Thomas A. Scully
Encyclopedia
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.
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.
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. But, 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 passage. A report by the Government Accountability Office on the investigation said that Scully threatened to fire Medicare's chief actuary, Richard Foster, if he provided the data to Congress and recommended that HHS seek to recover Scully's salary due to this infraction.
Scully denied threatening Foster, but acknowledged having told him to withhold information from Congress. Foster had estimated that the 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 Congress' "right to receive truthful information from federal agencies to assist in its legislative functions is clear and unassailable."
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.
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 restraint
s. 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 replacement
s. 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 US$30 million publicly-funded 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.
Federal law prohibits public funds from being used for "publicity or propaganda purposes within the United States not heretofore authorized by the Congress." Roughly 10 minutes in length, the video includes comments by Health and Human Services Secretary Tommy Thompson and shots of President Bush signing the Medicare drug bill.
would now be called the Centers for Medicare and Medicaid Services
.
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
(CMS) from 2001-2003 under President
President
A president is a leader of an organization, company, trade union, university, or country.Etymologically, a president is one who presides, who sits in leadership...
George W. Bush
George W. Bush
George Walker Bush is an American politician who served as the 43rd President of the United States, from 2001 to 2009. Before that, he was the 46th Governor of Texas, having served from 1995 to 2000....
. Scully currently is Senior Counsel at Alston & Bird LLP, a law
Law firm
A law firm is a business entity formed by one or more lawyers to engage in the practice of law. The primary service rendered by a law firm is to advise clients about their legal rights and responsibilities, and to represent clients in civil or criminal cases, business transactions, and other...
and lobbying
Lobbying
Lobbying is the act of attempting to influence decisions made by officials in the government, most often legislators or members of regulatory agencies. Lobbying is done by various people or groups, from private-sector individuals or corporations, fellow legislators or government officials, or...
firm, where he focuses on health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
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
Welsh, Carson, Anderson & Stowe
Welsh, Carson, Anderson & Stowe is a private equity investment firm in the United States. Founded in 1979, it has organized 14 limited partnerships with total capital over $16 billion and is currently in the process of raising a new $4 billion private equity fund Welsh, Carson Anderson & Stowe XI...
, a private equity
Private equity
Private equity, in finance, is an asset class consisting of equity securities in operating companies that are not publicly traded on a stock exchange....
investment firm, where he focuses on health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
investments.
Biography
Scully received his B.A.Bachelor of Arts
A Bachelor of Arts , from the Latin artium baccalaureus, is a bachelor's degree awarded for an undergraduate course or program in either the liberal arts, the sciences, or both...
from the University of Virginia
University of Virginia
The University of Virginia is a public research university located in Charlottesville, Virginia, United States, founded by Thomas Jefferson...
in 1979 and his J.D.
Juris Doctor
Juris Doctor is a professional doctorate and first professional graduate degree in law.The degree was first awarded by Harvard University in the United States in the late 19th century and was created as a modern version of the old European doctor of law degree Juris Doctor (see etymology and...
from Catholic University
The Catholic University of America
The Catholic University of America is a private university located in Washington, D.C. in the United States. It is a pontifical university of the Catholic Church in the United States and the only institution of higher education founded by the U.S. Catholic bishops...
in 1986.
Scully began his political career by working for US Senator Slade Gorton
Slade Gorton
Thomas Slade Gorton III is an American politician. A Republican, he was a U.S. senator from Washington state from 1981 to 1987, and from 1989 to 2001. He held both of the state's Senate seats in his career and was narrowly defeated for reelection twice as an incumbent: in 1986 by Brock Adams, and...
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
United States presidential election, 1988
The United States presidential election of 1988 featured no incumbent president, as President Ronald Reagan was unable to seek re-election after serving the maximum two terms allowed by the Twenty-second Amendment. Reagan's Vice President, George H. W. Bush, won the Republican nomination, while the...
of President
President of the United States
The President of the United States of America is the head of state and head of government of the United States. The president leads the executive branch of the federal government and is the commander-in-chief of the United States Armed Forces....
George H. W. Bush
George H. W. Bush
George Herbert Walker Bush is an American politician who served as the 41st President of the United States . He had previously served as the 43rd Vice President of the United States , a congressman, an ambassador, and Director of Central Intelligence.Bush was born in Milton, Massachusetts, to...
. Following that, he worked at the White House
White House
The White House is the official residence and principal workplace of the president of the United States. Located at 1600 Pennsylvania Avenue NW in Washington, D.C., the house was designed by Irish-born James Hoban, and built between 1792 and 1800 of white-painted Aquia sandstone in the Neoclassical...
as Deputy Assistant to the President and Counselor to the Director of the Office of Management and Budget
United States Office of Management and Budget
The Office of Management and Budget is a Cabinet-level office, and is the largest office within the Executive Office of the President of the United States .The current OMB Director is Jacob Lew.-History:...
