An Arkansas Medicaid official is leaving for a job with a company involved in the managed care initiative that serves program recipients with expensive health needs, a spokesman for the state Department of Human Services confirmed Friday.
Catherine Kelley Silva, deputy director of the department's Division of Medical Services, will step down on Thursday to become government relations director for Anthem, according to her resignation letter.
The Indianapolis-based company's subsidiaries include Amerigroup, which handles administrative duties for Summit Community Care and owns a partial stake in the company.
That company is one of three managed care companies that in March began providing health benefits to about 45,000 Medicaid recipients with significant mental illness or developmental disabilities.
The companies are known as Provider-led Arkansas Shared Savings Entities, or PASSEs.
"I have learned a great deal about Medicaid management, policy and operations during my tenure at DMS, and particularly under your leadership," Silva said in the Aug. 8 letter to Medical Services Director Janet Mann. "I look forward to continued opportunities to collaborate with you and others at the Department to serve Medicaid beneficiaries in my new role."
Arkansas Code 19-11-709 prohibits former state employees from being involved as a "principal or agent for anyone other than the state" regarding any state contract in which that employee provided "decision, approval, disapproval, recommendation, rendering of advice, investigation, or otherwise while an employee."
The law also bars state employees for one year from acting for a private company in connection with contracts that were within the person's "official responsibility" while employed by the state.
Department spokesman Amy Webb said in an email that Silva "followed our process of speaking with our ethics officers related to prospective employment" before accepting Anthem's offer.
In a June 25 memo to Mann, Human Services Department Chief Deputy Counsel Jim Brader said information presented at a meeting with Mann and Silva four days earlier indicated that Anthem's "current footprint in the state" is limited to Summit Community Care.
"Our review of Ms. Silva's current role and official duties with DMS indicated that she has not been directly involved with the PASSEs in a manner that would present a potential conflict," Brader wrote.
"She did not assist in the development of the PASSE agreements, policy manuals, nor does she have any direct role in administering the program or setting policy."
But Brader added, "The question of whether Ms. Silva would be subject to a cooling off period if she were to accept the position with Anthem remains somewhat uncertain at this point. More details would be needed to better understand the nature of the responsibilities of this position."
Brader said Human Services Department officials would also need to ensure Silva's future assignments with the department didn't involve the managed care program.
Webb said that Silva "is aware of her obligation under the statute to avoid acting as a principal or agent for Anthem in any matters that were within her official duties with DHS for one year and intends to comply with that obligation."
Human Services Department Secretary Cindy Gillespie told state lawmakers in May that Silva had been focused on improving how the Medicaid program enrolls health care providers.
Webb said Silva's duties with the department also involve dental managed care, nonemergency medical transportation, pharmacy and the Medicaid expansion program known as Arkansas Works.
She said Silva attended a recent conference on home- and community-based services but did so while on leave and paid for her own expenses.
The state's transparency website lists Silva's annual salary with the department at $110,249.98.
Webb said Silva was traveling on Friday and unavailable for comment. Representatives of Summit Community Care and Anthem didn't respond to messages seeking comment.
Silva is the second Human Services Department official whose plans to leave for a job in the private sector have been confirmed by the department this month.
Craig Cloud, director of the department's Provider Services and Quality Assurance Division, will become executive vice president over strategy and planning at Friendship Community Care, a Russellville organization that serves people with developmental disabilities and mental illness.
Cloud's last day at the Human Services Department will be Friday, according to an Aug. 20 letter from department Chief Counsel David Sterling.
Under the managed care program, Summit Community Care, Arkansas Total Care and Empower Healthcare Solutions receive monthly payments in exchange for paying for and coordinating recipients' care.
Through June 30, the payments to the three companies totaled $540 million, according to a Human Services Department report.
Act 775 of 2017, which authorized the managed care program, requires the companies to be at least 51 percent owned by health care providers.
Summit Community Care was formed by the Arkansas Provider Coalition, which is made up of more than 70 organizations that provide services to the developmentally disabled and mentally ill.
Before joining the division last November, Silva was a health policy adviser to Gov. Asa Hutchinson.
According to her LinkedIn profile, she has also worked as a health policy analyst at the multinational Dentons law firm, where Gillespie also worked, and at Minnetonka, Minn.-based United Health Group.
Metro on 08/31/2019