Timeline of the Alexander Report

Posted Thursday, May 29, 2014 in Investigation

Timeline of the Alexander Report

by Andi Parkinson

 

Gary Alexander and associate Erik Randolph exit Maine HHS Committee hearing, 1/14/14.

Gary Alexander and associate Erik Randolph exit Maine HHS Committee hearing, 1/14/14.

  • December 2010- Gary Alexander, the former head of Rhode Island’s Department of Human Services and current Secretary for the Rhode Island Executive Office of Health and Human Services (EOHHS) publishes “Rhode Island Medicaid Reform: Global Consumer Choice Compact Waiver” through the Galen Institute, on Rhode Island letterhead.

     

    It is later (2012) used as a cited source in Pacific Research Institute president and CEO’s Sally Pipes’ e-book, “The Pipes Plan: The Top Ten Ways to Dismantle Obamacare”. Pipes, a well known critic of the Affordable Care Act, goes before Congress’ House Oversight and Government Reform Committee to denounce ACA and is found by Mother Jones investigative reporting to have much of her and PRI’s supposed works to be that of ghost writers:

      If Pipes seems supernaturally prolific, there’s a good reason. To assist with her written output, PRI employs a DC-based ghostwriting and PR firm with drug and health care industry clients. That firm, Keybridge Communications, researches, drafts, and edits much of Pipes’ published work in an arrangement that’s unusual for someone at a supposedly independent think tank.

       

      Several former PRI staffers tell Mother Jones it was well known within the organization that Pipes relied heavily on Keybridge, particularly for her books, and did far from all of her own writing.

  • 1/5/11- Paul R. LePage, Sr. is sworn in as the 74th Governor of Maine.
  • 1/12/11- Alexander is named as Republican Pennsylvania Governor Tom Corbett’s pick as that state’s Public Welfare Secretary.
  • 1/20/11- RI NPR tells of how Alexander is reported to have published an unauthorized report on that state’s global waiver:

     

      Elena Nicolella- the director of RI’s Medicaid program- says there’s very little in Alexander’s report that’s accurate. In fact, it was published without the permission of the Department of Human Services, even though the state seal appears on every page of the report. Nicolella says RI asked The Galen Institute to take that seal off, but it hasn’t and she’s considering a call to the state’s attorneys.
  • 2/1/11- Democratic Rhode Island Governor Lincoln Chaffee’s administration publicly disputes the claimed numbers of monies saved by Alexander to that state’s Medicaid programs:

     

      … a spokesman in Chafee’s Health and Human Services Office said officials there do not know how Alexander came up with that number, and could not give their own.

       

      “The secretary of Health and Human Services is currently reviewing the assumptions, accomplishments and savings projections associated with the global waiver,” spokesman David Burnett said in a statement last week. “Without a detailed understanding of the author’s assumptions, it is difficult to offer a comment on the veracity of the statements contained in the Galen Institute article.”

  • 2/1/11- Rhode Island NPR runs a story on multiple versions discovered and edits of Gary Alexander’s report:

     

      … a report by RI’s former secretary for the Executive Office of Health and Human Services raised some eyebrows a few weeks ago for making unauthorized claims about RI’s Global Medicaid Waiver. His reportappeared on the website of the free market think tank the Galen Institute.

       

      But now it appears that there were two reports- the current one posted in January and another, featuring stronger language and some different numbers, posted at some point last year.

  • 2/10/11- In lieu of a budget, Governor LePage presents a “jobs bill” before the joint convention of the 125th Legislature. Details of the LePage “jobs bill” are released the following day, among them being denial of Temporary Aid for Needy Families (TANF), food stamps, health and disability benefits for non-citizen families who are in Maine legally and imposing an arbitrary 5 year cap on TANF funds for all Maine families.
  • 2/23/11-Governor LePage is recorded at a press conference as saying (regarding BPA’s usage and estrogen) that he has yet to see enough science to support a ban on BPA, a common additive to plastics that some research suggests may interfere with hormone levels and could cause long-term problems:

     

      “The only thing that I’ve heard is if you take a plastic bottle and put it in the microwave and you heat it up, it gives off a chemical similar to estrogen. So the worst case is some women may have little beards.”

