2010-07-07

President Barack Obama used a procedure known as a recess appointment to appoint Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS). The process means that Dr. Berwick, a pediatrician, Harvard University professor, and leader of a health-care nonprofit organization, can assume the post without being confirmed by the U.S. Senate, which is in recess for the July 4th holiday. He could serve through next year without Senate confirmation.

The President had nominated Dr. Berwick back in April, but no confirmation hearing had been scheduled. Use of the recess appointment means that the President bypassed opposition by Senate Republicans and a confirmation process that was expected to reopen the health-care debate. The President's appointment, however, has still received condemnation by Republicans even though this procedure has been used frequently by presidents of both political parties. In addition, the Republicans have criticized Dr. Berwick for a number of comments, including those supporting comparative effectiveness research.

The Medicare agency has been without an administrator since 2006, and the White House says the need to fill the post is critical because of its role in implementing the health reform law. Medicare is to be a key testing ground for numerous aspects of the new law, from developing new medical techniques to trying out new payment systems, and the White House says a permanent leader is key with deadlines approaching.

back to top