CMS Chief Berwick Will Step Down; Deputy Named as Replacement
CMS Administrator Donald Berwick will step down on Dec. 2, and the Obama administration has nominated Marilyn Tavenner, CMS' principal deputy administrator, to replace him, the Washington Post reports (Kliff, Washington Post, 11/27).
Background on Berwick
Berwick has occupied the post since July 2010, when President Obama chose to sidestep the traditional confirmation process by using "recess appointment" procedures. As a recess appointee, Berwick had all the powers of a permanent appointee but could serve only until the end of 2011. At that point, he would have to have been re-nominated and confirmed by the Senate. The Obama administration re-nominated Berwick in January.
Berwick -- who served as president and CEO of the Institute for Health Care Improvement and was a Harvard University professor -- is best known for helping hospitals use standardized procedures to improve quality. Since Berwick's nomination was announced in April 2010, Republicans alleged that he supports rationing care and the socialization of the U.S. health care system and complained that they have had few opportunities to question him.
At a February House Ways and Means Committee hearing, Berwick denied supporting rationing and socialized medicine for the U.S. health system (California Healthline, 3/8). Still, more than 40 GOP senators last spring said the White House should withdraw its support and threatened to block Berwick's confirmation.
GOP Blames Obama Administration for Berwick's Difficulty
GOP senators are blaming the Obama administration for Berwick's brief and turbulent tenure, the New York Times reports.
Sen. John Barrasso (R-Wyo.) said, "Berwick came in under a cloud, and he is leaving under the same cloud, because of the way the president appointed him." He added, "It was a disservice to Berwick and to the American people for the president to make a recess appointment, rather than requiring Berwick to come before Congress to explain his opinions on Medicare, Medicaid and the new health care law."
Meanwhile, Sen. Orrin Hatch (R-Utah) said, "Any nominee to a federal agency with this much power and authority over the lives of millions of Americans must be carefully scrutinized."
According to the Times, Berwick's complicated relationship with Republican lawmakers compromised his ability to advocate to Congress the administration's health policy positions, which is a major aspect of the CMS administrator's job (Pear, New York Times, 11/23).
Tavenner Garners Praise From AHA, AAMC
Tavenner -- a trained nurse -- previously served as the secretary of Virginia's Health and Human Resources agency. She also was president of the Virginia Hospital Association and a board member of the American Hospital Association.
In a statement, White House officials said, "Before entering government services, Tavenner spent nearly 35 years working with health care providers in significantly increasing levels of responsibility, including almost 20 years in nursing, three years as a hospital CEO, and 10 years in various senior executive-level positions for Hospital Corporation of America" (Fox, National Journal, 11/23).
The nomination of Tavenner to replace Berwick has been lauded by the American Hospital Association and the Association of American Medical Colleges.
In addition, Berwick praised Tavenner. In an email to CMS staff, Berwick wrote, "You already know, as I do, that [Tavenner] shares deeply our commitment to the important work of CMS especially as we launch new programs that are transforming health and our health care system" (McKinney, Modern Healthcare, 11/23).
Confirmation Battle Expected
Tavenner also is expected to face a confirmation battle, Politico reports. Senate Republicans have not explicitly endorsed Tavenner. A Republican health lobbyist said, "I can't imagine a lot of support for her," adding that the high-profile CMS role "always gets sucked into the controversy of the day" (Feder/Haberkorn, Politico, 11/23).
However, Tavenner is expected to be confirmed, according to The Hill's "Healthwatch" (Pecquet, "Healthwatch," The Hill, 11/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.