Tom Price to lead HHS, Seema Verma to lead CMS, Donald Trump announces

U.S. Rep. Tom Price. Photo by Gage Skidmore

President-elect Donald Trump on Tuesday formally named Georgia Republican Rep. Tom Price to lead the U.S. Department of Health and Human Services under his administration. Price has long been an opponent of the Affordable Care Act and is expected to lead efforts to repeal and replace President Barack Obama's signature legislation.

"Chairman Price, a renowned physician, has earned a reputation for being a tireless problem solver and the go-to expert on healthcare policy, making him the ideal choice to serve in this capacity," Trump said in a statement emailed to news organizations. "He is exceptionally qualified to shepherd our commitment to repeal and replace Obamacare and bring affordable and accessible healthcare to every American. I am proud to nominate him as Secretary of Health and Human Services."

[Also: Reactions pour in on Tom Price pick for HHS secretary]

Price had proposed plans in 2009 to replace Obamacare.

Trump on Tuesday also named Indiana healthcare consultant Seema Verma, an ally of Vice President-elect Mike Pence, to lead the Centers for Medicare and Medicaid Services. In Indiana, Verma worked with the then Indiana governor to craft the Healthy Indiana Plan 2.0, an alternative to Medicaid expansion under Obamacare.

"She has decades of experience advising on Medicare and Medicaid policy and helping states navigate our complicated systems," Trump said in a statement. "Together, Chairman Price and Seema Verma are the dream team that will transform our healthcare system for the benefit of all Americans."

As CMS chief, Verma will determine the future of many programs in which healthcare organizations participate, such as various value-based innovation models, the meaningful use program, and MACRA, the new law that changes how physicians are reimbursed under Medicare.

Price has history in healthcare

Price, an orthopedic surgeon who once ran the orthopedic clinic at Atlanta's Grady Memorial Hospital, first pitched an Obamacare alternative in 2009 dubbed the Empowering Patients First Act.

The bill calls for expanding tax credits to help Americans offset costs tied to purchasing health insurance. It also calls for states to establish high-risk pools and for the creation of an interstate market for selling health insurance. Trump, on the campaign trail, had often suggested allowing insurers to sell coverage across state lines as one way his administration would change healthcare legislation.

Price is also highly focused on healthcare information technology, especially laws tied to reporting meaningful use of electronic health records. Price specifically called for a 90-day reporting period, instead of a full year. CMS in November did change that requirement and also included the 90-day reporting option in its final MACRA rule.

Price was also one of several representatives who pushed to delay the industry's adoption of the ICD-10 diagnostic code set. Though the codes eventually went live, Price's efforts helped ensure CMS included a one-year grace period in 2016.

Value-based holdup?

Under Obama, HHS has pitched an aggressive timeline for converting Medicare and Medicaid payments from a fee-for-service model to value-based reimbursement. In fact, the current leadership said it planned to have half of Medicare payments tied to value by 2018. But Price has been outspoken against that timeline, pushing back on many models run by CMS' Center for Medicare and Medicaid Innovation, which runs pilot programs such as the Next Generation Accountable Care Organization model and bundled payments programs tied to joint replacement.

[Also: Columnists, media orgs probe concerns over Price, Verma]

"Medicare providers and their patients are blindly being forced into high-risk government-dictated reforms with unknown impacts," Price, along with other Republican members of Congress, wrote in a September letter to acting CMS chief Andy Slavitt. The outcry came after CMS announced new bundled payment programs tied to cardiac surgeries.

"Accordingly, we insist CMMI stop experiment with Americans' health, and cease all current and future planned mandatory initiatives within CMMI," Republicans said.

Consultant heads to CMS

While Trump went with a public official for his HHS pick, his choice for CMS leader comes from the private sector.

Verma is currently CEO of SVC Inc., a consulting firm focused in healthcare. In addition to helping Pence craft policy in Indiana, Verma worked with Kentucky Gov. Matt Bevin to design his alternative to Medicaid expansion. That plan, which has not yet been approved by the Obama administration, adds a requirement that beneficiaries must hold a job to be eligible.

This story will be updated.

Twitter: @HenryPowderly
Contact the author: henry.powderly@himssmedia.com