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Congressional HMO Medicaid Fraud Hearing, Follow Questions For Commissioner Jesson

Congressional HMO Medicaid Fraud Hearing, Follow Questions For Commissioner Jesson

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Published by SenatorNienow
MN Human Services Commissioner Lucinda Jesson testified before a Jt US Congress Oversight Hearing. They sent this letter as a followup, with very pointed questions, and very explicit requests for additional documenttion for her answers.
MN Human Services Commissioner Lucinda Jesson testified before a Jt US Congress Oversight Hearing. They sent this letter as a followup, with very pointed questions, and very explicit requests for additional documenttion for her answers.

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Categories:Types, Letters
Published by: SenatorNienow on May 21, 2012
Copyright:Attribution Non-commercial

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05/21/2012

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DARRELLE.ISSA,CALIFORNIACHAIRMAN
ONEHUNDREDTWELFTHCONGRESS
ELIJAHE.CUMMINGS,MARYLANDRANKINGMINORITYMEMBERDANBURTON.INDIANAJOHN
l.
MICA,FLORIDA
TODDRUSSEllPLAns.PENNSYLVANIA
MICHAELR.TURNER,OHIOPATRICKMcHENRY,NORTHCAROLINAJIMJORDAN.OHIOJASONCHAFFETZ,UTAHCONNIEMACK,FLORIDATIMWALBERG,MICHIGANJAMESLANKFORD,OKLAHOMAJUSTINAMASH,MICHIGANANNMARIEBUERKLE,NEWYORKPAULA.GOSAR.
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ARIZONARAULR.LABRADOR,IDAHOPATRICKMEEHAN,PENNSYLVANIA
SCOTTDESJARLAIS.M.D..TENNESSEE
JOEWALSH,ILLINOISTREYGOWDY,SOUTHCAROLINADENNISA.ROSS.FLORIDAFRANKC.GUINTA,NEWHAMPSHIREBLAKEFARENTHOLD.TEXASMIKEKELLY,PENNSYLVANIA
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MALONEY.NEWYORKELEANORHOlMESNORTON,
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DENNIS
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KUCINICH.OHIDJOHNF.TIERNEY,MASSACHUSETTSWM.LACYCLAY.MISSOURISTEPHENF.LYNCH.MASSACHUSETTSJIMCOOPER,TENNESSEEGERALDE.cmmOLLY.VIRGINIA
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DANNYK.DAVIS,ILUNOIS
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BRALEY,IOWA
PETERWELCH,VERMONTJOHN
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YARMUTH.KENTUCKYCHRISTOPHERS.MURPHY,CONNECTICUTJACKIESPEIER.CALIFORNIA
COMMITIEEONOVERSIGHTANDGOVERNMENTREFORM2157
RAYBURNHOUSEOFFICEBUILDINGWASHINGTON,
DC20515-6143
May15,2012
LAWRENCEJ.BRADYSTAFFDIRECTOR
Ms.LucindaJessonCommissionerMinnesotaDepartmentofHumanServices540CedarStreetSt.Paul,MN55164-0998DearMadamCommissioner:ThankyouforparticipatingintheConunitteeonOversightandGovernmentReform'sApril25,2012,hearing"IsGovernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?"lAtthehearing,theCommitteeexploredproblemsinMinnesota'sratesettingforitsMedicaidmanagedcareprogram.DavidFeinwachs,formerGeneralCounseloftheMinnesotaHospitalAssociation,testifiedthatMinnesotawas,andislikelystill,systematicallyoverpayinginsurancecompaniesforindividualsenrolledintheMedicaidprogram.'FeinwachspresentedtestimonythatMinnesotawasleveragingthefederalMedicaidreimbursementinordertocross-subsidizethestate'sunderpaymenttothestate'sinsurancecompaniesforindividualsenrolledinstate-onlyhealthinsuranceprograms?MembersoftheCommittee,frombothparties,weretroubledbytheseallegations.ManyofyouranswerstoMembers'questionsatthehearingsupportedDavidFeinwachs'testimony.Youtestifiedthatthe"healthplanshistoricallyhavesaid..,thattheylostmoneyonthestate-fundedprogram.?"Youalsostatedthatyouhad"seriousquestionsabouttheexcessmoneythatthehealthplansweremaking"andthatyou"veryclearlythoughtthatthestateofMinnesotaandthefederalgovernmentwerepayingtoomuchunder[Minnesota's]Medicaidcontracts.")The
I
u.s.
HouseofRepresentativesCommitteeonOversightandGovernmentReformSubcommitteeonHealthCare,DistrictofColumbia,Census,andtheNationalArchivesandSubcommitteeonRegulatoryAffairs,StimulusOversightandGovernmentSpendingjointhearing"IsGovernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?,"April25,2012.
2
DavidFeinwachs,TestimonybeforetheU.S.HouseofRepresentativesCommitteeonOversightandGovernmentReformSubcommitteeonHealthCare,DistrictofColumbia,Census,andtheNationalArchivesandtheSubcommitteeonRegulatoryAffairs,StimulusOversightandGovernmentSpendinghearing"IsGovernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?,"April25,2012.
3/d.
4
CommissionerJessonresponsetoquestionsfromCongressmanTreyGowdy,OversightandGovernmentReformSubcommitteeonHealthCare,DistrictofColumbia,Census,andtheNationalArchivesandtheSubcommitteeonRegulatoryAffairs,StimulusOversightandGovernmentSpendinghearing"IsGovernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?,"April2S,2012.
S
CommissionerJessonresponsetoquestionsfromCongressmanDannyDavis,OversightandGovernmentReformSubcommitteeonHealthCare,DistrictofColumbia,Census,andtheNationalArchivesandtheSubcommitteeonRegulatoryAffairs,StimulusOversightandGovernmentSpendinghearing"IsGovernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?,"April25,2012.
 
