Dennis G. Smith, former head of Medicaid under President George W. Bush, is to become a top Medicaid adviser in Arkansas effective Sept. 15.

He’ll be paid jointly as a faculty member at UAMS (10 percent of his time) and as a senior advisor for Medicaid and Health Care Reform in the Department of Human Services. 


I’ve asked for pay details and how this affects Dawn Stehle’s role as Medicaid director. She was recently elevated in that position to the title of  deputy director for Health and Medicaid.

Smith served for a time as secretary of Wisconsin Health Services under Gov. Scott Walker. That experience turned into a hot news story in Wisconsin, including allegations of an affair between Smith and an aide (he denied it) and an attempted murder charge filed against the husband of the female aide. He left in 2013 for a job with a Washington law firm. 


CORRECTION: I said in error that a news release didn’t include a mention of the Wisconsin work experience. It is included. The mistake was mine in copying the material.

More important is policy. From the Madison newspaper on Smith’s departure:


Democrats on Friday accused Smith of being “the mastermind of some of the Tea Party’s most radical public health policies.”

“From day one, Dennis Smith was more interested in an extreme ideology than in advocating for the health and well-being of Wisconsinites,” Democratic Party of Wisconsin Chairman Mike Tate said in a statement. “Wisconsin’s next DHS secretary has the opportunity to turn the page on this unprecedented assault on BadgerCare. I hope for all Wisconsin families, she takes it.”

This update on pay and responsibilities from Amy Webb at DHS:

His salary is $294,000. [This was later corrected by Webb to be $294,000 for salary and fringe benefits.] UAMS will pay 10 percent of the salary and DHS will be responsible for the remaining 90 percent. Because Dennis will be working only on Medicaid for us, 50% of our costs will be picked up by the feds and the remaining paid with State general Revenue. To offset our costs, we are reducing an existing Medicaid contract by at least $264,000.

Dennis will report to Director Gillespie and will no doubt work closely with Dawn Stehle, but he is not the Medicaid Director. His role will be to guide, advise and assist us as we negotiate waivers with CMS and help us design health care reforms.

The UAMS release on Smith:

Dennis G. Smith, former head of Medicaid under President George W. Bush, will become a visiting faculty member at UAMS and senior advisor for Medicaid and Health Care Reform for the Department of Human Services (DHS) effective Sept. 15.

“We were very excited when DHS Director Cindy Gillespie approached us about bringing Dennis Smith to Arkansas,” said Dan Rahn, M.D., chancellor of the University of Arkansas for Medical Sciences (UAMS). “As a visiting professor in the UAMS College of Public Health, Dennis will be teaching students and advising faculty and staff about health policy. Although he will only be spending a small percentage of his time at UAMS, we believe the experience and policy knowledge that he brings with him will be invaluable to our students and employees.”

Smith will spend 10 percent of his time as a visiting professor in the Fay W. Boozman College of Public Health (COPH). His duties at UAMS will include teaching COPH students, providing lectures on matters related to Centers for Medicare and Medicaid Services (CMS) policies and practices to UAMS faculty and staff, mentoring graduate students and advising faculty on CMS national and state policy. His appointment is from Sept. 15, 2016 to June 30, 2017.

The remainder of Smith’s time will be spent providing Medicaid policy and operations support to DHS, reporting directly to DHS Director Cindy Gillespie. Gillespie said Smith will provide valuable input and real-world experience with major health reforms as the state looks to modernize its Medicaid program. He will advise DHS during negotiations with CMS, draft and review waiver applications and help design health care reforms.

“For seven years, Dennis oversaw Medicaid in all fifty states and the territories under President Bush. He understands the nuances and intricacies of Medicaid on a level that few, if any, others can claim,” Gillespie said. “While leading Medicaid at CMS, he helped Republican governors in Rhode Island and Vermont develop the nearest version of ‘Medicaid block grants’ that the federal government has awarded. His advice and knowledge will be invaluable as we look for innovative ways to transform the Arkansas Medicaid program so that it is sustainable for future generations.”

Smith served as CMS’s Director of Medicaid and State Operations from 2001 to 2008. In addition to Medicaid, he was responsible for the State Children’s Health Insurance Program and the survey and certification arm of CMS. He served as the lead federal negotiator for landmark Medicaid demonstration projects. He also has extensive experience working with waivers associated with home and community-based care for people with developmental disabilities and is a nationally-recognized expert in long term care reform and helping programs become financially sustainable. During his time at CMS, Smith also served four months as the acting administrator of agency. 

Smith left CMS to work as a senior research fellow at the Heritage Foundation and eventually became Secretary of the Wisconsin Department of Health Services under Governor Scott Walker from 2011 to 2013. He has been in the private sector since March 2013 with McKenna Long and Aldridge and then Dentons US when the two firms merged.