With a vote of 91-7, the Senate confirmed Marilyn Tavenner, a former hospital executive and Virginia state government official as administrator of the Centers for Medicare and Medicaid Services (CMS). While the Senate showed broad bi-partisan support for her, there are still strong partisan divisions over the Affordable Care Act which she plays a significant role in implementing. It has been nine years since the Senate confirmed an administrator.  She has been serving as the acting head of the agency.