The U.S. Senate confirmed President Joe Biden's nominee to lead CMS Tuesday, giving the agency a permanent leader at a key moment for the administration.
Chiquita Brooks-LaSure, who worked for the Obama administration and helped implement the Affordable Care Act, will oversee the agency's efforts to expand the healthcare law, set the overall policy agenda for Medicare, Medicaid and the Children's Health Insurance Program (CHIP).
The nomination was approved 55-44 with four Republicans voting yes: Sen. Roy Blunt (R-Mo.), Susan Collins of Maine, Richard Burr (R-N.C.), Jerry Moran (R-Kan.) and Lisa Murkowski (R-Alaska.).
Before being nominated to lead CMS, she was a consultant for Manatt Health and previously worked for the House Ways & Means Committee, where she helped draft the ACA.
"This is clearly one of the most important healthcare jobs in America," Senate Finance Committee Chairman Ron Wyden (D-Ore.) said Monday.
"Ms. Brooks-LaSure brings decades of health policy experience to CMS and I think it would be fair to say she has worked on healthcare from just about every angle short of scrubbing into the operating room itself."
Brooks LaSure's nomination became controversial among Senate Republicans after CMS reversed the Trump administration's decision to approve a Medicaid wavier for an unprecedented 10-year period, arguing it did not give enough time for public comment.
The waiver pays Texas hospitals for uncompensated care and will remain in place until September 2022 and state officials will likely renegotiate the terms of the waiver with CMS.
But Senate Republicans used the debacle as a reason not to support her nomination.
In her new role at CMS, one of her first duties will be implementing the ban on surprise billing passed by Congress last year. The law prohibits providers from sending large bills to patients who were treated by out-of-network providers despite seeking care at in-network facilities.
The first regulations are due July 1, with providers and insurers pushing for favorable treatment.
Brooks-LaSure will also be responsible for setting the agenda for CMS's Medicare and ACA waiver programs which allow states to experiment outside of federal law.
She has previously supported reinsurance programs and could use the agency's power to encourage states to expand Medicaid.
After the pandemic, CMS and Congress will have to decide which telehealth services Medicare will pay for and how much providers will be paid for them.
Providers are eagerly awaiting more information from CMS on the future of the Provider Relief Fund, which is intended to help healthcare facilities and systems weather the financial difficulties of the pandemic.
There is still billions of dollars in the fund that providers want disbursed, including $8.5 billion appropriated by Congress earlier this year for rural providers.
In her confirmation hearing in April, Brooks-LaSure also mentioned high drug prices, health equity, mental health and substance abuse, and rural health as issues she wants to work on.
Brooks-Lasure's confirmation was cheered by provider and insurer groups.
"Brooks-LaSure takes the reins at CMS at a critical juncture for our nation, as COVID-19 and its lingering economic effects make access to health care coverage more important than ever," said Beth Feldpush, senior vice president of policy and advocacy at America's Essential Hospitals.
"Her intimate knowledge of, and experience with, Medicaid and Medicare make her well suited to meet these challenges."
Matt Eyles, president and CEO of America's Health Insurance Plans, said he looks forward to working with her to "strengthen and improve" Medicare, Medicaid and ACA marketplace coverage.
"Ms. Brooks-LaSure is passionately committed to improving health equity in our nation's health care system and has worked tirelessly to expand coverage to uninsured Americans by building on what we have through the Affordable Care Act," he said.