CMS head Tavenner, who presided over rocky HealthCare.gov launch, steps down

Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, announced she would step down from her post at the end of February.

Tavenner, a nurse by training and a former hospital executive, was thrust into the spotlight after the ill-fated launch of HealthCare.gov in October 2013. She was among the leading officials called on by Congress to explain the massive IT failure that resulted in relatively few users being able to access the site when it opened.

"To the millions of Americans who attempted to use HealthCare.gov to shop and enroll in health care coverage, I want to apologize to you that the website had not worked as well as it should," Tavenner told the House Ways and Means Committee in an Oct. 29, 2013 hearing. "HealthCare.gov can and will be fixed. We are working around the clock to deliver the shopping experience you deserve"

The role played by Tavenner and other senior political appointees, including Kathleen Sebelius, former secretary of Health and Human Services, in performing management oversight of the development and launch of HealthCare.gov has yet to be fully explained. The Office of the Inspector General at HHS is preparing reports on acquisition and contractor management due to be released sometime in the current fiscal year. These should provide more detail on the level of executive involvement in managing the IT behind the 2010 health care law. An email to the press office at the HHS OIG requesting an update on the status of these reports was not answered.

HHS Secretary Sylvia Burwell praised Tavenner's tenure as CMS administrator, including her work on implementation of the health care law. "It's a measure of her tenacity and dedication that after the tough initial rollout of HealthCare.gov, she helped right the ship, bringing aboard a systems integrator and overseeing an overhaul of the website," Burwell said in a memo announcing Tavenner's departure.

Implementation of the law was only part of Tavenner's job. As CMS administrator, she was responsible for managing the government health care payer programs that collectively spent almost $1 trillion in fiscal 2014, according to the Congressional Budget Office.

Tavenner was front and center as a spokesperson for the development of the Federally Facilitated Marketplace, the shopping portal for HealthCare.gov, and back end functionality as the Oct. 1, 2013 launch approached. Tavenner offered some details on the IT behind implementation in congressional testimony in August 2013, but this was largely focused on the "data hub" component of HealthCare.gov, which was used to confirm the eligibility of insurance applicants for coverage by pinging a variety of government databases, to check on income, immigration status, military service, existing coverage by government payers, and other factors. This portion of the system attracted the attention of many critics in Congress because of security and privacy concerns, and because of its complexity, but it largely worked as advertised.

The overall project to fix HealthCare.gov was given over to former top administration budget official Jeff Zients, who lead a team including former federal CTO Todd Parks, and a cadre of ace programmers drawn from Silicon Valley. The so-called tech surge also involved naming United Health division Optum as the principle contractor on the overall HealthCare.gov system.

Optum division chief Andy Slavitt was eventually tapped to serve as deputy administrator of CMS, and he will serve as acting administrator once Tavenner departs. Slavitt was, " a key member of the team that helped turn around the website last year," Burwell said in her memo.