(OMB) from 1992-1993; and as Associate Director of OMB for Human Resources, Veterans and Labor from 1989-1992.
Scully, then, reentered private practice
Private law
Private law is that part of a civil law legal system which is part of the jus commune that involves relationships between individuals, such as the law of contracts or torts, as it is called in the common law, and the law of obligations as it is called in civilian legal systems...
with the Washington, D.C.
Washington, D.C.
Washington, D.C., formally the District of Columbia and commonly referred to as Washington, "the District", or simply D.C., is the capital of the United States. On July 16, 1790, the United States Congress approved the creation of a permanent national capital as permitted by the U.S. Constitution....
law firm of Patton Boggs, LLP, where he focused on regulatory
Regulation
Regulation is administrative legislation that constitutes or constrains rights and allocates responsibilities. It can be distinguished from primary legislation on the one hand and judge-made law on the other...
and legislative work in health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
. 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
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
Administrator. In this role, Scully served as the top executive in the management of Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
, Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
, the State Children's Health Insurance Program, and other national health care initiatives.
Medicare Improvement and Modernization Act and Investigation
On December 8, 2003, PresidentPresident of the United States
The President of the United States of America is the head of state and head of government of the United States. The president leads the executive branch of the federal government and is the commander-in-chief of the United States Armed Forces....
George W. Bush
George W. Bush
George Walker Bush is an American politician who served as the 43rd President of the United States, from 2001 to 2009. Before that, he was the 46th Governor of Texas, having served from 1995 to 2000....
signed the Medicare Prescription Drug, Improvement, and Modernization Act
Medicare Prescription Drug, Improvement, and Modernization Act
The Medicare Prescription Drug, Improvement, and Modernization Act is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.The MMA was signed by President George W...
. 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
Medicare Part D
Medicare Part D is a federal program to subsidize the costs of prescription drugs for Medicare beneficiaries in the United States. It was enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and went into effect on January 1, 2006.- Eligibility and...
. 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. But, 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 passage. A report by the Government Accountability Office on the investigation said that Scully threatened to fire Medicare's chief actuary, Richard Foster, if he provided the data to Congress and recommended that HHS seek to recover Scully's salary due to this infraction.
Scully denied threatening Foster, but acknowledged having told him to withhold information from Congress. Foster had estimated that the 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 Congress' "right to receive truthful information from federal agencies to assist in its legislative functions is clear and unassailable."
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.
Collection & publication of data on healthcare providers
In his first speech as CMSCenters for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
Administrator, Scully announced that Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
would begin collecting and publishing quality data on health care providers across the country including hospitals, nursing homes, home health agencies and dialysis
Dialysis
In medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure...
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
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
. 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 restraint
Physical restraint
Physical restraint refers to the practice of rendering people harmless, helpless or keeping them in captivity by means such as handcuffs, fetters, straitjackets, ropes, straps, or other forms of physical restraint...
s. A $700,000 advertising campaign
Advertising campaign
An advertising campaign is a series of advertisement messages that share a single idea and theme which make up an integrated marketing communication...
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
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
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
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
, heart failure, pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...
, coronary artery bypass surgery
Coronary artery bypass surgery
Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease...
, and hip
Hip replacement
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement or a hemi replacement. Such joint replacement orthopaedic surgery generally is conducted to relieve arthritis pain or fix severe...
and knee replacement
Knee replacement
Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis...
s. 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
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
by leading to a more rational health care pricing system
Health care prices
Unlike most markets for consumer services in the United States, the health care market generally lacks transparent market-based pricing. Patients are typically not able to comparison shop for medical services based on price, as medical service providers do not typically disclose prices prior to...
.
Scully also initiated a broad public education campaign to improve seniors’ awareness and utilization of their Medicare benefits. The US$30 million publicly-funded advertising campaign called, "Helping You Help Yourself" was designed to inform Medicare beneficiaries
Beneficiary
A beneficiary in the broadest sense is a natural person or other legal entity who receives money or other benefits from a benefactor. For example: The beneficiary of a life insurance policy, is the person who receives the payment of the amount of insurance after the death of the insured...
about the Medicare web site and toll-free phone number, which could answer their questions about health care plans.
Federal law prohibits public funds from being used for "publicity or propaganda purposes within the United States not heretofore authorized by the Congress." Roughly 10 minutes in length, the video includes comments by Health and Human Services Secretary Tommy Thompson and shots of President Bush signing the Medicare drug bill.
New Name for HCFA
On July 1, 2001 Scully presided over his agency's name change: the Health Care Financing AdministrationCenters for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
would now be called the Centers for Medicare and Medicaid Services
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
.
Lawsuit by Gallup
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.Former and Present Employers
- Akin, Gump, Strauss, Hauer & Feld LLP
- United States Office of Management and Budget
- Patton Boggs, LLP
- Federation of American Hospitals
- Centers for Medicare and Medicaid Services
- Alston & Bird LLP
- Welsh, Carson, Anderson, & Stowe