Slavitt named second-in-command at CMS

Andrew Slavitt has huge responsibilities and challenges ahead as the new second-in-command at the CMS.

Slavitt, 47, was appointed last month by HHS Secretary Sylvia Mathews Burwell to succeed Jonathan Blum as the agency's principal deputy administrator. He oversees day-to-day decisionmaking regarding Obamacare implementation, Medicare, Medicaid, the Children's Health Insurance Program, payment and delivery reform, healthcare fraud and improving health outcomes.

Slavitt most recently worked as group executive vice president of Optum, owned by UnitedHealth Group. He was one of the executives helping with the so-called tech surge to fix HealthCare.gov when it was floundering last fall. Slavitt has an MBA from Harvard. He served as CEO at UnitedHealth's Ingenix unit before moving to Optum.

His appointment is part of Burwell's management restructuring at the CMS to create clearer lines of authority. Some observers said a lack of clear leadership contributed to the botched launch of the federal exchange and recommended creating a dedicated executive position for an exchange CEO.

Along with appointing Slavitt, Burwell announced her agency would be recruiting a CEO and chief technology officer to oversee the federal exchange. No hires have yet been made.

Critics say Slavitt has a conflict of interest since he's coming directly from UnitedHealth and Optum. HHS issued an ethics waiver July 11 for Slavitt, who will have to recuse himself from matters involving UnitedHealth, including contracts and analytics work from UnitedHealth subsidiary the Lewin Group. UnitedHealth operates a large Medicare Advantage program.

Sen. Chuck Grassley (R-Iowa) expressed skepticism about Slavitt's role. “Will the employee police himself, and if so, how are the recusals meaningful?” he said in a news release.

“If he's allowed to work too closely with the same firm that used to cut his paycheck, there are potential conflicts of interest,” wrote Michael Smallberg, an investigator for the Project on Government Oversight, in a blog post. “But if he has to recuse himself from too many agency decisions, it could limit his effectiveness as a public servant.”

Optum owns Quality Software Services, one of the contractors working on HealthCare.gov. Some experts say the firm's work on the data services hub and a registration tool called EIDM may have contributed to the website's problems.

Follow Paul Demko on Twitter: @MHPDemko