DENNIS SMITH: Senator questions whether federal Medicaid chief was cleared to talk with an Arkansas official given her past work for the state.

Sen. Ron Wyden, the ranking Democrat on the Senate Finance Committee, is raising questions about talks between Seema Verma, administrator of the Centers for Medicare and Medicaid Services, and Dennis Smith, a Medicaid advisor to the Arkansas Department of Human Services.

Verma had a private consulting firm that did work for Arkansas. Under an agreement entered when she took the federal Medicaid job last year, she was banned from speaking to Arkansas health officials without a written waiver from Health Secretary Tom Price. Press reports said she was supposed to speak with Smith in mid-March.


UPDATE: Arkansas Department of Human Services takes exception to Wyden’s characterization. Spokeswoman Amy Webb said Verma “was not a consultant to the state and did not have a contract with us. I believe she did some consulting work for HPE, which is one of our contractors.”

Her ethics disclousre form says she received income  fro “Hewlett Packard Arkansas Medicaid” and her agreement on seeking waivers for work with related partieis said:


“I provided consulting services to the States of Arkansas, Indiana, Iowa, Kentucky, Ohio, South Carolina, and-Virginia through SVC Inc. Pursuant to 5 C.F.R. § 2635.502(d), I will seek a written authorization to participate personally and substantially in particular matters involving specific parties in which I know the States of Arkansas, Indiana, Iowa, Kentucky, Ohio, South Carolina, and Virginia are a party or represents a party.”

Wyden distributed a letter and news release:

“I am growing increasingly concerned that the Department of Health and Human Services is not effectively implementing its process to enforce Administrator Verma’s ethics agreement and the standards of ethical conduct,” Wyden wrote in the letter to Elizabeth Fischmann, the Designated Agency Ethics Official for the Department of Health and Human Services (HHS). “Arkansas is listed repeatedly in Administrator Verma’s ethics materials as a state with which she has a covered relationship, and yet there does not appear to be any authorization for her participation in the March 17 call based upon the approved waivers released to and by OGE in response to its data call.”

This letter is the fourth that Sen. Wyden has sent to HHS regarding Verma’s compliance with ethical standards. To date, HHS has not supplied any substantive responses to these requests. This most recent letter was sent at a time when the Senate is considering close to $800 billion in cuts to the Medicaid program that Verma oversees.

Wyden noted that a call to Smith appeared on Verma’s calendar. Smith was hired under a deal where he was made a faculty member at UAMS, but would be spending most of his time advising on Medicaid issues. Smith, who came to Arkansas following a controversial period in Wisconsin, is paid $294,000 by Arkansas.

Wyden said Verma got a waiver to speak with another Arkansas official three days before the March 17 call and she obtained a waiver for a later call as well, but none is reflected for the scheduled call with Smith.

Wyden has asked a series of questions about the communications, including why a waiver should be granted for Verma to speak with Arkansas officials.

Arkansas has an interest in winning approval from the CMS for a number of changes in the operation of the Medicaid expansion program. At the core of Wyden’s letter: Should Arkansas be discussing such issues with someone it once employed (or had an arrangement with someone it employed)?

Verma was based in Indiana and had close ties to Mike Pence,, former Indiana governor.


PS: Coincidentally, Arkansas today submitted to CMS the waivers it needs to throw 60,000 people off the Medicaid expansion rolls by lowering the income qualification to 100 percent of poverty and imposing a work requirement.