Putting reform to work
Despite vacancies, CMS and HHS are ready
With health reform legislation signed and official Washington in downshift mode, government agencies charged with implementing the complex new law are flexing their own muscles.
Purposely quiet for most of the reform debate, HHS and the CMS stole the spotlight away from Capitol Hill and even the White House, showing a readiness to usher in the sweeping changes despite being drastically shorthanded at some key positions.
“It’s quite clear that the ball has been passed to the executive branch,” said Bruce Fried, a partner in the Washington law office of Sonnenschein, Nath & Rosenthal. “They have all been trying to get ready for some time, but they’ve all suffered from, ‘When is this going to happen?’ ”
Over the past two weeks, HHS and the CMS have jointly issued new rules that govern how Medicare Advantage plans operate; named a number of new regional directors; took the first steps toward over- hauling the health insurance sector; doled out millions of dollars for new information technology programs (See story, p. 12) and debuted a revised payment structure for some states under Medicaid.
Several longtime health policy watchers described the series of moves as a signal that the handcuffs have finally been removed at the agency level.
Meanwhile, HHS Secretary Kathleen Sebelius spent alternate days on the campaign trail with lawmakers helping to sell the new law and delivering a key speech in Washington that laid out the main tenets of reform. “I’m convinced that the more Americans learn about this legislation, the more they’ll like it. But our work didn’t end when President Obama put down his pen,” Sebelius said. “In some ways, it has just begun.”
Edward Howard, executive vice president at the Washington-based Alliance for Health Reform, noted that the size and scope of the reform law far outpaces anything seen in a generation’s time. The overhaul package could cause a problem not just for HHS and the CMS, but also other agencies—like the Treasury and Labor departments that also will play a key role—especially in light of some high-level vacancies there. “They are obviously under some pressure to do a bunch of things fairly quickly,” Howard said.
Last week, HHS put out a call to fill as many as 1,200 positions. But it’s perhaps the highest profile job that is still unfilled that garners the most attention. President Barack Obama had
Sebelius has been working to sell the new law to the public.