It's been a dramatic time recently at HHS. Usually we expect such upheaval from activist Democrats, but now it's Republicans causing all the fuss.
And no, I am not referring to a Medicare drug benefit, the SARS scare or bioterrorism. I am talking human interest here, folks. HHS Secretary Tommy Thompson, himself a sort of colorful character, has been overshadowed of late by his staff, which is either deserting him amid the department's most ambitious projects or landing it in court over allegations of sole-source contracting and vengeful investigations.
The most prominent of the HHS humans in the news has been Tom Scully, the increasingly irascible administrator of the Centers for Medicare and Medicaid Services. After dueling with Chuck Grassley, the powerful Iowa Republican senator, over a lack of fraud enforcement efforts, Scully now finds himself in an imbroglio of his own making over-of all things-a CMS patient-satisfaction survey.
As our Jeff Tieman has been reporting, the Gallup Organization complained that the survey, which the CMS is developing for a Medicare regulation it plans to issue later this year for hospitals, uses the same eight standards and nomenclature of the survey firm National Research Corp. In March, Bob Nielsen, Gallup's managing partner for healthcare programs, complained to the administration that statements made by NRC left the impression that the company would be handling the CMS survey without any bidding having taken place. In an e-mail to the White House Office of Management and Budget, Nielsen sought to cut off funding for the survey and called for a "thorough investigation" of the alleged CMS-NRC deal.
In response, Scully dashed off an electronic hissy fit, calling Nielsen "out of line-and out of your mind," as well as a "weasel" and a "jerk." Referring to Nielsen, Scully told the OMB officials that he'd "like to investigate this idiot."
The usual response in such affairs ensued, with Gallup suing the CMS, claiming intimidation and demanding a federal court injunction to cease and desist, etc.
Scully, usually a straight shooter, seems to be truly indignant about the Gallup charges of collusion. Unfortunately for him, the case has caught the attention of Billy Tauzin, the equally irascible Louisiana Republican and House Energy and Commerce Committee chairman, who has called Scully on the carpet on this one. We now know this survey deal will be closely monitored.
Meanwhile, Scully's main deputy, Ruben King-Shaw Jr., resigned earlier this month, making him only the latest in a string of high-profile departures during Thompson's two-year tenure. King-Shaw and Thompson's main deputy, Bobby Jindal, departed for professional reasons, but both left just as the policy work they were doing was nearing fruition.
As any reader of this magazine knows, Thompson's gun-toting inspector general, Janet Rehnquist, also left, but not until she had run out of the office a cadre of career investigators and found herself the subject of Grassley's investigative ire for failing to do her job.
Is there a common theme in all of this? I'm not sure. From a journalistic viewpoint, the Thompson-Scully tenure has been quite rewarding. From a governmental perspective, it has been tumultuous. If they have their legacy in mind, now may be the time to actually accomplish some of their major policy goals. After all, in this magazine's survey they were the two "most powerful people in healthcare" (Aug. 26, 2002, p. 6). With all that power, they should be able to do more than generate reams of interesting news copy.
What do you think? Write us with your comments. Via e-mail, it's [email protected]; by fax, dial 312-280-3183.