CMS Leadership

Center for Medicaid & CHIP Services

Daniel Tsai

Deputy Administrator & Director

Daniel Tsai is the Deputy Administrator and Director of Center for Medicaid and CHIP services at the Center for Medicare and Medicaid Services (CMS) where he leads the Center in addressing disparities in health equity and serving the needs of individuals and families who rely on these essential programs.

Before joining CMS, Tsai was the Assistant Secretary for MassHealth and Medicaid Director for the Commonwealth of Massachusetts, serving for six years—the state's longest-serving Medicaid director in nearly two decades.  His tenure focused on building a robust and sustainable Medicaid program to ensure equitable coverage and improve how health care is delivered for two million individuals and families in the state.

Tsai also helped lead Massachusetts Medicaid through its most significant restructuring since the 1990s through its landmark 2016 Medicaid 1115 waiver. Under these reforms, MassHealth implemented one of the most at-scale shifts to value-based care in the nation. Through the waiver, MassHealth also launched a unique program committing significant investments for nutritional and housing supports to address the social determinants of health for high cost, at-risk individuals. In addition, during his tenure, the agency has made critical investments in strengthening community health centers, behavioral health, and home and community-based services.

Having worked closely with organizations across almost every aspect of health care, including a diverse range of Medicaid programs and provider organizations, Tsai brings extensive experience across Medicaid, Medicare, and working with stakeholders to design and implement innovative models for health care coverage, delivery and payment. Tsai earned a Bachelor of Arts in Applied Mathematics and Economics from Harvard University, summa cum laude.

Anne Marie Costello

Deputy Director

Anne Marie Costello is the Deputy Director for the Center for Medicaid & CHIP Services (CMCS) within the Centers for Medicare & Medicaid Services (CMS) at the U.S. Department of Health and Human Services (HHS). Previously, Anne Marie was Director of the Children and Adults Health Programs Group (CAHPG) in CMCS. There, she directed CMS’s work on eligibility, enrollment, quality of care measurement, and quality improvement initiatives for children and adults served by Medicaid, the Children’s health Insurance program (CHIP), and the Basic Health Program (BHP), leading the development of national policy for low-income children and adults enrolled in Medicaid, CHIP, and BHP. She led the implementation of quality improvement initiatives on maternal and child health, children’s oral health and prevention, and special initiatives related to the Agency’s response to the Zika virus and the Flint water crisis.

Anne Marie is a nationally recognized expert on health policy and has extensive experience implementing Medicaid, CHIP, and BHP policies and operations at the federal and state levels. Before joining CMS, she held a number of leadership positions in state and local government and in the nonprofit sector. Anne Marie also served as the Director of the Bureau of Compliance at the New York State Department of Health. She was responsible for oversight of Medicaid policy implementation in New York City and implementation of statewide outreach and enrollment initiatives.

Anne Marie holds a Master of Public Health degree from Hunter College.

Sara Vitolo

Deputy Director

Sara Vitolo serves as Deputy Director of the Center for Medicaid and CHIP Services (CMCS) within the Centers for Medicare & Medicaid Services (CMS) at the U.S. Department of Health and Human Services (HHS).


Since joining CMCS in March 2022 as Acting Deputy Director, Sara leads work across CMCS to protect and strengthen the Medicaid and CHIP programs. In addition to promoting excellence in all aspects of CMCS operations, Sara guides the center to achieve its proactive policy priorities of improving coverage and access, advancing health equity, and driving innovation and whole-person care. Prior to CMCS, Sara was the Deputy Director of the Medicare-Medicaid Coordination Office (MMCO) at CMS, working to improve outcomes for the 12 million individuals dually eligible for Medicare and Medicaid. In this role, Sara focused on modernizing the Medicare Savings Programs, promoting high-value Medicare-Medicaid integrated care, and reducing disparities in coverage and access.


Before joining MMCO, Sara worked on Medicare payment policy within CMS and at the White House in the Office of Management and Budget. Prior to federal service, Sara helped strengthen access to health services abroad at IntraHealth International, and taught science at an elementary school in Boston as an AmeriCorps member. Sara received a B.S. in biology from Stonehill College and an M.S.P.H. in health policy from the University of North Carolina at Chapel Hill.  

Jessica Lee, M.D.

Acting Chief Medical Officer

Jessica Lee, MD, MSHP is the acting Chief Medical Officer for Center for Medicaid and CHIP Services, where she leads the center's clinical strategy. Dr. Lee was previously the medical officer in the Division of Quality and Health Outcomes at CMCS, where she led initiatives in quality measures and quality improvement.

Dr. Lee has deep expertise in clinical medicine and quality, and a background in health policy at the health system, state, and federal levels. She has served as a senior health policy analyst at the Government Accountability Office, focusing on payment policy, and has conducted grant-funded research focused on the intersection of health care delivery systems and population health.

Dr. Lee continues to care for patients as a practicing pulmonologist at the University of Pennsylvania and ICU physician at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia. She earned her A.B. with honors from Harvard College and her M.D. from the University of Colorado School of Medicine. She completed internal medicine residency at Brigham & Women’s Hospital and pulmonary and critical care fellowship at the University of Pennsylvania.


CMCS Functional Statement

  • Serves as CMS's focal point for assistance with formulation, coordination, integration, and implementation of all national program policies and operations relating to Medicaid, the Children's Health Insurance Program (CHIP), and the Basic Health Program (BHP).
  • In partnership with States, assists State agencies in successfully carrying out their responsibilities for effective program administration and beneficiary protection, and, as necessary, supports States in correcting problems and improving the quality of their operations.
  • Identifies and proposes modifications to Medicaid, CHIP, and BHP program measures, regulations, laws, and policies to reflect changes or trends in the health care industry, program objectives, and the needs of Medicaid, CHIP, and BHP beneficiaries. Collaborates with the Office of Legislation on the development and advancement of new legislative initiatives and improvements.
  • Serves as CMS's lead for management, oversight, budget, and performance issues relating to Medicaid, CHIP, BHP, and the related interactions with States and the stakeholder community.
  • Coordinates with the Center for Program Integrity on the identification of program vulnerabilities and implementation of strategies to eliminate fraud, waste, and abuse.  Leads and supports all CMS interactions and collaboration relating to Medicaid, CHIP, and BHP with States and local governments, territories, Indian Tribes, and tribal healthcare providers, key stakeholders (e.g., consumer and policy organizations and the health care provider community) and other Federal government entities.  Facilities communication and disseminates policy and operational guidance and materials to all stakeholders and works to understand and consider their perspectives, support their efforts, and to develop best practices for beneficiaries across the country and throughout the health care system.
  • Develops and implements a comprehensive strategic plan, objectives, and measures to carry out CMS's Medicaid, CHIP, and BHP mission and goals and positions the organization to meet future challenges with Medicaid, CHIP, and BHP.
Page Last Modified:
08/01/2023 02:49 PM