Centers for Medicare & Medicaid Services Leadership
Liz Richter, Acting Administrator
Liz Richter is the Acting Administrator for the Centers for Medicare & Medicaid Services. In this position, she leads the staff that develops policies for and manages the operations of the fee-for-service portion of the Medicare Program.
Liz has served with CMS since 1990. She began in the Bureau of Policy Development working on inpatient hospital payment policy. She subsequently worked on a variety of Medicare payment issues. In 1998, Liz moved to the Office of Financial Management, where in 2001 she became Director of the Financial Services Group. In 2003, she became Director of the Hospital and Ambulatory Policy Group in the Center for Medicare Management and took on her current responsibilities in 2007.
Centers for Medicaid & CHIP Services Leadership
Anne Marie Costello, Acting Deputy Administrator and Director
Anne Marie Costello serves as Acting Deputy Administrator and 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 & 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.
Judith Cash, Acting Deputy Director
Judith Cash serves as the Acting 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, as the Director of the State Demonstrations Group (SDG), Judith led the agency’s work on Medicaid demonstrations and waivers authorized under Section 1115 of the Social Security Act. Prior to assuming the role of Director, Judith served as the Deputy Director for Policy in SDG and, before that, had led CMCS’ work on Medicaid eligibility and enrollment.
Before arriving at CMS in 2012, Judith had spent most of her career in Virginia, working to ensure access to health care for low income and other vulnerable children and families. She was the Deputy Director at the Virginia Health Care Foundation, where, among other things, she led the Foundation’s grant making and strategic partnerships. She also led the Foundation’s work on Medicaid and CHIP outreach and enrollment, and served as Chair of the Virginia General Assembly’s Medicaid and Children’s Health Insurance Program Advisory Committee. Judith also served as President and CEO of CHIP of Virginia, was Health Policy Analyst for the Virginia General Assembly’s Commission on Youth, and Executive Director of the Children’s AIDs Network.