Obama Nominates Donald Berwick To Be Next Administrator of CMS

President Obama April 19 nominated Harvard professor Donald Berwick to be the next administrator of the Centers for Medicare & Medicaid Services, a post that has been vacant since late 2006. Berwick is a clinical professor of pediatrics and health care policy at the Harvard Medical School and the Harvard School of Public Health. He is also president and chief executive officer of the Institute for Healthcare Improvement, a Cambridge, Massachusetts-based not-for-profit organization that promotes the improvement of health care.

CMS has been without a permanent administrator since October 2006 when Mark McClellan left the agency. Kerry N. Weems served as acting CMS administrator from 2007 until the end of the Bush administration. Charlene Frizzera is currently the agency's acting administrator.

Berwick, whose name surfaced several months ago as a possible nominee for the post, must be approved by the Senate Finance Committee and the entire Senate before beginning his job.

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CMS Initial Medicaid Guidance on Section 2001 of Health Care Law Establishing New Eligibility Group (April 9, 2010)

CMS released initial Medicaid guidance on Section 2001 of Health Care Law Establishing New Eligibility Group. To view the document click here.

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Harvard Professor to Be Named CMS Head

Donald M. Berwick, a professor at the Harvard School of Public Health, is expected to named head of the Centers for Medicare & Medicaid Services. The announcement is expected during the congressional two-week April recess that begins on March 29.

Berwick is a clinical professor of pediatrics and health care policy at the Harvard Medical School and the Harvard School of Public Health, according to the school. He is also president and chief executive officer of the Institute for Healthcare Improvement, a Cambridge, Mass.-based, a not-for-profit organization that promotes the improvement of health care.

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CMS Issues Clarifying Letter on Ticket to Work Outcome and Milestone Payments to Employment Networks

On Thursday, January 28th, CMS issued a letter to State Medicaid Directors clarifying that Ticket Outcome and Milestone payments to Employment Networks (ENs) under the Ticket to Work program do not conflict with regulatory requirements and do not constitute an overpayment of Federal dollars for services provided because EN payments are payment for an outcome, rather than for a Medicaid service rendered. The letter indicates that State agencies and/or providers interested in participating in the Ticket to Work program as ENs are encouraged to do so.

We know that many organizations have been waiting for this policy clarification in order to make the final decision to become an EN or, if already an EN, to accept Ticket assignments and receive payments. To obtain the EN RFP, visit: http://www.ssa.gov/work/enrfp.html. For assistance with completing the application to become an EN, please contact a CESSI Account Manager at 1-877-743-8237 (v/tty) or visit www.cessi.net/ttw. Existing ENs should contact MAXIMUS at 1-866-949-ENVR (3687) or 1-866-833-2967 (tty) with any questions.

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HHS Delegates Authority for the HIPAA Security Rule to Office for Civil Rights

HHS Secretary Kathleen Sebelius announced that the Office for Civil Rights (OCR) will take over from the Centers for Medicare & Medicaid Services (CMS) authority for the administration and enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The switch is to eliminate duplication and increase efficiency in how health information privacy is protected. Read more!

CMS Places Moratorium on Alaska Waiver Services

CMS issued Tuesday a moratorium on all new Medicaid waiver services in Alaska, effective immediately, and putting services on hold for over 1000 individuals.
A CMS team spent a week in a “focused site visit” reviewing implications of a an assessment backlog of about 2000 people waiting for service. CMS left the site visit instructing Alaska to immediately address the backlog and other issues of non-compliance and followed with a written report reiterating those instructions and additional corrective action, including the moratorium on new admissions or enrollments into Alaska’s four HCBS waiver programs. Alaska must now send a detailed report to CMS by September 1st. According to the Anchorage Daily News, the moratorium is expected to last four or five months. Thank you to Emily Ennis, Executive Director of Fairbanks Resource Agency for providing additional information on this issue. Read more!

CMS June 17th Letter to Medicaid Directors Summarizing ARRA

This letter is one of a series designed to provide guidance on the implementation of the American Recovery and Reinvestment Act of 2009 (ARRA), Public Law 111-5. It summarizes most sections of ARRA that impact titles XIX (the Medicaid program) and XXI (the Children’s Health Insurance Program, or CHIP) of the Social Security Act (the Act) and provides detail on the sections specific to payments that should not be counted for purposes of eligibility for Federal programs. This letter includes information on the FMAP and disregard of one-time only SSI $250 check for purposes of all federally funded programs. Read more!

