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FILE - This combo of 2014 file photos shows Massachusetts Republican gubernatorial hopefuls Charlie Baker, left, and Mark Fisher, seeking their party's nomination in the Sept. 9 primary. (AP Photos, File)

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** FILE ** This undated file photo, provided Nov. 17, 2010 by Goodman Media International Inc., shows Donald Berwick, installed last year by President Barack Obama as a recess appointment, bypassing the Senate. Unable to repeal Obama's health care law, 42 Republican senators asked Obama in a letter released on Thursday, March 3, 2011, to withdraw his nomination of Berwick as Medicare administrator. (AP Photo/Goodman Media International, Inc., File

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FILE - This undated file photo provided Nov. 17, 2010, by Goodman Media International, Inc., shows Donald Berwick, the official quarterbacking the overhaul of the nation's medical system, installed last year by President Barack Obama as a recess appointment, bypassing the Senate. Unable to repeal Obama's health care law, 42 Republican senators asked Obama in a letter released Thursday, March 3, 2011, to withdraw his nomination of Berwick as Medicare administrator. (AP Photo/Goodman Media International, Inc., File) NO SALES.

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Dr. Donald Berwick, whom President Obama appointed as head of Medicare and Medicaid without Senate hearings, now needs Senate approval. (Associated Press)

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RECESS APPOINTMENT: Dr. Donald Berwick can serve for a while without a Senate vote or a hearing. (AP Photo)

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