TheHonorableLucindaJessonMay152012Page2laterstatementechoescommentsGovernorDaytonhasmadeaboutpastcontractsbetweenthestateandtheinsurancecompaniesbeing"toogenerouswiththetaxpayers'money."?Since,asyoutestified,Minnesota'sinsurancecompanieswerelosingmoneyonprogramsfundedwithstate-onlydollarsandthestatesinsurancecompaniesweremakingexcessprofitsonMedicaid,itappearsthatfederaltaxpayers,whofinanceoverhalfofMinnesota'sMedicaidprogram,werecross-subsidizingstate-onlyhealthinsuranceprograms.AtthehearingCongressmanDannyDavisaskedyouspecificallywhetherthestatewascross-subsidizinglowerthanactuariallyappropriatepaymentratesforstate-onlyprogramswithhigherthanactuariallyappropriatepaymentratesforMedicaid.Youreplied,"[TheGeneralAssistanceMedicalCare]programwasnolongerinexistencewhenIstartedasCommissioner.Ididn'tworkatthedepartmentthen,soIdon
t
havefirst-handknowledgeofwhetherthathappened.:"Althoughyoumaynothaveworkedatthedepartmentduringmostofthetimeperiodwhenthecrosssubsidizationallegedlyoccurred,youarethehighestrankingofficialwithdirectoversightofthestate'sMedicaidprogram.Oneandahalfyearsintoyourterm,therefore,youshouldknowhowthestate'sprogram,whichhasan$8billionannual
budget.f
wasoperatingwhenyoubecameCommissioner.ThisisespeciallytruegiventhescrutinythatMinnesota'sMedicaidprogramhasreceivedrecently.Yourtestimonyraisedseveraladditionalquestionsthatneedtobeanswered.Moreover,wewouldliketogiveyouanopportunitytoclarifyseveralremarksyoumadeatthehearingregardingMinnesota'sratesettingprocessforitspublichealthinsuranceprograms.PleaseprovidetheanswerstothefollowingquestionsbyMay18,2012.1.ThereisstillconfusionaroundUCare's$30millionrefundtoMinnesotalastyear.OnMarch152011,thedaybeforeUCaresentitsletterregardingtherefund,youemailedDanPollock,ahigh-levelstafferinyourdepartment,abouttheproperwaytomessagetheUCarecontribution.Youwrote,"Inordertohaveagoodchanceofkeepingallthismoney,
it
mustbecharacterizedasadonation.Ifarefund,fedsclearlygethalf.CanyouworkwithScottonredrafting?Also,Ithoughtweweregoingtohandlethisthroughphonecalls.
9
InyourresponsetoaquestionfromChairmanGowdyattheCommittee'shearing,youexplainedthatyouremail"wascorrectingadraftpressrelease,'
10
WereyoureferringtoapressreleasefromthestateorfromUCare?Pleaseattachthereferencedpressreleasetoyourresponse.
6
ChristopherSnowbeck,"MinnesotanonprofitHMOstopaystate$73million."PioneerPress.April6,20II.
7
lei.
8
9
E-mailfromLucindaJeson,Commissioner,MinnesotaDepartmentofHumanServices(DHS)toDanPollock,Staff,DHS(March15,2011).
10
CommissionerJessonresponsetoquestionsfromCongressmanTreyGowdy,OversightandGovernmentReformSubcommitteeonHealthCare,DistrictofColumbia.Census,andtheationalArchivesandtheSubcommitteeonRegulatoryAffairs,StimulusOversightandGovernmentSpendinghearing"IsGovernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?"April25.2012.
2
 
