Donald Berwick to step aside as CMS administrator

Obama to name Tavenner as new Medicare chief

November 23, 2011

The Obama administration is expected to nominate Marilyn Tavenner to succeed Donald Berwick as CMS administrator, after Senate Republicans vowed to block his confirmation.

Berwick’s 17-month tenure

Berwick has headed CMS since July 2010, when President Obama chose to sidestep the traditional confirmation process by using "recess appointment" procedures. As a recess appointee, Berwick has all the powers of a permanent appointee, but must be re-nominated and confirmed by the Senate to serve past 2011.

Although the Obama administration re-nominated Berwick in January, 42 GOP senators in March asked the White House to withdraw Berwick's nomination, writing in a letter that his "lack of experience in the areas of health plan operations and insurance regulation raise serious concerns about his qualifications for this position."

Because of the political impasse, Berwick will step aside on Dec. 2, AP/Google News reports.

Tavenner’s own background

According to CQ HealthBeat, Tavenner—who currently is CMS' principal deputy administrator—will serve as the agency's interim administrator during the confirmation process. In her post, Tavenner has been a "central leader" in managing the development of rules, overhauling payment systems, and issuing reform law and Medicare and Medicaid grants. A trained nurse, Tavenner also oversaw two hospitals owned by Hospital Corporation of America before beginning her government service.

Industry officials and lobbyists have praised Tavenner's management skills. Former CMS Administrator Tom Scully, who served under President George W. Bush, calls her "smart, sharp, fair, organized," noting that "[u]nlike a lot of people in government, she actually had to run health care day to day for many years." Scully has predicted that Tavenner probably would be confirmed if she were nominated to lead CMS.

However, Politico notes that Tavenner now faces a confirmation battle, too—and it may ultimately resemble the fight that would have confronted Berwick. Beyond lingering tension over the health reform law, Senate Republicans have not explicitly endorsed Tavenner. Meanwhile, a Republican lobbyist tells Politico that the high-profile CMS role "always gets sucked into the controversy of the day," further complicating confirmation (Alonso-Zaldivar, AP/Google News, 11/23; Pecquet, "Healthwatch," The Hill, 11/23; Reichard, CQ HealthBeat, 11/23 [subscription required]; Feder/Haberkorn, Politico, 11/23).

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