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Medicare nominee gets lifetime payout

No waiver despite hospital ties

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President Obama's nominee to run the nation's Medicare and Medicaid agency can count on receiving more than $160,000 a year in retirement pay for the rest of her life from the country's largest private hospital chain, records show.

Marilyn Tavenner, a former executive at Hospital Corporation of America (HCA), was nominated in November to be administrator for the Centers for Medicare and Medicaid Services, the agency at the heart of Mr. Obama's health care initiative. She disclosed the arrangement with her old employer in a newly filed government ethics form.

HCA routinely lobbies on Medicare issues on which Ms. Tavenner has a big influence, but officials say there are no plans afoot to issue a waiver exempting Ms. Tavenner from Mr. Obama's "revolving door" ethics rules.

Under the Obama rules, appointees are barred for two years from "participating in any particular matter involving specific parties that is directly or substantially related" to former employers and clients.

Because Ms. Tavenner left HCA in 2006, "she would not need a waiver" as a result of the annual payment from the company, said Eric Schultz, a White House spokesman. Still, she "would likely be recused from anything that would impact HCA's ability and willingness to make the payment," Mr. Schultz said.

Craig Holman, legislative representative at Public Citizen, a watchdog group, said that although ethics provisions may not apply in Ms. Tavenner's case because she quit working for the company more than two years ago, she still would be required to comply with federal conflict-of-interest rules.

"If she weighs in on some action that substantially and directly impacts HCA out of proportion with the rest of the industry, then that would run afoul of the conflict-of-interest code," he said.

HCA, based in Tennessee, operates more than 260 hospitals and surgery centers in 20 states and Great Britain, employing about 183,000 people, according to the company. It has recently lobbied Congress to repeal provisions of the Patient Protection and Affordable Care Act, Senate lobbying disclosure reports show.

The company also lobbied the Senate on proposed issues for Medicare inpatient payment systems, records show.

"Ms. Tavenner was a senior executive at HCA who retired from the company over six years ago," said HCA spokesman Ed Fishbough. "Any retirement payments to her are fixed and irrevocable and in accordance with the terms of our retirement plans at the time."

Ms. Tavenner was nominated to replace Dr. Donald Berwick as chief of CMS after he encountered sharp Republican opposition. After serving in an acting basis, he resigned late last year, weeks before his appointment was set to expire.

Ms. Tavenner worked as principal deputy administrator at CMS. She also led Virginia's Health and Human Resources Department under Gov. Tim Kaine, a Democrat currently running in Virginia's U.S. Senate race.

She spent nearly 20 years in nursing, worked as a hospital chief executive for three years and spent about a decade in various executive-level positions with HCA, according to the White House announcement of her nomination.

In a recent filing with the U.S. Office of Government Ethics, she reported that through a supplemental executive retirement plan at HCA, "I will continue to receive $162,524 for life."

She has been a less controversial pick than Dr. Berwick and won the backing even of House Majority Leader Eric Cantor, Virginia Republican.

Mr. Cantor told the Associated Press in November that Ms. Tavenner was "eminently qualified" to run the agency.

"I would hope to be able to support her," Mr. Cantor was quoted as saying. "Obviously, I'm not in the Senate, so I don't have that vote, but I do think she is qualified. Obviously, she'll be working for a president with an agenda that's quite different from mine."

After the White House announced the Tavenner nomination, Sen. Orrin G. Hatch, Utah Republican and ranking member of the Senate Finance Committee, said the Senate would "thoroughly examine" the nomination.

"Any nominee to a federal agency with this much power and authority over the lives of millions of Americans must be carefully scrutinized," he said. "Republicans on the Finance Committee look forward to examining her record and gaining an understanding of her views on Medicare, Medicaid and the president's health law."

Ms. Tavenner isn't the only nominee to join the administration with a hefty separation package from the health care industry.

Thomas Strickland, chief of staff at the Interior Department, reported a $2 million bonus on disclosure forms for his work at UnitedHealth Group before his nomination hearing. He was one of three top corporate officers who received more than $5 million from the company in 2008, according to Securities and Exchange Commission filings.

He sailed through his Senate confirmation hearing months earlier with no mention of his bonus.

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