Governor optimistic on Medicaid work waiver | Arkansas Blog

Tuesday, January 16, 2018

Governor optimistic on Medicaid work waiver

Posted By on Tue, Jan 16, 2018 at 2:17 PM

SEEMA VERMA: Medicaid admionistrator, who once made money advising Arkansas on Medicaid, is epxected soon to make a decisiion on allowing Medicaid rule changes in Arkansas requested by Gov. Asa Hutchinson. - WIKIPEDIA
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  • SEEMA VERMA: Medicaid admionistrator, who once made money advising Arkansas on Medicaid, is epxected soon to make a decisiion on allowing Medicaid rule changes in Arkansas requested by Gov. Asa Hutchinson.
Gov. Asa Hutchinson's press aide J.R. Davis tells me today that the governor is confident that positive word will come soon on a federal waiver requested by Arkansas to allow it to impose a work requirement on Medicaid recipients.

I asked if they'd met with Seema Verma, the Medicaid administrator, and if she'd offered any assurances of success on requests for the work requirement and for changing the income eligibility from 100 to 138 percent of the federal poverty income.

Said Davis by e-mail:

Yes, we’re confident. The Gov spoke with both the acting HHS Secretary and Administrator Verma last week re: Arkansas’s waiver and the guidance from CMS last week. We should hear something soon, in terms of Arkansas’s work requirement.
The Trump administration opened the door to the work rule last week, with the first approval going to Kentucky, as David Ramsey reported in detail here

I was interested on reading of Hutchinson's continued meetings with federal officials because of the criticism Democratic U.S. Sen. Ron Wyden raised in June about his perception of a conflict in Verma participating in discussions with Arkansas.

Verma's ethics disclosure form said she did consulting work on Medicaid for Arkansas and other states before taking the job as administrator of Medicare and Medicaid Services. The state took exception at the time, saying Verma didn't work for the state, but for a contractor, Hewlett Packard, that did business with the state. At that time, Verma reportedly had to receive permission from the Health and Human Services Department director to meet with Arkansas and it was granted. Wyden particularly objected to Verma's communication with Dennis Smith, an Arkansas Medicaid advisor paid $294,000 from a combination of state agency and UAMS contributions. Wyden complained that Verma shouldn't be holding talks about favors requested by Arkansas, a state that had once been a source of money paid to her.

I asked J.R. Davis about the restriction mentioned in June on Verma talks with Arkansas.
To our knowledge CMS has placed no restrictions on Administrator Verma’s involvement with Arkansas in these negotiations. It’s on CMS to do so. 
If any special permission is still required by the acting department director, she clearly has received it to talk with Hutchinson. I've emailed a requestion to the federal agency on the point.

UPDATE: It's worth noting that Kentucky's plan, similar to Arkansas's, is already under court challenge. The nutty governor there has threatened to end coverage for 480,000 people if he doesn't get his way on the work requirement. Would Asa Hutchinson do that?

UPDATE II: A CMS spokesman says Verma received authorization to work on matters involving Arkansas shortly after her appointment and that authorization remains in effect. She does not have to receive waivers for each subsequent meeting.

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