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Farewell to CMS' Dennis Smith

Farewell to CMS' Dennis Smith

April 14, 2008

Those who pay extremely close attention to national Medicaid policy know the name, Dennis Smith, well; and he's unknown to 99.999% of everyone else. Here's a note from the Kaiser Daily Report:

Dennis Smith on Friday left his position as the director of CMS' Center for Medicaid and State Operations, which he had held for the past seven years. Smith -- who also briefly was acting administrator of CMS -- has been criticized for proposing Medicaid regulations that state governors and some lawmakers believe will reduce health care funding for low-income residents. He also received criticism regarding regulations that limit how states may expand coverage under SCHIP.

Acting CMS Administrator Kerry Weems said Smith has "played an invaluable part in shaping Medicaid policy to provide greater flexibility to states in administering their Medicaid programs effectively, to increase the overall efficiency of the Medicaid program and to remove barriers to community living for people with disabilities." CMS Deputy Administrator Herb Kuhn will assume the role of acting director.

For the past seven years, every state Medicaid waiver -- including Massachusetts' -- was first approved by Smith. Smith was an extremely tough negotiator, and more than a few state officials across the nation must have cheered the news of his departure. But Smith was also the federal bridge between CMS and the Office of Management and Budget. Some observers worry whether negotiations with the Bush Adminstration for a new 1115 waiver will be even more difficult with Smith's departure.