Verma Submits Resignation as CMS Chief Ahead of Biden Transition, Touts Nursing Home COVID Work

Seema Verma, the administrator of the Centers for Medicare & Medicaid Services, submitted her official resignation on January 14, ahead of the inauguration of President-elect Joe Biden on January 20 — and touted the agency’s work with nursing homes, particularly amid the COVID-19 public health emergency.

“As the Trump Administration comes to a close, I have submitted my official resignation and am preparing to turn the keys over to the next Administrator next week,” she wrote on Twitter on January 15. “The past four years have been filled with many tests and accomplishments.”

Verma’s resignation will be effective January 20; it is customary for appointed officials in an outgoing presidential administration to pre-submit their letters of resignation prior to the formal transition.


In a blog post to CMS, Verma detailed “the many achievements the @CMSGov team has effected during my tenure,” as she described it on Twitter. Those changes included lowering premiums for Medicare Advantage, implementing price transparency measures, promoting value-based care, and cutting “time-consuming regulations.”

“Crucially, all these successes have proven a strong foundation on which CMS has built a highly effective Coronavirus pandemic response,” Verma wrote in the blog post. “We acted with unprecedented speed and vigor, pushing out no fewer than four rules related to Coronavirus during the public health emergency, waiving over a hundred Medicare regulations, and approving over 600 Coronavirus-related waivers, demonstrations and other state-designed and federally approved flexibilities in the Medicaid program.”

During her tenure as CMS administrator, Verma oversaw a range of initiatives at CMS that changed the landscape for nursing homes.


The Patient-Driven Payment Model (PDPM), which was announced in April 2018, overhauled Medicare reimbursement for nursing homes by centering payment on patient conditions. It took effect in October of 2019. At the time of the announcement, experts said the new system was a sign that the agency had listened to provider concerns about the abandoned Resident Classification System, Version I (RCS-I).

“It appears as if CMS has listened very carefully to the feedback on the proposed final rule … and they’ve returned back to the industry what appears to be a sound proposal to better capture patients’ clinical characteristics, and pay for appropriate nursing and medical care,” Colleen O’Rourke, senior vice president of network and clinical solutions at care transitions company naviHealth, told SNN at the time.

During the pandemic, providers found the new system critical to their finances, with the Morganville, N.J.-based consulting firm Zimmet Healthcare Services Group noting in December 2020 that “it arrived just in time.”

Verma also spotlighted the agency’s work on “Transforming Medicaid,” which included a push for block grant programs for Medicaid funding and a controversial attempt to overhaul regulations for Medicaid supplemental payment programs to nursing facilities.

The Medicaid Fiscal Accountability Rule (MFAR), announced in November 2019, put the fate of billions in such payments into uncertain territory and drew a deluge of comments from stakeholders ranging from operators to residents of continuing care retirement communities.

MFAR was eventually withdrawn via a Twitter announcement in September 2020, after several stakeholders had requested it be rescinded.

Verma crucially oversaw the agency’s work with nursing homes during the COVID-19 pandemic. In her resignation, the outgoing leader touted CMS’s work given the vulnerability of residents to the novel coronavirus.

“We reissued and updated infection control guidance, visitation guidance, stayed in constant communication with the industry, focused surveys on infection control, developed training, supported efforts to deliver supplies and testing, and organized strike teams to support nursing homes dealing with outbreaks,” she wrote. “We worked with the CDC to implement a nationwide reporting system in a matter of weeks, and more.”

CMS came under fire from several sources for not taking enough action in the early days of the pandemic, criticism that Verma strongly rebuked when it arose in various media outlets, ranging from The New York Times to “60 Minutes” on CBS.

Deaths in long-term care facilities from COVID-19, including residents and workers, passed 100,000 in November, and cases and deaths in such facilities across the U.S. have continued to rise through December 2020.

President-elect Biden has already signaled his intention to nominate California attorney general Xavier Becerra to lead the Department of Health and Human Services (HHS), under which CMS falls, though who will end up in the administrator’s chair remains unknown.

The Biden team on Friday did indicate that former CMS chief Andy Slavitt, who served on an acting basis during the final two years of the Obama administration, will join the new administration as a senior advisor on COVID-19 matters, CNN reported.