Tavenner on track for confirmation after 'remarkably friendly' hearing

The acting administrator earned the support of some committee Republicans

Acting CMS Administrator Marilyn Tavenner on Tuesday—during a hearing before the Senate Finance Committee—said she would run the agency "as a business and act like business partners" with stakeholders.

The Obama nominee said, "We have an $820 billion dollar business to run that a large amount of this country has a stake in, from beneficiaries to providers to hospitals to insurance companies to Congress to the administration to our CMS employees and contractors."

If Tavenner—who has been serving as acting administrator since December 2011—is confirmed by the Senate, she would the first permanent CMS administrator since 2006.

Details of the confirmation hearing

In her prepared testimony, Tavenner said a leader with "strong operational skills" is most important to CMS, noting the agency's ongoing efforts to reduce fraud and payment errors and to increase data access.

During the hearing, committee Republicans "grilled" Tavenner on various aspects of the Affordable Care Act (ACA) and CMS's implementation of some of the law's main provisions, according to Reuters.

Sen. Orrin Hatch (R-Utah), the committee's ranking member, said, "We still know very little about how the [insurance] exchanges will operate, what the key operational and implementation deadlines are, and how CMS is monitoring them to determine if things are on track or not." He added that Tavenner would have to "assure members of this committee that CMS is heading in the right direction and that your leadership will help steer the agency through the very turbulent times that lie ahead."

Tavenner responded that CMS would not issue guidance on premiums for health plans offered in the exchanges until late August or September, but added that the agency would provide the Finance Committee with biweekly updates on enrollment.

She also noted that CMS is monitoring states' actions on insurance reforms and would use its authority under the ACA to take over the implementation in "a couple of states" if local officials there do not act.

During the hearing, Tavenner also rejected a suggestion by Committee Chair Max Baucus (D-Mont.) to identify a target date for ending fee-for-service payments for Medicare providers. However, she said the agency might expedite some payment reform initiatives for outpatient care.

Prospects for confirmation

Overall, Kaiser Family Foundation's Jackie Judd said the hearing was "remarkably friendly." Tavenner at the end of the hearing "appeared to be on track to win approval" from the Finance Committee, the New York Times reports.

According to Reuters, it was "a sign of her bipartisan appeal" that Tavenner was introduced to the panel by House Majority Leader Eric Cantor (R-Va.), a longtime public critic of the ACA. Cantor previously worked with Tavenner when she ran Virginia's Medicaid program and he served in the state's Legislature.

Cantor said, "If there is anyone that I trust to try and navigate the challenges, it is Marilyn Tavenner. And I feel that strongly about her." Tavenner is "eminently qualified" to lead CMS, he added.

Following the hearing, Baucus told reporters that he plans to hold a vote on Tavenner's nomination next week (Clarke, Reuters, 4/9; Daly, Modern Healthcare, 4/9 [subscription required]; Wald/Pear, New York Times, 4/9; Baker, "Healthwatch," The Hill, 4/9; Kaiser Health News, 4/9).

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