The chief of federal Medicaid operations under President George W. Bush has been hired as a senior Medicaid adviser to the director of Arkansas' Department of Human Services at a salary of more than $257,000, state officials announced Friday.
Dennis Smith also will serve as a visiting faculty member at the University of Arkansas for Medical Sciences, which will fund 10 percent of his salary, Human Services Department spokesman Amy Webb said.
Smith, who starts work at the department Thursday, is a principal in the Washington, D.C., office of the Dentons law firm, where Human Services Department Director Cindy Gillespie was also a principal until she started work in Arkansas in March.
With a salary of $257,347.68, Smith appears set to earn more than any Human Services Department employee except for Gillespie, whose salary this year is $280,000.
Federal Medicaid funds will cover half the department's portion of Smith's salary, with the other half of the department's share coming from state general revenue, Webb said.
In an emailed statement, Gillespie said Smith's contributions to state officials' efforts to make changes to the Medicaid program, which provides medical care and other services to more than 927,000 Arkansans, will be worth the money.
"He can provide insight into what every other state has tried and whether their efforts were successful," Gillespie said. "I truly believe that this investment will help Arkansas save a great deal of money and help us create a more financially sustainable Medicaid program."
She indicated that she wasn't troubled by the circumstances surrounding Smith's departure in February 2013 from his job as secretary of the Wisconsin Department of Health Services, which includes that state's Medicaid program.
According to news reports, the Feb. 22, 2013, resignation came two days after he was accused in a court affidavit of having an affair with Mary Spear, a longtime friend whom Smith had hired as the Wisconsin department's general counsel.
The accusation came from Spear's husband, Andrew Spear, who at the time was facing charges of attempted first-degree intentional homicide in an August 2012 attack on Mary Spear, the reports say.
According to the daily Wisconsin State Journal, Andrew Spear later pleaded guilty to misdemeanor charges of battery, disorderly conduct and criminal damage to property in the attack and was sentenced to about seven months in jail.
"I've worked closely with Dennis since he was the director of Medicaid," Gillespie said. "In the years I've known him, he's always been a person of great personal and professional integrity, and I have nothing but excitement about him joining my team."
Smith, who has denied having an affair with Mary Spear, declined to comment on the matter Friday.
He said in a phone interview that he saw the Arkansas job as "a great opportunity to get back into public service."
"I think you've got a great governor and a great senior team, a vision, and I'm just delighted to come there and help," Smith said.
Bush appointed Smith director of Medicaid operations for the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services in July 2001.
He served in that role until April 2008 and was acting administrator of the agency for three months after Thomas Scully resigned in December 2003.
After leaving the Centers for Medicare and Medicaid Services, Smith was a senior research fellow at the Heritage Foundation, a conservative policy research organization.
He was the Wisconsin Health Services Department secretary under Wisconsin Gov. Scott Walker from 2011 to 2013.
In Arkansas, Smith's duties will include helping officials craft changes to the Medicaid program, apply for waivers from federal rules and negotiate with federal officials, Webb said.
It was a waiver from the Centers for Medicare and Medicaid Services that allowed Arkansas in 2014 to become the first state in the country to expand its Medicaid program as authorized under the 2010 Patient Protection and Affordable Care Act, primarily by purchasing coverage in private plans on the state's health insurance exchange.
The expanded portion of the program was covering more than 307,000 Arkansans as of July 31, including more than 258,000 who were enrolled in the private plans under the so-called private option as of June 15.
In applying for an extension of the waiver, state officials have asked the Centers for Medicare and Medicaid Services for permission to make changes to the private option that Gov. Asa Hutchinson has said would encourage enrollees to stay employed and take responsibility for their health care.
The revamped program would be known as Arkansas Works.
Hutchinson set a goal in December of reducing the growth of spending in the Medicaid program, which covers primarily children, the elderly and disabled, by enough to save $835 million over five years.
A legislative task force is expected to make recommendations on cost-saving measures and other changes by the end of this year.
At UAMS, Smith will give guest lectures to students in the College of Public Health during the fall semester, which started Aug. 15, and he will begin teaching at least one class in the spring, UAMS spokesman Andrea Peel said.
He also will mentor graduate students and advise faculty on federal and state health policy issues, she said.
In a news release, UAMS Chancellor Dan Rahn said Gillespie approached the university about bringing Smith to Arkansas, and university officials supported the idea.
"Although he will only be spending a small percentage of his time at UAMS, we believe the experience and policy knowledge that he brings with him will be invaluable to our students and employees," Rahn said.
Metro on 09/03/2016