Pallone & Wyden Request GAO Review of Medicaid Waivers Following Work Requirement Announcement

Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ) and Senate Finance Ranking Member Ron Wyden (D-OR) sent a letter to the Government Accountability Office (GAO) today requesting a review of major changes that the Centers for Medicare & Medicaid Services (CMS) have allowed states to make to their Medicaid programs.

The Democrats' letter follows yesterday's announcement from CMS encouraging states to submit waiver requests to add work requirements to their programs and today's news that CMS has approved the first work requirement in the 52 year history of Medicaid.

"These Medicaid demonstrations can have a significant impact on beneficiaries, providers, states, and local governments," Pallone and Wyden wrote to GAO. "As such, it is critical that key decisions regarding eligibility, coverage, benefits, delivery system reforms, federal Medicaid spending, and other important aspects of these demonstrations are transparent, accountable, and in line with Congressional intent under Title XIX."

The Democrats continued, "The Medicaid program serves beneficiaries; evaluation of any demonstration before, during and subsequent to implementation must operate from that standpoint. As part of your ongoing work, we believe that GAO should continue to review the compliance of states and the federal government with existing law as part of its ongoing work and advise Congress on needed improvements to public transparency and accountability."

As part of their request, the Democrats are requesting GAO examine several key matters, including:

• CMS's policies and procedures for ensuring transparency and compliance with federal law when approving new 1115 demonstrations;
• CMS's policies and procedures for ensuring transparency of changes CMS has allowed to ongoing demonstrations, including… changes states are allowed to make to benefits or cost sharing;
• CMS's policies and procedures for ensuring transparency of state data and public input on the impact of proposed changes on benefits, coverage, and access.

A copy of the letter is available here.

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