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Medicare administrator Donald Berwick resigns in the face of Republican opposition

Donald Berwick, right, Administrator of the Centers for Medicare and Medicaid Services speaks during a roundtable discussion about health care at Denver Health in Denver on Wednesday, June 22, 2011. U.S. Secretary of Health and Human Services Kathleen Sebelius looks on at left. (AP Photo/Ed Andrieski) (Ed Andrieski/AP)

President Obama’s top Medicare official has resigned in the face of Republican pledges to block his confirmation in the Senate.

Center for Medicare and Medicaid Services Administrator Donald M. Berwick notified colleagues Wednesday that he will step down Dec. 2, nearly a month before the expiration of his recess appointment.

The White House will nominate Marilyn Tavenner, Medicare’s deputy administrator, as his replacement.

“Don Berwick did outstanding work at CMS,” White House deputy press secretary Jamie Smith said Wednesday. “It’s unfortunate that a small group of senators obstructed his nomination, putting political interests above the best interests of the American people.”

Obama nominated Berwick to run Medicare in April 2010. In July 2010, with no confirmation hearing scheduled, the president appointed him to the job while Congress was in recess. As a recess appointment, Berwick’s term was to expire Dec. 31. Earlier this year, 42 Republican senators signed a letter pledging to block his confirmation, effectively ending any chance of him serving beyond 2011.

“It was a mistake to recess-appoint him,” said Sen. John Barrasso (R-Wyo.), who has been a vocal Berwick critic. “He was the wrong person for the job, and I think it was wrong of the president to make an end run around Congress.”

A Harvard-educated pediatrician, Berwick won accolades and the endorsements of major health-care groups for his academic work, which focused on reducing the cost of care while improving quality and patient experience.

Republicans, however, seized on remarks he made praising Britain’s National Health Service as an “example” for the United States to follow. Many accused him of supporting the “rationing” of services, a claim Berwick has rejected.

“Every bone in my body, as a physician, even as a person, is to get everything [patients] want and need and to help them at every step,” he told The Washington Post in an interview this summer. “I have gone to the mat to get a last-ditch bone marrow transplant for a child with leukemia . . . and they are telling me I'm rationing? They haven’t met me.”

In his 18-month tenure, Berwick oversaw the rollout of crucial health reform regulations that stand to reshape both the private insurance market and the Medicare program. His agency drafted rules for the new health insurance marketplaces, called exchanges, where Americans will be able to compare and buy health insurance plans in 2014.

Berwick also weathered an aggressive backlash to his draft rules for Accountable Care Organizations, a pilot program that is meant to move Medicare away from paying doctors for the volume of services they provide and toward reimbursements based on quality of care. Medical groups reacted much more positively to the final regulations for that program.

Republicans have responded cautiously to the White House’s nomination of Tavenner, a former nurse and hospital administrator who has served in the Obama administration since February 2010. She was Virginia’s secretary of health and human resources under then-Gov. Tim Kaine (D).

In announcing her nomination, the White House highlighted Tavenner’s nearly 35-year health-care career, “including almost 20 years in nursing, 3 years as a hospital CEO and 10 years in various senior executive level positions for Hospital Corporation of America.”

Sen. Orrin Hatch (R-Utah), ranking member of the Senate Finance Committee, said, “Republicans on the Finance Committee look forward to examining her record and gaining an understanding of her views of Medicare, Medicaid and the presi­dent’s health law.”



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