The CMS says Indiana has been unresponsive to its attempts to enter a data-sharing agreement so the agency can obtain information on the beneficiaries who have gained coverage under the state's Medicaid expansion.
In April, the CMS provided the state with a proposed data-use agreement so the agency's contractor could begin an evaluation of the state's conservative approach to expansion. As many as 350,000 residents were expected to gain coverage after Republican Gov. Mike Pence obtained a waiver to expand Medicaid coverage eligibility last year.
The CMS has yet to receive a response and reminded Pence's insurance and health policy director, Tyler Ann McGuffee, that the state must cooperate with federal attempts to evaluate the state's expansion.
“I would note that both the Medicaid transparency regulation and the state's special terms and conditions for the approved demonstration … require the state to cooperate fully with any federal evaluation,” Eliot Fishman, director of the State Demonstrations Group at the CMS said in the letter (PDF).
The CMS has set a June 17 deadline for the state to come to terms on a data-use agreement.
Late Monday, a Pence spokeswoman confirmed receipt of the letter and said a formal response would be sent in the coming days.
The June 10 correspondence was sent one week after McGuffee sent a letter to the CMS saying state officials felt the federal agency was planning to use biased surveys to evaluate the state's conservative approach to Medicaid expansion.
For instance, enrollees are asked to consider their overall experience and then asked about the specific reasons for being dissatisfied. However, the surveys don't include a question asking about being satisfied. “The lack of balance points to dissatisfaction and is leading,” McGuffee said.
In April, the federal Office of Management and Budget approved an emergency request by the CMS to let it examine whether Indiana's conservative-friendly, alternative Medicaid expansion model known as Healthy Indiana Plan 2.0, or HIP 2.0, has hurt beneficiaries' access to care.
The OMB's quick approval of the three beneficiary surveys proposed by the CMS is critical, because other Republican-led states including Arizona, Kentucky and Ohio are looking to implement versions of Indiana's plan, said Judith Solomon, vice president of health policy at the left-leaning Center on Budget and Policy Priorities. She said data on Indiana's expansion will offer insights about whether there are any drawbacks for patients.