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'Remarkably Friendly' Hearing For Acting Medicare Chief

Apr 09, 2013

Marilyn Tavenner, the acting head of the Centers for Medicare & Medicaid Services and President Obama's nominee to keep the job, found both Democratic and Republican support during a Senate Finance Committee hearing today. KHN's Mary Agnes Carey talks with Jackie Judd about the hearing and when the Senate could vote on the confirmation.

>>Click here to listen to their conversation

JACKIE JUDD: Good day. This is Health on the Hill, I’m Jackie Judd. Marilyn Tavenner, who has been running the Centers for Medicare & Medicaid Services for over a year was on Capitol Hill today in a bid to finally be confirmed to the job. Senior Correspondent for Kaiser Health News Mary Agnes Carey covered the Senate Finance Committee hearing, and she joins us now. Hello, Mary Agnes.

MARY AGNES CAREY: Hi there.

Tavenner (Photo via CSPAN)

JACKIE JUDD: Going into the hearing there was speculation that unlike Tavenner’s predecessor, Republicans might well support her confirmation. Calling this a lovefest might be an overstatement, but it was a remarkably friendly hearing.

MARY AGNES CAREY: It was. There were a lot of Republicans that even though they had particular concerns or questions, they expressed support for her qualifications. They said: We think you’ll be a fine administrator. Orrin Hatch, for example, the ranking member of the Senate Finance Committee, said that he wishes her the best of luck and that he supported her nomination, so she did get praise from other Republicans as well.

JACKIE JUDD: And it was notable that one of the three lawmakers introducing her was Eric Cantor, from the House side, the [Republican] House majority leader. How did that come about, and what’s its significance if anything?

MARY AGNES CAREY: They've known each other a long time, and he explained how they met when he was first in the Virginia House of Delegates, and he talked about what a great job that Marilyn Tavenner has done – not only as a nurse but as a hospital administrator. She ran Virginia’s Department of Health and Human Resources. He expressed his confidence in her and talked about her qualifications. At the end of his remarks, which I thought was very interesting, he said to Republicans: Look, I don't care for the 2010 law, I don't support the ACA, but I support Marilyn Tavenner.

And I think that was a nod to Republicans to encourage them, if they're undecided about her, they can still dislike the health law but support her nomination. 

JACKIE JUDD: How did we get to this point? The atmosphere with her predecessor, Don Berwick, was so poisonous. Does this have to do with actual policy positions? Or her personal style?

MARY AGNES CAREY: I think that they're two different people, and these are two different times. You have to remember that things were much more volatile when Don Berwick was nominated to be CMS administrator. There were a lot of questions about his endorsement of the British health system. He felt that many of his remarks were taken out of context. But nonetheless, it's been a different road for Marilyn Tavenner.

She has been working [Capitol] Hill since she was named acting administrator. Many members of the Senate talked about their personal meetings that she had with them. And she knew a lot about the items they were bringing up, their concerns. And again, her extensive background as a nurse, as a hospital administrator, working at the state and federal level has given a lot of lawmakers, it seems, comfort with her in this job.

JACKIE JUDD: There were some tough questions today. Some lawmakers on both sides of the aisle actually talked about problems they view with the Affordable Care Act, and then something came up more recently related to the early release of rate information from CMS that affected market prices. Sen. [Charles] Grassley [R-Iowa] brought that up. Fill us in.

MARY AGNES CAREY: Last week, CMS was to announce the rates that it would pay Medicare Advantage plans. These are the private plans that cover about a quarter of Medicare beneficiaries. And before the official CMS announcement came out, information leaked out that CMS was not going to make as severe of a rate cut as predicted. And so when that information came out, there were lots and lots of stock trades – about $600 million of stock trades in that time period and into the next day.

And so the question from Sen. Grassley is: How did this information get out, and what are you, Marilyn Tavenner, going to do about it? And she talked about that there’s currently a full investigation into what happened, because, of course, it would be illegal for any employee – if an employee of CMS did this.

She also mentioned that the Department of Health and Human Services inspector general would be involved in this. So she promised a full investigation and to give Congress the complete result, of course.

JACKIE JUDD: Final question: When will there be a vote?

MARY AGNES CAREY: That’s unclear. The committee didn’t vote today. There were a lot of questions that she was asked that she has to get back to members on. But if those were resolved fairly quickly, they could meet soon to confirm her – which it certainly looks like that’s what’s going to happen. And then it could proceed to the floor. So the timing is unclear, but could move fairly quickly.

JACKIE JUDD: Thank you so much, Mary Agnes Carey of Kaiser Health News. I’m Jackie Judd.

MARY AGNES CAREY: Thank you.

This article was produced by Kaiser Health News with support from The SCAN Foundation.

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