Donald Berwick, MD, was sworn in last week as CMS administrator. Dr. Berwick, who served as president and CEO of the Institute for Healthcare Improvement (IHI) and as a Harvard University professor, is best known for helping hospitals use standardized procedures to improve quality. Dr. Berwick is the first permanent CMS administrator since Mark McClellan stepped down from the role in 2006, and he will lead the implementation of many of the new health reform law changes, including expanding Medicaid and controlling Medicare costs. Since Dr. Berwick’s nomination was announced in April, some Republicans have alleged that he supports rationing care and the socialization of the U.S. health care system.

President Obama chose to bypass Congress and use a "recess appointment" to name Dr. Berwick as CMS administrator. As a recess appointee, Dr. Berwick will have all the powers of a permanent appointee, but serve only until the end of the 111th Congress. He then must be re-nominated and confirmed by the Senate.