Agency not forthcoming, legislator says

Human Services keeping lid on private-option details, GOP senator states

Arkansas Sen. Bryan King said Thursday that he believes the Department of Human Services is withholding information about the state’s private-option Medicaid expansion plan, which uses federal funds to purchase private health insurance for low-income Arkansans.

King made the accusation after agreeing to postpone a request before the Joint Legislative Audit Executive Committee to perform another audit involving a portion of the state’s private-option plan. Several members of the committee questioned whether the request should be redirected to another committee before King, R-Green Forest, agreed to table the request until the next meeting.

The lawmaker was one of eight senators to vote against continued funding for the private option during the fiscal legislative session that ended last month. The funding narrowly passed both chambers after a weeks long fight.

King said after the audit meeting that he and other lawmakers are tired of not having their questions fully answered.

“I’ll stand by my statement that the [Department of Human Services] is withholding information from us. When it’s bad news, they’re keeping it quiet,” King said in an interview Thursday afternoon.

King said he couldn’t point to specific information he believed the agency was currently withholding, but pointed to recent revelations about Qual-Choice Health Insurance instituting a cap on the number of private-option enrollees it was willing to accept.

“DHS knew back in November about QualChoice … that they had put in a cap, and they didn’t tell us,” King said. “We don’t know what else they’re withholding. We’re not getting questions answered, and we’re right now finding out that two months, three months into this, they’re over budget. … Maybe we need to look at another company that can come in and tell us where we go from here.”

Human Services Department spokesman Amy Webb said that Director John Selig was unaware Thursday of King’s complaints.

“Sen. King has not expressed that to Director Selig, and they’ve always had a pretty open line of communication,” Webb said. “The director will reach out to the senator and see if there’s additional information he needs. We’ve always tried to be very responsive to the Legislative Audit. This is an important program and we want to be transparent, and we feel like we have been.”

Regarding QualChoice, Webb said that the Human Services Department had to follow directions from the Arkansas Insurance Department, which has specific regulations about what information it can release about insurance companies. Human Services officials spoke to reporters about the cap several times, including in November, but had to refer those questions to the Insurance Department, she said.

Webb noted that the Human Services Department provided information related to the newest audit committee hearing request within two hours Thursday.

Six senators and seven representatives signed two letters addressed to the Joint Audit Executive Committee chairmen asking that they call Optumas, the company that performed the actuarial study of the private-option plan, before the committee to answer questions regarding its estimates for the program.

“Based on new data, participation rates and increasing concerns of unsustainable costs, I believe it is necessary we have Optumas revise their findings based on these facts,” the letter signed by the representatives said. “Additionally, I would like to discuss the possibility of contracting with a new, independent and reputable consulting firm to analyze all the new data in order to further understand how the Private Option will fiscally impact our state and citizens.”

Rep. Joe Farrer, R-Austin, was the lead signature on the letter. He was absent from Thursday’s meeting because of a family illness.

King and several other legislators requested an audit in November to look at the enrollment process, the numbers and other aspects of the private option. The audit was returned to the committee in January and showed no discrepancies. During discussion over authorizing the first audit request, several legislators called the request “theatrics.”

The committee debated for about 20 minutes Thursday whether the Joint Auditing Committee was the appropriate place for the new hearing request. King, who is co-chairman of the committee and who signed the letter from the senators asking for the Optumas hearing, explained why the legislators made the request Thursday.

“If we hold this hearing in, say, Public Health [committee], first, the majority of that committee is people who supported the private option, and two, the Bureau of Legislative Research isn’t the same as the Legislative Audit,” he said.

“If we request information in that committee, we don’t have staff people to analyze what they say, and I feel like we kind of have to take their word for it. But this committee can have a more independent look at this. Audit staff are more factual and numbers-based while the Bureau [of Legislative Research] is more policy.”

The private option, approved by the Legislature last year, extends coverage to adults with incomes of up to 138 percent of the poverty level - $16,105 for an individual or $32,913 for a family of four.

An estimated 250,000 Arkansans are eligible for coverage. Enrollment began Oct. 1.

The number of Arkansans approved for coverage rose to 149,666 as of March 21, according to a release from the Human Services Department.

Of the total approved for coverage at that time, 106,324 had enrolled in Medicaid-funded private health insurance, she said.

The ranks of the approved also include 14,969 people who were assigned to the traditional fee-for-service Medicaid program because they were determined to have exceptional health needs. Thousands of others who were approved for coverage as of March 21 had not completed enrollment.

Funding for the private option was made possible by the Patient Protection and Affordable Care Act of 2010.

Legislators spent most of the fiscal session haggling over whether to reauthorize funding for the private option. Private-option backers needed a three-fourths supermajority in both chambers to advance the measure.

The 35-member Senate approved the private-option extension in a single vote, with 27 senators voting for it. But it took five votes in the 100-member House before the private-option measure passed with 76 representatives favoring it.

Passage of the measure means Arkansas can accept $915 million in federal funds for the private option in fiscal 2015, which begins July 1.

Arkansas, Pages 10 on 04/11/2014

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