Erase any thought you had of Donald Berwick, MD, breezing through the Senate confirmation process and into a corner office at CMS HQ. He's received support from Democrats and medical associations, but Republicans are mounting opposition to his bid for CMS administrator. 

Sen. John Barrasso, MD, (R-Wyo.) took to the Senate floor April 21 and warned Americans that Dr. Berwick supports rationing patient care. "He has a history of support for government rationing of health care resources on the grounds of cost," said Sen. Barrasso, who is a trained orthopedic surgeon. "Not on the grounds of quality, not on the grounds of survivability but on the grounds of cost. And he has said, as recently as last June, ‘the decision is not whether or not we will ration care.' he said, ‘the decision is whether we will ration with our eyes open.' So here we are, the newly nominated person has said, I'm going into this to ration care." [emphasis mine, CF]

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A little known tweak to privacy rules will mean private practices get more unwanted publicity when they experience a HIPAA slip up.  

President Barack Obama nominated Donald Berwick, MD, of Massachusetts to be the next CMS administrator on April 19.

"Dr. Berwick has dedicated his career to improving outcomes for patients and providing better care at lower cost," Obama said in a statement from the White House. "That's one of the core missions facing our next CMS Administrator, and I'm confident that Don will be an outstanding leader for the agency and the millions of Americans it serves."

Dr. Berwick is president of the think tank the Institute for Healthcare Improvement and he is a professor at Harvard Medical School and the Harvard School of Public Health.

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It appears that almost no Part B claims wound up being processed at the reduced rate of -21%, even though Medicare contractors were technically supposed to begin processing claims at the lower rate on April 15. They had about one eight-hour business day to do so before Congress passed a pay-fix bill that reverses the cut effective to April 1 and lasting until May 31.

An amendment tacked on to a bill containing the 30-day doc fix would further delay the 21% cut to physician payments until June 1. The amendment passed the Senate by a 60-40 vote Wednesday, but the entire bill is still awaiting final passage.

Today, April 15, marks the day carriers will start processing Part B claims at reduced rates. The 21% cut was implemented April 1, but CMS demanded carriers hold Medicare claims for 10 business days -- thus buying Congress time to adopt a pay fix. 

Senate Majority Leader Harry Reid (D-Nev.) said Thursday morning he hoped to pass the bill by the close of business. The bill would then need to go back to the House of Representatives for approval before going to the president to be signed into law.

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