There may be a permanent CMS head sooner than expected. President Obama plans to bypass the highly politicized Senate confirmation of Dr. Donald Berwick as CMS Administrator. Instead, the President will appoint Berwick while the Senate is out on recess, according to press reports. The President's supporters say he was forced to resort to the recess appointment because some Republicans intended to stall Berwick's appointment to focus on protesting larger health care reform. The President's detractors say he is trying to stifle debate on a controversial candidate who supports care rationing.