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Berwick Urges Insurers to Cooperate in Law's Implementation

By Rebecca Adams, CQ HealthBeat Associate Editor

September 13, 2010 -- Centers for Medicare and Medicaid Services (CMS) administrator Donald M. Berwick, in his first public address since taking office, urged insurers Monday to become partners with the administration to implement the new health care law.

Berwick, addressing a conference organized by the trade association America's Health Insurance Plans (AHIP), told the gathering of industry officials that if they stand in the way of changing the U.S. health system as the law requires, the partnership will not work.

During the health care debate, President Obama and health officials often tussled over new regulations that the law will impose on the insurance industry.

"My door is wide open," Berwick said, to anyone "who will join authentically join" the administration to update the health care system. "Those who welcome change and will agree to meet it will find a friend."

However, he said, "Those who wish only to preserve the status quo . . . cannot be effective partners."

At one point during the meeting, tensions between Obama administration health officials and the health insurance industry became clear when an industry representative questioned Berwick. He asked what the new CMS administrator would do to alleviate the image within the administration as a "villain," change the culture within CMS to "acknowledge there are forces for good within the insurance industry," and reduce the "tone of hostility" shown toward health plan executives.

"Let's look ahead, not back," answered Berwick, who was sworn in two months ago. He said that if the administration and insurers steadily work together to make care better, "trust will resurface . . . If we do this together and make care better, the rest will follow."

Several new provisions of the new law will take effect Sept. 23, six months after its signing, forcing insurers to change the way they do business. At that point, the industry will have to allow dependents to stay on their parents' coverage until age 26; stop imposing lifetime limits and rescinding coverage when patients get sick; and cover all conditions, including pre-existing medical problems, for children.

Obama and top administration officials are expected to tout these changes as the anniversary approaches in an attempt to convince the public that the health care law will benefit many Americans.

Berwick's speech offered him the chance to show both a willingness to work with the industry as well as a determination to permanently alter its business model. Obama tapped Berwick for the CMS job as a recess appointment in July after it was clear that Senate Republicans would try to block his confirmation.

Berwick said Monday that he views his job at the helm of Medicare and Medicaid as involving three tasks: running a huge health coverage system; implementing the health care law; and, most importantly in his mind, improving health care in America.

He called the health care legislation an answer to the gaps in the U.S. health care system, but said it also poses an important question "for every single person in this room."

"The question the law asks is: Will we redesign health care in America? Will we reshape it together?" Berwick said, adding that his vision is for a "responsive, continually improving health care system that's available for all Americans at an affordable cost."

After the speech, AHIP president and CEO Karen Ignagni said the health insurance executives in the room intend to be helpful and work closely with CMS as the law is implemented.

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