Putting re­form to work

De­spite va­can­cies, CMS and HHS are ready

Modern Healthcare - - The Week In Healthcare - Matthew DoBias

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.

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