions of the legislation earlier in the year, but several offsets were used in the newly enacted health care reform laws.

The American Medical Association has relayed to its membership its expectations that Congress will consider repealing the SGR formula later this year.  However, last October, the Senate failed to gain the support of 60 Senators to proceed to floor consideration of S. 1776, the “Medicare Physicians Fairness Act of 2009.”  The legislation would have frozen physician payments at a 0 percent update to prevent the 21 percent payment and sunset the SGR formula. While Senators largely agree that the sustainable growth rate, known as the SGR, is flawed and must be replaced, moderate Democrats and Republicans opposed the measure on the basis of the $245 billion price tag.

President Obama Nominates Donald Berwick as CMS Administrator

Last week, President Obama formally nominated Donald Berwick, a pediatrician and professor at Harvard University, to serve as the CMS Administrator. Dr. Berwick must be confirmed by the Senate.  As the Administrator, he would be responsible for overseeing the implementation of the Patient Protection and Affordable Care Act and the health-related provisions in the Reconciliation Act of 2010.

Dr. Berwick currently is a clinical professor of pediatrics and health policy at the Harvard Medical School and a professor in the Department of Health Policy and Management at the Harvard School of Public Health.

Dr. Berwick is considered a renowned expert in quality of care. In 1991, Dr. Berwick founded the Institute for Healthcare Improvement (IHI) to develop best practices. He led a “100,000 Lives” campaign to establish practices to reduce the number of deaths attributable to medical errors in hospitals. He previously served as Vice Chair of the U.S. Preventive Task Force, a member of the Board of Trustees of the American Hospital Association, Chair of the National Advisory Council of the Agency for Healthcare Research and Quality (AHRQ), and as a member of President Bill Clinton’s Advisory Commission on Consumer Protection and Quality in the Healthcare Industry.

Charlene Frizzera has served as Acting Administrator since President Obama took office in January 2009. She will continue to work in the Administrator’s Office to assist with the implementation of health care reform. CMS has not had a permanent Administrator since October 2006.

CMS Principal Deputy and Chief Operating Officer, Marilyn Tavenner, relayed to staff that the reorganization of the Agency announced in February is effective. The goal of the reorganization is to focus on beneficiary services, program integrity, and strategic planning.  Principal Deputy Tavenner also announced that Caya Lewis, currently serving in the HHS Office of Health Reform and a former Senator Ted Kennedy staffer, will join CMS as the Chief of Staff.

Senate Considers FY2011 Budget Resolution

The President’s push to complete work on health care reform legislation consumed Congress during the first quarter of the year.  However, Congress must now turn its attention to preparing the Fiscal Year (FY) 2011 budget resolution. In accordance with the 1985 Balanced Budget Act, Congress is required to adopt a Budget Resolution by April 15. The Act also requires the Senate Budget Committee to report a Budget Resolution by April 1. Senate Budget Committee Chairman Kent Conrad (D-ND) began mark up a resolution during last week. The Chairman’s mark would reduce the deficit by $2 billion over FYs 2010-2015 and includes a reserve fund to improve health care, which could be used to increase physician payment rates under Medicare, address health care workforce shortages, increase or repeal Medicare outpatient therapy caps, extend expiring Medicare and Medicaid provisions. The FY 2011 budget resolution will establish budgetary targets that will help to shape spending bills for the Fiscal Year.

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Capital Thinking Podcast

CT_radio1 With great fanfare, President Obama signed into law the Patient Protection and Affordable Care Act last Tuesday. By a vote of 56-43, the Senate passed an amended version of H.R. 4872, the Reconciliation Bill of 2010 last Thursday. Sens. Lincoln, Pryor, and Ben Nelson joined Republicans in voting against the legislation. Later that evening, by a vote of 220-207, the House passed the amended Reconciliation bill. The bill now goes to President Obama for his signature.

The passage of the Patient Protection and Affordable Care Act and the Reconciliation Bill of 2010 brings to a close the legislative work on comprehensive health care reform that began in November 2008 when Senate Finance Committee Chairman Max Baucus released his “Call to Action” white paper on health care reform.

House and Senate Republicans have already introduced legislation to amend the Patient Protection and Affordable Care Act to require the President, Vice President, Members of Congress and their staff to purchase health care insurance through the Exchange. At least four other pieces of legislation that amend the health care reform law have been introduced, and we expect that Republicans, in particular, will continue to seek changes through legislative action. Republicans are also expected to mount challenges to reform by opposing funding for the newly authorized entities and programs in the Fiscal Year 2011 appropriations bills. Congress will at some point certainly consider technical, if not policy, changes to the newly enacted legislation.

The challenges of implementation now loom large. For example, the Department of Health and Human Services must develop a number of new insurance regulations. The government will also establish a temporary risk-pool for uninsured individuals who have pre-existing conditions and create the health care exchanges in 2014.

The buzz about a Presidential nomination for the Center for Medicare and Medicaid Services Administrator were kicked up again late last week. It is thought that the President could nominate Donald Berwick, a pediatrician and professor at Harvard University, as early as sometime this week. A CMS official has acknowledged that Dr. Berwick has been under consideration for the position, which would require confirmation by the Senate. Charlene Frizzera has served as Acting Administrator since President Obama took office in January 2009.

The Senate adjourned for recess without passing an extension of the Medicare physician fee fix to prevent a 21 percent payment cut from going into effect on April 1. Earlier this month, the House passed the Continuing Extension Act of 2010 to extend the physician fee fix through April 30. The Senate attempted to pass the legislation by unanimous consent, but Senator Tom Coburn of Oklahoma objected. He opposed consideration of the legislation on the basis that the bill is not paid for and would increase the deficit by $9.2 billion. We expect that CMS will issue a notice this week instructing Medicare physicians to hold their claims for some time.

While many are breathing a sigh of relief that the debate on health care reform legislation is done, the difficult work of implementation is just about to begin.

Following House passage of the Senate health care reform legislation, Representative Nathan Deal resigned so he can focus on the Georgia’s governor’s race. Representative John Shimkus of Illinois has been tapped as the new House Energy and Commerce Health Subcommittee Chairman.

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