President Obama's July 7 appointment of Dr. Donald Berwick as CMS Administrator continues to cause controversy. The president made the recess appointment to avoid opposition in a Senate hearing. Berwick's appointment likely signals big program changes coming to Medicare, predicts the National Association for Home Care & Hospice. "As providers of low-cost, high-quality health care services, home care agencies and hospices should remain on the lookout for opportunities to play their part in delivery system changes the health reform law is meant to accomplish," NAHC counsels.