Alicia Smith lands N.M. Medicaid overhaul contract
The New Mexico Human Services Department (HSD) has awarded a contract to overhaul the state Medicaid program to Alicia Smith & Associates of Washington, D.C.
The cost of the contract to taxpayers — and whether the contract will include implementation of the restructuring effort or merely its planning — is not yet clear. The decision was made Monday, but was not immediately announced to the public.
“The Department is moving forward with the award and contract negotiations with Alicia Smith & Associates,” spokeswoman Betina McCracken said in an e-mail Thursday morning.
The state Medicaid system, a public health insurance program for people with disabilities and low income, and the children of parents with low income, serves more than one quarter of New Mexico’s population, McCracken said.
“HSD hopes to complete the contract negotiations process by the end of May,” McCracken wrote. “The contract negotiations are a continuation of the procurement and selection process.”
Contracts negotiated in secret
That will likely allow HSD to continue to withhold for the time being records requested by Veritas NM, including the losing Medicaid restructuring proposals submitted by other firms.
New Mexico procurement code allows such documents to be withheld from the public until a contract is signed.
“New Mexico does not have a transparent process for hiring professional services at public agencies,” noted New Mexico Foundation for Open Government Executive Director Sarah Welsh.
“The proposals come in without a price tag attached, and they’re reviewed and negotiated in secret,” Welsh explained. “By the time the public gets a chance to look at the proposals, the deal is done. We’re not the only state that does it this way, but there are several other states that are more transparent – they make competitive proposals publicly available once the submission deadline has passed, once they’ve been opened, or some short time thereafter. That protects the competitive advantage for individual companies while providing some advance oversight of the selection process.”
Firm helped expand private sector role in other states’ Medicaid programs, holds other N.M. Medicaid contracts
Alicia Smith & Associates has helped several other states expand the role of private health insurance corporations, known as Managed Care Organizations (MCOs), in state Medicaid programs, according to the firm’s website.
Founder Alicia C. Smith and HSD Secretary Sidonie Squier both served previously in Florida state government, but at different times, McCracken wrote in an e-mail:
Secretary Squier worked in Florida from May, 2002 to January, 2004 and did not work with Alicia Smith. As we understand Alicia left Florida in December 1985 and began consulting work for the state of Florida in 2005. The two actually had never met until earlier this year here in New Mexico as part of Alicia’s work with the Behavioral Health Collaborative.
Smith served as Florida’s Medicaid director. Squier served at the Florida Department of Children and Families.
Smith has also worked with private health corporations to help them improve their “positions” in state Medicaid programs, according to her firm’s website.
Smith has not publicly revealed the names of those clients or responded to a request for comment.
McCracken would not comment on whether or not Smith was asked for information about potential conflicts of interest during HSD’s evaluation of Smith’s proposal.
“More detailed information can be made available upon the award of the contract,” McCracken wrote by e-mail.
Smith already holds three Medicaid-related contracts with HSD, all signed in late 2010, Veritas NM has reported.
N.M. Senate President Tim Jennings, Sen. Dede Feldman (D-Albuquerque) and others have voiced concern about the lack of transparency or public involvement in the outsourcing of the Medicaid overhaul to a private company — an approach that stands in stark contrast to former Gov. Gary Johnson’s Medicaid reform effort, which involved legislators.
But Squier indicated Wednesday that there would be a series of public meetings throughout the state once a contract is signed.
“We look forward to engaging in an important discussion with stakeholders throughout New Mexico about ways to ensure that Medicaid continues to serve the most vulnerable among us for years to come,” Squier said. “As exhibited by the Governor’s decision to increase Medicaid funding by $10 million in her executive budget, we take seriously the charge of providing basic health care services to those most in need in our State.”
Note: Alicia Smith & Associates’ three 2010 professional service contracts are among the documents below. Contract file names start with “PSC” and end with 0011, 0012 or 0013.