Relying on an age-old tradition, President Obama today is using the Fourth of July congressional recess to appoint Donald M. Berwick, MD, to head The Centers for Medicare & Medicaid Services.

A blog entry yesterday by Dan Pfeiffer, White House Communications Director, confirmed the action. What is called a “recess appointment,” Berwick will remain as the Administrator of CMS until the end of next session of Congress in 2011.

It is not uncommon for presidents to use recess appointments in anticipation of controversial appointments. Although Berwick, a Harvard University professor and president of the non-profit, Cambridge, MA-based Institute for Healthcare Improvement, has attracted support among healthcare associations such as the American Medical Association, political opposition has been gathering steam.

Senate Republican Leader Mitch McConnell is critical not only of the appointment but the process. In a news release on his Web site, McConnell said yesterday “the Obama Administration intends to arrogantly circumvent the American people yet again by recess appointing one of the most prominent advocates of rationed health care to implement their national plan.”

Meanwhile, Pfeiffer in his blog noted the opposition and said, “President Obama nominated (in April) Dr. Donald Berwick to serve as Administrator of the Centers for Medicare and Medicaid Services (CMS). Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points.”

Noting that CMS has been without permanent administrator since 2006 when Mark McClellan served as administrator under President George W. Bush, Pfeiffer said, “there’s no time to waste with Washington game-playing. That’s why tomorrow (Wednesday) the President will use a recess appointment to put Dr. Berwick at the agency’s helm and provide strong leadership for the Medicare program without delay.”

Berwick will oversee an agency of over 4,000 employees and is reported to have a budget, according to the New York Times, of more than $800-billion annually. The CMS Web site identifies Marilyn Tavenner as Acting Administrator.