After helping usher in the biggest changes to the Medicare program in its 38-year history, CMS Administrator Thomas Scully says he will resign effective Dec. 15.
Scully insists that he behaved ethically and legally in entertaining calls from prospective employers, some of whom could have an interest in the final language of the Medicare reform bill, even while he was negotiating that legislation.
"There are rules that are out there. I followed them, at my initiation, from the first day," Scully told reporters today. "I've been told by our general counsel that I was a model citizen."
Scully took the helm of the agency formerly called the Health Care Financing Administration on March 22, 2001, and soon after adopted its new name, the Centers for Medicare and Medicaid Services.
He says he told HHS Secretary Tommy Thompson in May that he wanted to leave, but complied with Thompson's requests that he stay on until the Medicare legislation was resolved, which Scully says took longer than he expected. Scully says he received an ethics waiver from the general counsel at HHS allowing him to have discussions with firms considering employing him.
Scully did not initiate any of the calls, he says, and claims he did not have any discussions with the callers that had anything to do with the Medicare bill. He says he is not concerned about even the appearance of impropriety.
"I'm not worried about it. I know that I'm as straight as they come," Scully says. "I've followed the rules by the book."
Scully says he is proud of the work he has done on quality with programs for home health, nursing homes and hospitals.
"I hope I've worked to de-bureaucratize CMS, to make it a little better liked on the Hill and by the constituency we serve," he says.
As for his replacement, who will be responsible for implementing the changes wrought in the Medicare reform bill, Scully says "some have argued that someone who is not as big a target" and a "little more low-key" might have an easier time doing it. President Bush is expected to sign the bill, which passed both chambers of Congress late last month, on Dec. 8.
"I'm choosing to look at it as sign of respect that Congress decided not to split the agency and gave us $1 billion in new money to get going with reforms," he says. "It's a huge job, but I think it can be done."
Changes in the Medicare bill on average wholesale price (AWP), used by CMS to reimburse physicians for certain drugs administered in their offices, and general physician payment changes, already are in the works and should be implemented by Jan. 1, Scully says.
CMS says an acting administrator will be named prior to Dec. 15.
The office of Assistant Secretary of Defense for Health Affairs William Winkenwerder Jr., M.D., today had no comment about rumors that Winkenwerder is being considered among those who might replace Scully.