Congress has not confirmed an administrator for the Centers for Medicare & Medicaid Services (CMS) for six and half years until last week when the U.S. Senate confirmed Acting Director Maryiln Tavenner . Ms. Tavenner has served as Acting Administrator for CMS since December 2011 after preceding Donald Berwick, who also served as Acting Administrator for 17 months. Because of political turmoil and the controversy behind the Affordable Care Act (ACA), the confirmation of an administrator’s position has been stalled. As the CMS Administrator, Ms. Tavenner plays a huge role in carrying out major provisions of the new health care law, including expanding Medicaid and creating the new health insurance marketplaces.