RN Heads Federal Agency

December 2nd, 2011

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By , BSN, RN

Starting today a nurse is taking the helm of the Centers for Medicare and Medicaid (CMS). Marilyn Tavenner is replacing Dr. Donald Berwick. Tavenner joined the Obama administration in February 2010 as Medicare’s principle deputy administrator. Tavenner is certainly not new to the healthcare arena: she began her career at the bedside as an ICU nurse.

Tavenner will serve as interim administrator for the CMS until the United States Senate confirms her nomination. CMS is the federal agency that administers the two government programs along with the State Children's Health Insurance Program and oversees HIPPA (Health Insurance Portability and Accountability Act) standards.

Before entering government service Tavenner had nearly 35 years of healthcare experience, steadily moving up the ranks. She spent nearly 20 years in nursing, three years as a hospital CEO and 10 years a hospital executive for the Hospital Corporation of America (HCA). Tavenner later served as Secretary of Health and Human Services in Virginia, in the administration of Governor Tim Kaine, from 2006 to 2010.

Tavenner's nomination was met with little surprise after her predecessor became a lightning rod for Republican anger at the healthcare reform law. President Barak Obama nominated Berwick three times but the Senate would never confirm him. Finally, the president made him head of the CMS in a recess appointment, which only allowed him to serve through the end of this year.

Berwick is a pediatrician and the co-founder of the Institute for Healthcare Improvement. He is well-respected throughout the healthcare industry, but his past statements of support for Great Britain's socialized medicine system made him a target for conservatives. Berwick's fate was cemented when 42 Republican senators wrote to President Obama back in March warning him they would not confirm him and urging the president to withdraw the nomination.

In a recent Washington Post article the paper reported that Tavenner's pragmatic attitude could help her avoid the controversy that has dogged the outgoing chief. While Berwick “spent decades writing, thinking, and speaking about overhauling America’s health care system,” his former deputy has a more management-centered outlook.

"Former colleagues described her as a patient-centered manager, a hands-on medical professional equally comfortable in the board room and the emergency room," the newspaper continued.

“One of the things she’s really good at is being respectful, respecting different views and being willing to listen,” said Patrick Finnerty, who served under Tavenner as Virginia’s Medicaid director, to the Washington Post.

Tavenner is not a shoe-in for confirmation but many insiders believe it ultimately will happen. Republicans have reacted cautiously to her nomination. “This is a name that should be sent up to the Senate,” Sen. John Barrasso (R-Wyoming), a vocal Berwick critic, said in an interview. “She should appear and answer our questions on her views on Medicare, Medi¬caid and the president’s health-care law. Then people can make a reasoned judgment.”

Tavenner has been a relatively quiet presence in the agency, never testifying before Congress. ."

Even the American Medical Association (AMA) has thrown its support to Tavenner. In a statement, Peter W. Carmel, M.D., president of the AMA, said:

"The American Medical Association supports the nomination of Marilyn Tavenner for CMS administrator. We have worked extensively with her in her role as deputy administrator, and she has been fair, knowledgeable and open to dialogue. With all the changes and challenges facing the Medicare and Medicaid programs, CMS needs stable leadership, and Marilyn Tavenner has the skills and experience to provide it."

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