The BlueCross BlueShield Association gave more than $5 million to the Institute for Healthcare Improvement, according to the group's website. Dr. Donald Berwick, the founding honcho of that nonprofit, which campaigns for safer, more efficient health care services, is now the top official in the federal Medicare agency.
Courtesy of Donald Berwick
Even though Dr. Donald Berwick took the reins of Medicare and Medicaid without a confirmation hearing, one senator hasn't stopped asking questions.
Many Blues health plans do business with Medicare. So is there a potential for conflict?
Sen. Charles Grassley, (R-IA), says yes, and has demanded that Berwick disclose the nonprofit's donors, something he says the public would have gotten out a Senate confirmation — if Obama hadn't skipped that process with a recess appointment.
The White House says Berwick will respond to Grassley, but that he is in full ethics compliance. Outside experts say the request is a fishing expedition.
"That sounds like a red herring," said Melanie Sloan, the director of Citizens for Responsibility and Ethics in Washington, a watchdog group. "No 501(c)3" - the tax designation for charitable nonprofits - "is required to disclose its donors."
Sloan's group, as it happens, is a nonprofit founded by Obama ethics czar Norman Eisen, whose financial disclosure documents don't list any CREW business or contributors; the group says he never held a formal title there.
The Washington Times reported yesterday that Berwick would recuse himself from IHI business, and has asked for ethics waivers to deal with a couple of organizations from his nonprofit past.
But, the paper noted, his "ethics agreement does not indicate that he will have to recuse himself from matters involving other entities listed as major donors on the institute's website." That's what irks Grassley, who has been outspoken in his opposition to Berwick's appointment.
The senator said Berwick's disclosures so far left "unresolved… the potential for conflicts arising from donors to the Institute for Healthcare Improvement," in a Jul. 29 letter asking Berwick to supply tax forms for the IHI, including the so-called Schedule B forms which list individual donors and the amounts they gave.
The tax forms, called 990s, are available online, but the IRS does not disclose donor lists in order to protect contributors. Grassley's office didn't respond immediately to questions about whether the senator wants to change that rule in general.
IHI, however, has its own policy for disclosing commercial supporters. On its website, the nonprofit lists major donors in order to maintain "an independent position with respect to commercial products and services." Aside from the Blues, donors include Aetna and Kaiser Permanente, which also runs Medicare plans, and an array of foundations.
Given the IRS rules for nonprofits and IHI's disclosures, critics may be reaching to make an issue of this. But, the idea that nonprofit donors may create conflicts of interest is gaining Washington's attention lately, as the embattled Rep. Charles Rangel, (D-NY) could attest.
Rangel's ethics case centers on whether he solicited donations for an educational nonprofit set up in his name in exchange for influence. He's not the only lawmaker with such ties. The New York Times reported a week ago that nearly a dozen current and former members of Congress also risk such conflicts.
Update: Sen. Grassley’s spokeswoman, Jill Gerber, was in touch yesterday after this post ran "to point out that Dr. Berwick promised to give the donor information to Sen. Grassley before the recess appointment short-circuited the vetting process." She also noted that Grassley is opposed to Berwick’s recess-appointment, but not necessarily to the man himself.