January 28, 2013
On January 22, the U.S. Department of Health and Human Services (HHS) released 229 documents to Public Record Media in response to PRM’s ongoing federal lawsuit. In December of last year, PRM sued HHS for failing to respond to its FOIA request of February 22, 2012.
PRM’s request sought correspondence between Minnesota State Senator John Marty and CMS, the component of HHS responsible for overseeing state Medicaid spending. The request also sought documentation related to the “1115 waiver” that allows federal dollars to be spent on Minnesota’s public health care programs, even though those programs do not entirely conform to federal Medicaid rules.
Managed care controversy
Since 2010, members of the Minnesota Legislature have been asking questions about the operation and oversight of the state’s Medicaid-funded public programs. Minnesota’s public programs are paid for by blocks of state and federal money that are distributed through non-profit Health Maintenance Organizations (HMOs). Under Minnesota’s “managed care” program model, HMOs reimburse medical providers for costs associated with public program enrollees.
In 2010, David Feinwachs – former general counsel for the Minnesota Hospital Association – began raising questions about the amount of money that HMOs were retaining from their public program business, as opposed to paying out for program costs. Minnesota legislators – including State Senator John Marty – began asking questions about managed care oversight and accountability.
Senator Marty request
In 2011, Senator Marty sent letters to the Centers for Medicaid Services (CMS) in which he asked CMS to discontinue the 1115 waiver that allowed Minnesota’s public programs to receive federal Medicaid funds. Senator Marty’s letters expressed concerns that such funds were being wasted, rather than being channeled towards their intended purposes.
In early 2012, PRM obtained some of Senator Marty’s correspondence, and filed a FOIA request with CMS to discover the extent to which Senator Marty’s letters had been discussed within CMS, and whether they had had an impact on determinations about the renewal of Minnesota’s 1115 waiver.
PRM waited two months for HHS to provide documents, and then filed an administrative appeal in April of 2012. By December of 2012, PRM had received no determination related to its administrative appeal, and filed suit in federal court to compel compliance the FOIA.
On January 22, 2013, HHS released 229 un-redacted documents to PRM in an “interim response” to PRM’s FOIA request. The release came three days before HHS filed its answer to PRM’s complaint in federal court.
The documents released by HHS contain copies of correspondence between Senator Marty and CMS, as well as pages of records related to the review of Minnesota’s Medicaid waiver. Among these records are multiple reviews of public programs elements, as well as a draft of an “Agreement in Principle” to extend the Medicaid waiver.
In its letter of Jan 22 – as well as in its answer filed on Jan 25 – HHS indicated that additional documents will be forthcoming.
We will post the documents in our archive shortly, and will provide summary information when we have reviewed the records in total.