During a hearing on April 9, the Senate Finance Committee will consider President Barack Obama’s nomination of Marilyn B. Tavenner for administrator of the Centers for Medicare & Medicaid Services (CMS). Tavenner is the current acting CMS administrator; the Obama administration seeks to make her appointment permanent.
Tavenner was nominated in November 2011 to replace Donald Berwick, MD, who had been at the helm of CMS under something of a loophole, a recess appointment in 2010, which kept him clear of a Senate grilling, but also provided only a temporary post. Senate Republicans opposed Berwick, saying he was in favor of government healthcare rationing, a point Berwick denied.
Berwick stepped down Dec. 2, 2011, to be replaced with Obama’s nomination of Tavenner, who was then serving as the CMS principal deputy. The Senate Finance Committee — the body mandated to approve such presidential nominations — failed to hold a nomination hearing in 2012 for Tavenner. Her nomination expired at the close of 2012, and Obama re-nominated Tavenner on Feb. 7 of this year.
According to the White House, Tavenner served as principal deputy administrator of CMS since February 2010. Previously, she served as the Commonwealth of Virginia’s Secretary of Health and Human Resources in the administration of former Gov. Tim Kaine.
Before entering government service, Tavenner spent nearly 35 years working with healthcare providers in significantly increasing levels of responsibility, including almost 20 years in nursing, three years as a hospital CEO and 10 years in various senior executive level positions for Hospital Corporation of America. She has served as a board member of the American Hospital Association and as president of the Virginia Hospital Association. Tavenner holds a bachelor's degree in nursing and a master's degree in health administration, both from the Virginia Commonwealth University.
Tavenner’s hearing comes as significant pressure mounts in Washington over budget issues that threaten Medicare and Medicaid spending. During her time as a temporary head of CMS, Tavenner continued the work Berwick, her predecessor, started. Berwick was involved in the planning and implementation of health reform, and developer of “the triple aim” of improved patient-centered care that bolsters population health at a lower cost. Berwick’s strategy relies on healthcare IT as a foundation for bringing about the changes mandated under the Affordable Care Act, including formation of accountable care organizations and the meaningful use of electronic health records.
Tavenner has not been as controversial a figure as Berwick — or Tom Daschle, who was nominated to be the Secretary of Health & Human Services, and stepped down as a candidate after facing a rigorous Senate vetting process. Tavenner is expected to continue to hold bipartisan support. However, the history of confirmations under the Obama Administration has been steeped in political wrangling.
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