Senate confirms Tavenner to lead CMS

Washington The Centers for Medicare & Medicaid Services has a permanent administrator leading the agency for the first time in nearly seven years.

Marilyn Tavenner was confirmed by a 91-7 vote in the Senate on May 15. The former hospital nurse and executive assumes responsibility for the agency she has led in the capacity of acting administrator since 2011.

Tavenner had the support of many organizations representing physicians, including the American Medical Association.

The AMA “is very pleased that the Senate has confirmed Marilyn Tavenner as administrator of CMS,” said AMA President Jeremy A. Lazarus, MD, in a statement. “As acting administrator, she has demonstrated her ability to be a capable and effective leader. We look forward to continuing to work with the administrator to strengthen the Medicare system to improve health outcomes for patients and the practice environment for physicians.”

The 2013 confirmation process for Tavenner was relatively smooth, with only a few hurdles. Sen. Tom Harkin (D, Iowa) had prevented the nomination from moving forward since the end of April because of a dispute with the Obama administration over what he saw as mishandling of health funds earmarked for prevention and wellness activities, such as anti-smoking campaigns and childhood immunization programs. The administration instead has used money from the $15 billion fund for implementing parts of the health system reform law, which has had its appropriations blocked by congressional Republicans.

That dispute aside, however, Tavenner was a fine choice to head up CMS, Harkin said, and he lifted his hold on May 7.

Clinical and administrative experience

Tavenner now officially leads an agency of more than 4,000 employees that oversees $820 billion in federal health care spending annually.

Tavenner began her career as a nurse at Johnson-Willis Hospital in Richmond, Va., in 1981. She rose up the ranks to serve as CEO of the hospital starting in 1993 and later led 20 hospitals as president of the facility's parent company, Hospital Corp. of America. In 2005, she left the system as the group president of outpatient services.

Before moving to CMS, she served as the Virginia secretary of health and human resources. In that post, she oversaw 18,000 employees and a $9 billion budget that funded Medicaid, mental health and other social service programs in the commonwealth.

Tavenner first was nominated for the permanent CMS post in November 2011, after former Administrator Donald M. Berwick, MD, resigned. He had been appointed to the position during a congressional recess, over the strenuous objection of Republicans on Capitol Hill, and his term was about to expire.

After being renominated in February 2013, Tavenner's nomination appeared destined for confirmation, as she had wide support from Democrats, Republicans and those in the health care sector. House Majority Leader Eric Cantor (R, Va.), the second-highest ranking member of the lower chamber, was a vocal champion.

“Her experience is drawn from her time as a nurse and as a health system administrator,” Cantor said after President Obama re-nominated her. “I always found her to be extremely professional and understanding of the value of the private sector in health care. I am convinced that with Marilyn we can work together to bring much-needed reform to Medicare and Medicaid, and save them for those seniors and working families that rely on these programs.”

The last administrator confirmed by the Senate was Mark B. McClellan, MD, PhD, who led CMS from March 2004 to October 2006.