Thomas A. Scully

Thomas A. Scully was the Administrator of the Centers for Medicare and Medicaid Services (CMS) from 2001-2003 under President George W. Bush. Scully currently is Senior Counsel at Alston & Bird LLP, a law and lobbying firm, where he focuses on health care regulatory and legislative matters, as well as on advising clients on health policy and strategies for health care delivery. Scully is also a general partner at Welsh, Carson, Anderson & Stowe, a private equity investment firm, where he focuses on health care investments.

Biography

Scully received his B.A. from the University of Virginia in 1979 and his J.D. from Catholic University in 1986.

Scully began his political career by working for US Senator Slade Gorton from 1980-1985. Scully then served as an attorney with Akin, Gump, Strauss, Hauer & Feld LLP from 1985-1988. In 1988, Scully joined the presidential campaign of President George H. W. Bush. Following that, he worked at the White House as Deputy Assistant to the President and Counselor to the Director of the Office of Management and Budget (OMB) from 1992-1993; and as Associate Director of OMB for Human Resources, Veterans and Labor from 1989-1992.

Scully, then, reentered private practice with the Washington, D.C. law firm of Patton Boggs, LLP, where he focused on regulatory and legislative work in health care. In his next role, Scully served as President and CEO of the Federation of American Hospitals from 1995-2001. The Federation represents over 1,700 privately owned and managed hospitals. It was from this position that Scully was nominated and confirmed as CMS Administrator. In this role, Scully served as the top executive in the management of Medicare, Medicaid, the State Children's Health Insurance Program, and other national health care initiatives.

CMS career

Scully served as CMS Administrator from May 29, 2001 to December 15, 2003. Scully was noted for his role in passing Medicare reform legislation, as well as for making the agency and its associated health care providers more open and accountable to the public.

Medicare Reform

On December 8 2003, President George W. Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act. Scully's role in the passage of this legislation is perhaps his most notable achievement while at CMS. The bill's most important provision was a prescription drug benefit for Medicare, known as Medicare Part D. Under Part D, Medicare beneficiaries can receive prescription drug coverage through private insurance plans that are then reimbursed by CMS. Scully had fought for prescription drug coverage throughout his time at CMS beginning with an effort to create a discount prescription drug card. That effort was blocked by lawsuits from the major pharmacy chains that claimed that CMS did not have the statutory authority to create the program.

Greater Transparency

In his first speech as CMS Administrator, Scully announced that Medicare would begin collecting and publishing quality data on health care providers across the country including hospitals, nursing homes, home health agencies and dialysis centers. The program began with the reporting of quality measures for nursing homes in a handful of states. In those states, 78 percent of the nursing homes reported that they tried to improve, according to CMS. The next step for the program was the publication of performance by nursing homes nationwide on 10 measures ranging from the percentage of residents with pressure sores to those in physical restraints. A $700,000 advertising campaign publicizing the measures began in conjunction with the release of the data. The intention of the program was to provide consumers with a comparison of nursing homes while encouraging the homes to get better, according to a statement by Scully at the time. Critics of the program complained that nursing homes were being asked to do additional work in order to report the measures while they were dealing with funding cutbacks.

In July 2003, Scully announced that CMS would begin paying bonuses to hospitals that scored well on 35 quality measures. Hospitals nationwide would vie for $7 million in higher reimbursement by providing superior care for five conditions: heart attack, heart failure, pneumonia, coronary artery bypass surgery, and hip and knee replacements. In addition, CMS posted report cards on the hospitals' performance on the public CMS website. The program was hailed as large step towards improving the American health care system by leading to a more rational health care pricing system.

Scully also initiated a broad public education campaign to improve seniors’ awareness and utilization of their Medicare benefits. The $30 million advertising campaign called, "Helping You Help Yourself was designed to inform Medicare beneficiaries about the Medicare web site and toll-free phone number, which could answer their questions about health care plans.

New Name for HCFA

On July 1, 2001 Scully presided over his agency's name change: the Health Care Financing Administration would now be called the Centers for Medicare and Medicaid Services. Department of Health and Human Services Secretary Tommy Thompson explained that in order "to give the agency a new direction, a new spirit, it is necessary that we give it a new name - one that truly reflects the agency's vital mission to serve millions of Medicare and Medicaid beneficiaries across America."

Controversy at CMS

Scully's CMS career was not without conflict. According to an internal investigation by the Department of Health and Human Services, Scully took part in efforts to intentionally withhold cost estimates of the Medicare prescription drug benefit from Congress while it was being considered for law. A report on the investigation said that Scully threatened to fire Medicare's chief actuary, Richard Foster, if he provided the data to Congress. However, the report found that neither the threat nor the withholding of information violated any criminal law. Scully denied threatening Foster, but acknowledged having told him to withhold information from Congress. Foster estimated that the Medicare legislation would cost $500-$600 billion over 10 years. The White House told Congress the cost would not exceed $400 billion. A subsequent report by the Congressional Research Service concluded that Scully and the Bush administration broke federal law by telling Foster to withhold information from Congress because it violated Congress' "right to receive truthful information from federal agencies to assist in its legislative functions is clear and unassailable."

In 2003, the Gallup Organization filed a $5 million lawsuit against him alleging that he asked an OMB aide to investigate a Gallup executive who had accused CMS of unfairly favoring a competing firm in a hospital-survey project.

While he was participating in the crafting of the Medicare Prescription Drug, Improvement, and Modernization Act, Scully interviewed with law firms and private equity firms that might have been affected by the bill, for which he sought and received a waiver from the top ethics officer for the Department of Health and Human Services.

External links

Former and Present Employers

* [http://www.akingump.com/ Akin, Gump, Strauss, Hauer & Feld LLP]
* [http://www.whitehouse.gov/omb/ United States Office of Management and Budget]
* [http://www.pattonboggs.com/Home.aspx Patton Boggs, LLP]
* [http://www.fahs.com/ Federation of American Hospitals]
* [http://www.cms.hhs.gov/default.asp? Centers for Medicare and Medicaid Services]
* [http://www.alston.com/index.cfm?fuseaction=main Alston & Bird LLP]
* [http://www.welshcarson.com/ Welsh, Carson, Anderson, & Stowe]

CMS career

* [http://www.cms.hhs.gov/MMAUpdate/ Medicare Modernization Act] — includes PDF file of the law's text.
* [http://www.cms.hhs.gov/NursingHomeQualityInits/ CMS Nursing Home Quality Initiative]
* [http://www.cms.hhs.gov/HospitalQualityInits/ CMS Hospital Quality Initiative]
* [http://www.oig.hhs.gov/publications/docs/press/2004/070704IGStatement.pdf DHHS Report on Scully's involvement in witholding information from Congress regarding Medicare Part D]

References

* New York Times September 8, 2004 by Robert Pear.
* New York Times March 4, 2001 by Robert Pear.
*