COLUMBIA -- Gov. Nikki Haley's nominee to run the state's cash-strapped Medicaid agency won initial approval Thursday in a Senate confirmation hearing, clearing the way for likely final approval next week.

Anthony Keck, 43, would run the S.C. Department of Health and Human Services, the Medicaid agency that provides health care coverage for the state's elderly, disabled and poor. The agency is running a $228 million deficit in the current fiscal year. Haley also charged Keck with finding a way to avoid being part of the federal health care overhaul law.

The Senate could give Keck final approval next week. Keck declined to talk to reporters until after that vote. Haley has asked the Senate to wrap up all confirmation work on her Cabinet nominees by Feb. 1.

Keck has been deputy secretary for Louisiana's Department of Health and Hospitals since October 2009. The committee's screening process turned up a couple of instances of late and erroneous taxes that Keck said he had taken care of previously.

Senate Medical Affairs Committee Chairman Harvey Peeler, a Gaffney Republican, asked Keck how he'd deal with the current fiscal year deficit at the agency.

Keck's predecessor had told the state's financial oversight board that unless the state covered the shortfall, it would have to shut down payments to health care providers on March 1.

Peeler wanted to know whether Keck would continue to pursue the request or pare it back.

"In this case, operating the program essentially as agreed with the federal government seems to be costing us $228 million more than we thought," Keck said. "It will have to be a multi-prong strategy. It cannot rely, in my opinion at this juncture, solely on cuts."