Donald Berwick is many things: a Harvard-trained pediatrician, a former professor of health policy and management at that same university, a co-founder of the Institute for Healthcare Improvement. But GOP members of Congress still are eager to point out one thing he’s not: confirmed by the U.S. Senate to serve in his current role as CMS administrator.
CMS head faces off against GOP at first hearing
That issue came up repeatedly in Berwick’s first congressional committee appearance, when he testified before the influential Senate Finance Committee on Nov. 17. Ranking Member Chuck Grassley (R-Iowa) noted that the CMS has more than 4,400 employees and an annual budget of more than $700 billion—which is larger than the Pentagon’s—and that Berwick has one of the most important jobs in government today. The fact that Berwick was recess-appointed without a hearing, Grassley said, “contradicts promises made by candidate Obama about having the most open and transparent administration in history.”
President Barack Obama appointed Berwick to become CMS administrator in July while Congress was in recess, so he never had a formal hearing and was not confirmed.
Grassley also asked Berwick a question about the senator’s request in August for the three most recent 990 forms from the IHI, which Berwick co-founded in 1989. Berwick responded that he had tried to provide all the information requested, but that it was not entirely in his authority to do so. However, Berwick said, all of his previous activities—financial and otherwise—were reviewed, and he was in full compliance before being named to the position.
Berwick’s brief opening remarks and written testimony for the record focused more on ways to improve the Medicare and Medicaid programs, such as moving away from a fragmented healthcare system to a coordinated model that includes accountable care organizations, medical homes and bundled payments. He also discussed the benefits of this year’s Patient Protection and Affordable Care Act.
“The new law strengthens our ability to measure quality and to use good market forces on behalf of beneficiaries to find them the best possible deals on health plans and supplies and with medicines,” said Berwick, who also noted that millions have benefited since the Affordable Care Act was enacted, including nearly 2 million seniors in the “doughnut hole” who have received checks to help with prescription drugs and who next year will see a 50% discount on those payments.
Because of a pending Senate vote, Grassley requested another hearing so the senators had more time to ask their questions. Senate Finance Committee Chairman Max Baucus (D-Mont.) did not specify a date, but said later, “We will have sufficient hearings.”
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