Senate finance panel backs Tavenner to head CMS

The Senate Finance Committee voted Tuesday to advance Marilyn Tavenner's nomination to be CMS administrator, clearing the way for a Senate vote.

Fourteen bipartisan members of the panel gave voice vote approval to her nomination.

“This committee will work with Mrs. Tavenner, as she will work with us because the challenges facing CMS are daunting,” said Sen. Max Baucus (D-Mont.), chairman of the Finance Committee.

Tavenner, acting administrator since December 2011, has spent much of that time implementing many aspects of the Patient Protection and Affordable Care Act, which has drawn both political opposition and concerns from supporters, including Baucus. He warned at a recent hearing that problems with the law's implementation may be leading to a “train wreck” next year when its insurance exchanges are supposed to begin offering coverage to millions of enrollees.

Despite that, Tavenner has drawn broad bipartisan support for her efforts at the agency and little of the political backlash that kept Democrats from offering her predecessor, Dr. Donald Berwick, a confirmation hearing.

The committee's vote was the latest indication that Republicans view Tavenner, a former hospital administrator, separately from their ongoing opposition to the 2010 healthcare overhaul.

“Marilyn Tavenner has a lot of experience, and she has proven herself to be a very valuable person and we need a very valuable person,” said Sen. Orrin Hatch (R-Utah), shortly before the committee's vote.

Senate leadership has yet to establish a timeframe for the full Senate to consider her nomination.

Baucus also confirmed earlier reports that he is retiring and will not seek re-election.

“You guys are really good and get wind of things awfully quickly,” Baucus told reporters in a Senate hallway. But Baucus declined to offer any comments or answer questions about his departure from Congress.

Hatch told reporters he was surprised by Baucus' retirement but was unsure what impact it would have on health policy. He called Baucus' authorship of much of the healthcare law a “signal achievement.”

“He rammed it through committee; it was a very difficult thing to do,” Hatch said. “But he did what they asked him to do—and when I say 'they,' I mean Democrats.”

Provider groups praised Tavenner and urged quick approval by the full chamber.

“We deeply appreciate the Senate Finance Committee's leadership and look forward to swift approval of her nomination by the full Senate,” Chip Kahn, president of the Federation of American Hospitals, said in a written statement.

Dr. Jeremy Lazarus, president of the American Medical Association, expressed similar support.

“CMS has been led by acting administrators for many years, and during this important time for the Medicare and Medicaid programs it is important to have a strong, well-qualified leader who is able to build consensus,” Lazarus said in a written statement. “Marilyn Tavenner has shown that she is the right person for the job.”

Among Baucus' priorities for the remainder of his last term in office is "implementing and expanding affordable healthcare for more Americans," according to a written statement issued by his office.

The Finance Committee's vote included approval from Sen. Chuck Grassley (R-Iowa), who released a statement on Tuesday saying Tavenner "has been responsive" to a series of questions he sent her earlier this month regarding the CMS' final decision on Medicare Advantage payment rates for next year. Grassley's statement also said he would support her nomination.

In early April, the Iowa Republican asked Tavenner (PDF) to send him a timeline and specific information on all communication the CMS had about the agency's decision to change course on the MA payment rate after the CMS made an initial announcment in mid-February. Before CMS announced its final decision after the markets closed on April 1, the firm Height Securities had issued a report indicating the CMS had plans for more favorable payment rates, which boosted stocks in Medicare Advantage plans.

Tavenner responded to Grassley's questions in a letter dated April 19 (PDF) and also in a phone call this morning, according to Grassley's statement.

"I share your concerns with the news that an outside entity issued an advisory about the 2014 MA rates before CMS announced our final policy," Tavenner wrote in her letter. "As I indicated last week, the HHS Acting General Counsel has referred the matter to the HHS Office of the Inspector General (OIG)."

Senate leadership has yet to establish a timeframe for the full Senate to consider her nomination.

— with Jessica Zigmond