TheHonorableLucindaJessonMayIS,
2012
Page3Additionally,youtoldChairmanGowdythatyouremailwaspartofalargeremailchainandthatthephraseabout'handl[ing]thisthroughphonecalls"wastakenoutofcontext.
II
Pleaseprovidetheentireemaildiscussionthatyoureferencedinyouranswer.
2.
Atthehearing,theCommitteelearnedthatKarenPeed,Minnesota'sformerDirectorofManagedCareContracting,statedthatMinnesotawasunderpayingthestate'sinsurancecompaniesforstate-onlyfundedprogramsandoverpayingthesesameinsurancecompaniesthroughMedicaid.
12
BetweenNovember
2010
andpresent,haveyoudiscussedMinnesota'sratesettingprocessforitspublichealthinsuranceprogramswithMs.Peed?DuringanyofyourconversationswithMs.PeeddidyoudiscussMinnesota'sratesettingprocessforitspublichealthinsuranceprograms?Pleaseprovidealldocumentsandwrittencommunications,includingemails,betweenMs.PeedandyourselfoverthepasttwoyearsthatreferorrelatetoMinnesota'sratesettingprocessforitspublichealthinsuranceprograms.3.Inaninterviewwithalocaltelevisionstation,youwereaskedwhetherMs.Peed'sstatementthatMinnesotawasunderpayingthestate'sinsurancecompaniesforstate-onlyfundedprogramsandoverpayingthesesameinsurancecompaniesthroughMedicaidamountedtoMinnesotadefraudingthefederalgovernment.Youstated,"Letmebeveryclear.Wearenotdoingitthatwayanymore...andKarenPeedisnolongerinchargeofcontractingwiththeplans.,,13Whatwereyoureferringtowhenyousaid"thatway"?4.InresponsetoaquestionfromCongressmanDannyDavis,youstated,"IveryclearlythoughtthatthestateofMinnesotaandthefederalgovernmentwerepayingtoomuchunderourMedicaidcontracts."!"Whenandhowdidyoucometothisconclusion?5.HowlongdoyoubelievethatMinnesotaandthefederalgovernmentwerepayingtoomuchunderthestate'sMedicaidcontracts?6.GovernorDaytonhasstatedthatpastcontractsbetweenthestateandtheinsurancecompanieswere"toogenerouswiththetaxpayers'money.?'?Duringyourtestimony,youstatedthatyou"veryclearlythoughtthatthestateofMinnesotaandthefederal
Il
ld
12
DavidFeinwachs,TestimonybeforetheU.S.HouseofRepresentativesCommitteeonOversightandGovernmentReformSubcommitteeonHealthCare.DistrictofColumbia,Census,andtheationalArchivesandtheSubcommitteeonRegulatoryAffairs.StimulusOversightandGovernmentSpendinghearing"IsGovernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?."April25.2012.
13
Id.
14
CommissionerJessonresponsetoquestionsfromCongressmanDannyDavis,OversightandGovernmentReformSubcommitteeonHealthCare,DistrictofColumbia.Census,andtheNationalArchivesandtheSubcommitteeonRegulatoryAffairs.StimulusOversightandGovernmentSpendinghearing"IsGoernmentAdequatelyProtectingTaxpayersfromMedicaidFraud?,"April25,2012.
IS
ChristopherSnowbeck,"MinnesotanonprofitHM.ostopaystate$73million,"PioneerPress,April6,2011.

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