New Medicare chief promises accountability

Centers for Medicare and Medicaid Services (CMS) acting Administrator Kerry Weems on Wednesday promised a higher level of transparency and accountability at his agency.

In a briefing with reporters one week after he took office, Weems vowed to make CMS’s operations and decision-making more public, to improve program management and to evaluate the agency’s relationships with health plans and other private contractors.

{mosads}“We’re going to try and do our business in daylight. I mean that literally and figuratively,” said Weems, whose nomination as CMS administrator is pending in the Senate.

One of Weems’s first official acts last week was to disapprove an application by New York to expand coverage under the State Children’s Health Insurance Program (SCHIP). Weems noted that the announcement went out at the beginning of the business day, a departure from standard CMS practice.

“That happened in the morning, in daylight. It was not a cocktail-hour press release. We are going to try to end those,” he said.

Weems acknowledged that an August letter from CMS to state officials, which outlined strict new SCHIP expansion guidelines, should have been issued more openly. “We probably could have done a slightly better job of the way that that letter got out,” he said.

“Things like that happen when there’s ambiguity about leadership,” Weems said. CMS has been without a confirmed administrator since October 2006 and without an acting administrator since July, until Weems’s appointment.

The new CMS chief defended the policy underpinning the new restrictions and the New York rejection, saying the Bush administration wanted to prioritize poorer children before expanding eligibility.

Weems also said that CMS would seek to refute criticisms that the agency is too close to and too lenient with the private companies with which it does business.

“The tone that I’m trying to set is that CMS needs to make sure that we maintain an arm’s-length relationship with our partners,” he said.

Part of that approach will be more aggressive monitoring of the marketing practices of health plans selling Medicare Part D prescription drug plans, Weems said.

CMS also will issue a report in the coming days on how it will resolve a chronic problem that has prompted consternation on Capitol Hill: Medicare premiums being erroneously deducted from beneficiaries’ Social Security checks.

Weems also said that the administration is sticking to its guns regarding the veto threats issued against both the House- and Senate-passed SCHIP reauthorization bills and its opposition to cuts in Medicare Advantage. “From what I see inside of the administration right now, no, there’s no rethinking of that veto,” he said, noting that he had not discussed the issue with President Bush.

Although the children’s health program expires on Oct. 1, the contentious SCHIP and Medicare legislation pending on the Hill will take the rest of the year to be finalized, he said. “I think things like this sort of get settled at the end of a session. There are a lot of things that get into bills that make a final deal,” Weems said.