Payment, Billing Issues Await Bush Nominee for Medicare Chief
Kerry Weems, President Bush's nominee for CMS administrator, "will find a full plate of issues waiting for him" if he is confirmed by Congress in the coming months, The Hill reports. Weems currently is the deputy chief of staff for HHS Secretary Mike Leavitt.
Weems likely would "be at the center" of a political debate over Medicare in which a Democratic-led Congress has favored changes to the Medicare prescription drug benefit and limits on the expansion of Medicare Advantage, The Hill reports.
If confirmed, Weems also will be responsible for setting next year's payment rate for hospital services under the inpatient prospective payment system. CMS recently has proposed expanding the number of billing codes of hospital services in order to more accurately direct payments for severely ill patients.
The agency anticipates that hospitals will respond by "upcoding" to maximize their payments, so it is seeking cuts to compensate.
CMS also is developing new payment policies for post-acute care provided at nursing homes, long-term care facilities and inpatient rehabilitation facilities. In addition, CMS soon will begin accepting new bids from health insurers for contracts to administer the payments it makes to providers under traditional Medicare.
Alissa Fox, vice president of legislative and regulatory policy at the BlueCross BlueShield Association, said that BCBS plans historically have assumed this responsibility, but the agency is seeking to consolidate the 50 companies currently under contract to about 15.
Other issues on CMS' agenda include expanding the use of health care information technology and improving access to information on the price and quality of medical services -- initiatives long supported by Leavitt and the Bush administration, according to The Hill.
Health care industry groups "are not expecting Weems to unveil large initiatives but instead to carry out the implementation and management of Bush administration priorities already under way," The Hill reports.
American Hospital Association Executive Vice President Rick Pollack said, "The opportunities to really do something new and bold are going to be limited." He added, "As a practical matter, how many months (in this administration) are really left?"
Scott Whitaker, the chief operating officer of the Biotechnology Industry Organization who has worked with Weems in the past, said the nominee "knows the issues very well, he knows the department very well, he knows the agency very well" (Young, The Hill, 5/18).