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.

Karen Shields

Deputy Director

Karen Shields is the Deputy Director for 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).

Karen has held several leadership positions in the public sector, as well as at HHS. She previously served as the Deputy Director at Consumer Information and Insurance Oversight (CCIIO) and as the Director for Marketplace Operations. During her time at CCIIO she led multiple Open Enrollment periods and oversaw the team responsible for the implementation, design and launch of systems for the disbursement of over $23 billion in federal payments to health insurance plans.

Before joining CCIIO Karen worked in the Office of Information and Technology (OIT) and led the Division of Customer Liaison and Support services. She joined CMS in 2009 leading multiple laptop refreshes and the agency’s Homeland Security Presidential Directive (HSPD)-12 technology implementation.

Prior to joining CMS, Karen worked at Lockheed Martin for nine years, where she led multiple technology projects with the Departments of Defense, Treasury and other government agencies.

Page Last Modified:
08/16/2021 07:42 AM