Former Bush Medicaid head to advise Arkansas Department of Human Services

The man who oversaw Medicaid under President George W. Bush will be a senior advisor for Medicaid and health care reform for the state Department of Human Services.

Beginning Sept. 15, Dennis Smith will advise the state DHS during negotiations with the federal Centers for Medicare and Medicaid Services (CMS), where he led Medicaid from 2001 to 2008. He will help draft waiver negotiations sent to that agency that free the state from federal requirements. He also will help the state create health care reforms. His contract runs to June 30, 2017.

Amy Webb, DHS spokesperson, said Smith’s salary will be $257,347.68, or $294,000 with benefits, and 90% of his salary will be paid by Medicaid. The rest will be paid by UAMS, where he will be a visiting professor. DHS is reducing another Medicaid contract by at least $264,000 to offset the cost.

Smith was CMS’ director of Medicaid and state operations from 2001 to 2008, where he oversaw Medicaid and was responsible for the State Children’s Health Insurance Program. He also was the lead federal negotiator for Medicaid demonstration projects. He has significant experience with waivers associated with care for individuals with developmental disabilities and is an expert in long-term care reform and in helping programs become financially sustainable, the UAMS release said.

After working with CMS, he became a senior research fellow at the Heritage Foundation and later secretary of the Wisconsin Department of Health Services from 2011-13 under Gov. Scott Walker. He has since been in the private sector.

The news first became known through an email sent to Department of Human Services employees by DHS Director Cindy Gillespie. The subject heading was, “The leading Medicaid expert in the United States is joining us.” Smith oversaw Medicaid for seven years and was the agency’s acting administrator for four months.

In the email, Gillespie said, “He understands the nuances and intricacies of Medicaid on a level that few, if any, others can claim. While leading Medicaid at Centers for Medicare and Medicaid Services (CMS), he helped governors in Rhode Island and Vermont develop the nearest version of ‘Medicaid block grants’ that the federal government has awarded.”

Block grants are funding awarded to states with fewer strings attached, allowing states to spend the money as they see fit.

Sen. Jim Hendren, R-Gravette, said he liked Smith’s record with block grant programs, adding, “It will at least give us the benefit of someone who’s worked it before. As (the Affordable Care Act) continues to implode, even if Clinton is elected, the feds will be more receptive and less dictatorial – I hope.”

According to a press release from the University of Arkansas for Medical Sciences, 10% of Smith’s time will be spent as a visiting professor in the Fay W. Boozman College of Public Health, where he will teach students, lecture faculty and staff about CMS policies, and mentor graduate students.

Ray Hanley, president and CEO of the Arkansas Foundation for Medical Care, said he first met Smith when Smith was the Virginia Medicaid director at the same time Hanley was directing Medicaid in Arkansas.

“He brings a very unique mix of experience leading at the federal and state levels,” he said. “His CMS experience especially will be benefit to Arkansas. I’m glad he is here.”