By Louise Radnofsky
WASHINGTON--Marilyn Tavenner, the top official at the U.S.
agency overseeing the troubled rollout of the health law and the
Medicare insurance program for the elderly, is leaving her post in
February, agency officials confirmed Friday.
She will be succeeded as administrator at the Centers for
Medicare and Medicaid Services by Andy Slavitt, who is currently
the second-highest ranking official at the agency. Mr. Slavitt will
ultimately need Senate confirmation if he is to become the
permanent administrator. As a top executive at UnitedHealth Group,
Mr. Slavitt had worked closely with the agency on HealthCare.gov's
technical issues and was brought in-house in 2014.
Ms. Tavenner had come to CMS from Virginia state government,
where she was health secretary. She started her career as a nurse,
and rose to executive positions in the for-profit hospital sector.
At the time of her nomination, she had been considered among the
least controversial candidates to succeed Don Berwick, who never
got Senate confirmation and remained acting administrator for more
than a year. News of Ms. Tavenner's plans to leave after five years
at the agency were first reported by the Huffington Post.
Both the Obama administration and the George W. Bush
administration faced problems confirming CMS administrators, which
left the agency without a permanent head for more than six years
until Ms. Tavenner's confirmation in 2013 after more than a year as
acting administrator. With many Republicans in the GOP-controlled
Senate pressing for major changes to the 2010 health law, the
confirmation process could again be difficult.
Still, the Obama administration had a relatively easy process
winning approval last year for Sylvia Mathews Burwell as secretary
of Health and Human Services after the departure of Kathleen
Sebelius. It now faces a number of challenges to the health law,
including a Supreme Court case challenging the subsidies for
millions of consumers, as well as Republican efforts to scrap other
parts of it.
Mr. Slavitt, 48 years old, was one of Ms. Burwell's first hires
last summer. He quickly took on preparations for the second main
open-enrollment period for the health law, which started relatively
smoothly in mid-November. He had been group executive vice
president at Optum, a unit of insurer UnitedHealth Group and the
parent company of Quality Software Services Inc., the contractor
picked to lead the cleanup effort when HealthCare.gov was crippled
by technology troubles.
Ms. Tavenner, 63, didn't give a reason for her departure in a
farewell email to CMS staff. She listed a series of agency
accomplishments under her tenure, including slowing the growth of
health-care costs, now at a historically low rate.
She also praised the current operation of the health law's
online insurance exchanges. But problems with the law's rollout
have continued to dog her, including overestimating the number of
people who had coverage through the exchanges in congressional
testimony last fall.
HHS Secretary Burwell praised Ms. Tavenner in a separate email
for her "exemplary service, leadership, and historic record of
accomplishment." That email also noted her Senate confirmation as
"a great testament to the respect she's earned."
Ms. Tavenner has enjoyed good relationships with a number
Republicans, helping to insulate her from criticism at the height
of the problems during the first open enrollment period.
Sen. Orrin Hatch, the Utah Republican who heads the Senate
Finance Committee, said in a statement that "Marilyn has done a
great job in a very difficult position under near impossible
circumstances." He called her "a strong leader and a
straight-shooter who brought much needed private sector sensibility
into the agency."
Mr. Slavitt's role at CMS has raised some questions on Capitol
Hill. Last year, Sen. Hatch and other Republican lawmakers sent a
letter to CMS about the potential for a conflict-of-interest from
executives at Mr. Slavitt's company working so closely with CMS. A
CMS spokesman said the agency had taken the steps to prevent
organizational conflicts of interest.
Ms. Tavenner has also faced scrutiny over Medicare operations. A
Wall Street Journal article last month highlighted her intervention
on Medicare fraud investigations after being contacted by elected
officials.
In one case, Ms. Tavenner instructed deputies to restore blocked
Medicare payments to Houston's Riverside General Hospital in 2012,
even as the agency was cooperating in a criminal investigation of
the facility, according to former investigators and documents
obtained by the Journal. The hospital's top executive was indicted
in a $158 million fraud scheme two months following the order, and
the CEO was convicted in October.
In a statement at the time, Ms. Tavenner said the Riverside
episode "reflected the tension between fraud prevention and access
to care." While she also noted that she was unaware of the pending
indictments, her job required her to "balance two important policy
goals"--saving taxpayer money and protecting Medicare
beneficiaries.
Tom Scully, who had served as the CMS administrator for three
years during the Bush administration, said Ms. Tavenner had been
thinking about leaving for around six months. "Five years is a long
time, and I can't imagine anyone doing that job for five years," he
said.
Christopher S. Stewart contributed to this article.
Write to Louise Radnofsky at louise.radnofsky@wsj.com
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