A high-ranking Senate Democrat is probing whether Centers for Medicare & Medicaid Services Administrator Seema Verma violated her ethics agreement by reviewing waiver proposals from states that worked with her consulting firm.
Sen. Ron Wyden, D-Ore., ranking member of the Senate Finance Committee, outlined his concerns in a letter (PDF) sent Friday to Robert Charrow, the general counsel for the Department of Health and Human Services.
Wyden noted that provisions in Verma’s ethics agreement require her to obtain written approval to participate “personally and substantially” in matters involving seven states that her consulting firm, SVC Inc., provided services to before she became CMS administrator.
But despite this, Wyden contends, governors in Arkansas, Kentucky and Iowa—three of the states named in Verma’s ethics agreement—have made statements that suggest she was significantly involved in matters those states brought before CMS.
Both Arkansas and Kentucky have submitted Section 1115 waivers seeking to impose work requirements on Medicaid beneficiaries, while Iowa submitted a Section 1332 waiver aimed at retooling its individual insurance market. CMS approved Kentucky’s application earlier this month, just days after the agency released guidelines that pave the way for states to issue similar policies.
Because she helped Kentucky design its demonstration project as a consultant, Verma said back in April that she’d recuse herself from reviewing the state’s application. But Kentucky Gov. Matt Bevin said during a press conference in January that Verma personally informed state officials that their waiver had been approved, Wyden’s letter said.
In an emailed statement about the letter, an HHS spokesman said "the department received Senator Wyden’s inquiry and is in the process of reviewing his concerns.” But he also pointed out that Verma has a “limited authorization” that allows her to participate personally and substantially in matters involving the seven states her firm has worked with—provided she recuse herself from reviewing Arkansas, Kentucky or Iowa's waivers.
Still, Wyden wants both a detailed description of Verma’s involvement with the three states and whether she sought any waiver or approval prior to that involvement.
This is not the first time that Wyden has raised questions about Verma’s ethics. During her confirmation hearing, he quizzed Verma about her work with then-Indiana Gov. Mike Pence to design the state’s Medicaid demonstration project, while also being paid by contractors charged with carrying out the program. Verma responded that her company took steps to ensure there was no conflict.
Editor's note: This article has been updated to include comment from an HHS spokesman.