Leslie Norwalk, deputy CMS administrator, will take over the top job at CMS on an acting basis, reports CQ.com (registration required). Herb Kuhn, head of the agency's Center for Medicare Management, will move into the number-two position. The moves follow the departure of Mark McClellan, announced earlier this month. Both Norwalk and Kuhn have been mentioned as potential permanent successors to McClellan. Either would be a fine choice, as the agency needs continuity as it works to implement sweeping changes introduced under McClellan's watch.

Boston Scientific says sales of drug-eluting stents and implantable cardioverter-defibrillators are slowing, which will cause the firm to miss Wall Street analysts' earnings expectations for the third quarter, according to the Boston Globe. Third-quarter earnings will be around $2 billion, short of Wall Street's projected $2.2 billion. Doctors are slightly shifting away from implanting drug-eluting stents and ICDs. Safety concerns may be a factor.

The controversy over biomedical conflicts of interest between doctors and companies continued at a Cleveland Clinic conference yesterday. This relationship is necessary, but it shouldn't cause the financial interest of doctors to get in the way of patient care, advised medical experts. While the issue has increased with the rapid pace of medical innovation, Philip Pizzo, Stanford University's medical dean, said the key is to manage the conflicts, not try to eliminate them. The Associated Press also reports that as of October 1, Stanford University is prohibiting doctors that work at its hospitals from accepting any gifts in efforts to "eliminate corporate influence from medical decisions." It's not likely that this debate will end anytime soon, considering many doctors need to work with companies, from serving as consultants to being trained on a device's use.

A consortium of 22 patient groups in New Jersey is growing concerned about the amount of reprocessed single-use devices used in state hospitals, reports the Star-Ledger of Newark. The consortium is meeting today to raise awareness about the issue and to advocate for a state law requiring patient consent before reprocessed SUDs are used. If the idea gets traction, New Jersey would become the second state that we know of to consider passing such a law. The Massachusetts legislature considered such a bill last year, but no action has been taken yet. There are legitimate arguments on both sides about the safety of reprocessed SUDs. Regardless of which side you believe, there should be no harm in allowing patients to decide for themselves whether they want such devices used on them.