President Proclaims Year of Community Living

Marking the 10th Anniversary of the U.S. Supreme Court’s Olmstead decision, President Obama launched a new effort to assist Americans with disabilities—The Year of Community Living. The President directed Health and Human Services Secretary Kathleen Sebelius and Housing and Urban Development Secretary Shaun Donovan to work together to identify ways to improve access to housing, community supports, and independent living arrangements. In joining the President in commemorating the anniversary of the Olmstead decision, HHS Secretary Sebelius announced that agencies within her department would begin aggressively addressing barriers that prevent some Americans with disabilities from enjoying a meaningful life as part of their community.

Throughout this “Year of Community Living,” HHS will hold listening sessions, giving stakeholders an opportunity to come together for a common purpose: overcoming barriers to community-based living for people with disabilities and the elderly. These forums will help HHS craft the agenda to improve federal programs and better support the efforts of state and local government.

HUD announced that it will make1,000 housing vouchers available for individuals with disabilities transitioning from institutions to the community—targeting states operating Money Follows the Person Demonstration programs. HUD will award an additional 3,000 housing vouchers to serve non-elderly people with disabilities and encourage Public Housing Authorities to form working relationships with state Medicaid agencies interested in addressing community living needs of beneficiaries.
See the next issue of LINKs for more information. Read more!

Secretary Sebelius Announces Appointment of Cindy Mann as Director of the Center for Medicaid and State Operations

U. S. Health and Human Services Secretary Kathleen Sebelius today announced the appointment of Cindy Mann to serve as Director of the Center for Medicaid and State Operations (CMSO), part of the Centers for Medicare & Medicaid Services (CMS). Mann most recently served as a research professor and executive director of the Center for Children and Families at Georgetown University's Health Policy Institute. "Cindy Mann has decades of experience in health care financing at the federal and state level, and vast knowledge of health care policy," said Secretary Sebelius. "She has devoted her career to working on behalf of children and families, the elderly and people with disabilities. She will be an outstanding leader at CMSO, particularly as the nation moves forward with health care reform."

Mann previously served as director of the Family and Children's Health Programs at CMSO from 1999-2001; in that capacity she played a key role in implementing Medicaid and the Children's Health Insurance Program (CHIP).

"Cindy has been instrumental in recent efforts to expand health care coverage in our country," said Sebelius. "Her knowledge of health care issues and management experience will be a great asset to CMSO and to the millions of Americans who rely on Medicaid."

A brief biography is included below:

Cindy Mann, J.D., is a research professor at Georgetown University, Health Policy Institute and the executive director of the Center for Children and Families at the Institute. Her work focuses on health coverage, financing, and access issues affecting low-income populations.
She has written extensively on these issues -- and on how they relate to the Medicaid and CHIP, in particular -- and has worked closely with state and federal policymakers and program administrators on the design and implementation of Medicaid and CHIP. From 1999-2001, Ms. Mann was the director of the Family and Children's Health Program Group at the Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services. In that capacity, she directed, at the federal level, the implementation and oversight of the Medicaid program with respect to families, children, and pregnant women, and oversaw the implementation of CHIP. Prior to her work at HCFA, Ms. Mann led the Center on Budget and Policy Priorities' federal and state health policy work. She also has extensive state-level experience, having worked on health care, welfare, and public finance issues in Massachusetts, Rhode Island, and New York. She holds a law degree from New York University School of Law.

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Three CMS Regs Rescinded--with Partial Rescission of Targeted Case Management

HHS Published a notice in the Federal Register May 6 rescinding the outpatient and school-based health regulations and partially rescinding the targeted case management regulation. The provider tax regulation is being delayed for one year while more information is gathered. Read more!

CMS Issues Letter on Implementation of New SCHIP Law

The purpose of the letter, released by CMS on April 17, is to give an overview of the new SCHIP law passed in February 2009. Included in the letter are summaries of key provisions related to funding, eligibility and rates. CMS will release more detailed guidance letters in the coming months. Read more!

HHS Names Henry Claypool as Director of Office on Disability

Henry Claypool currently serves as the policy director for a long-term care provider, has held various advisory positions at HHS, and worked for CMS during the Clinton administration. He has a physical disability and has received Medicaid and Social Security benefits, giving him a unique perspective into these programs. His role as Director of the Office on Disability will be to oversee and advise HHS on policies and programs related to individuals with disabilities.
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