    On that same day it is reported that Dr. Dora Mills, the former head of Maine’s Center for Disease Control,  was fired from her post as Medical Director of MaineCare. Mills had testified months earlier that BPA removal should be a priority under the Kid-Safe Products Act of 2008. Soon afterwards, other senior DHHS appointees as fired as well.

  • March 2011- Maine Hospital Association lobbyist Mary Mayhew is named head of DHHS. Among those whovoice immediate concerns about her hiring is Senator Margaret Craven (D-Lewiston):

     

     

    An irate DHHS Commissioner Mary Mayhew answers questions asked by Rep. Peter Stuckey (D-Portland) on January 14. Beside Mayhew is Gary Alexander, who had previously spoken to the HHS committee about his infamous report denouncing Medicaid expansion.

    An irate DHHS Commissioner Mary Mayhew answers questions asked by Rep. Peter Stuckey (D-Portland) on January 14. Beside Mayhew is Gary Alexander, who had previously spoken to the HHS committee about his infamous report denouncing Medicaid expansion.

      While legislators unanimously praise Mayhew’s intelligence and toughness, some Democrats opposed her nomination because of her lack of experience managing people and money.

       

      “She has never managed a budget, and it’s a $3.2 billion budget,” said Sen. Margaret Craven, D-Lewiston, one of three Democrats who opposed Mayhew’s confirmation in committee. “She has 3,500 employees … She’s very smart, but smart isn’t going to do it all the time.”

      Mayhew’s role as a hospital lobbyist and her lack of experience with social services and welfare programs also raised concerns.

      “I think that is her job — to stand up for the vulnerable people,” Craven said. Craven and others said they worry that Mayhew’s lack of experience will make it harder for her to stand up to political pressures to cut safety net programs.

  • 5/15/11- Via New York Times: “Rhode Island’s Medicaid Experiment Becomes a Talking Point for Budget Cutters” :

     

      The Rhode Island agreement shares the same goals as the block-grant plan proposed by Representative Paul D. Ryan, Republican of Wisconsin, and contained in the budget resolution that passed the House last month, said Conor Sweeney, a spokesman for Mr. Ryan.

       

      During a Senate Finance Committee hearing in February, Senator Tom Coburn, Republican of Oklahoma, also pointed to the experiment in Rhode Island as a success.

      “Why don’t we just block-grant every state, take the rules off and let them do these strategies,”
       he asked.“Rhode Island’s obviously already figured it out.”

      Among the governors who support the idea are Chris Christie of New Jersey, who wants to pursue an agreement of his own with the federal government, and Scott Walker of Wisconsin, who wrote an article for the Op-Ed page in The New York Times last month contending that states’ success with such agreements“shows that we can move beyond demonstration projects and let the federal government relinquish control over Medicaid.”

    The article also made note of the multiple versions of Alexander’s report, huge mathematical shifts in projected savings without explanation and that there was no transparency in how or why the numbers changed:

      In an early version of the paper, Mr. Alexander said that Rhode Island had saved about $150 million during the first 18 months of the agreement. A later version lowered the estimate to $110 million. The paper does not detail how he arrived at those numbers, nor does it explain the reason for the change.

  • Sept 2011- Galen Institute sends out a newsletter to its members with an item under its “STATES ISSUES”section of:

     

  • 9/25/11- Gary Alexander in his capacity as Secretary of Public Welfare for the Commonwealth of Pennsylvaniatestifies before the House Ways and Means Committee in DC regarding reauthorization of the TANF program.
  • 12/22/12- GOP Presidential candidate Mitt Romney made note of the Alexander/ Rhode Island model “Mitt Romney says Rhode Island demonstrated that it can run Medicaid more cost-effectively than the federal government”, in which Politifact chewed both Romney and Gary Alexander’s report up:

     

      Gary Alexander, who was secretary of health and human services when the waiver was approved, published a paper with the conservative Galen Institute, pegging the savings at $110 million over 18 months, or $73 million a year.

       

      The Romney campaign cites the Alexander paper as evidence that Rhode Island saved money.

      The liberal-leaning Center on Budget and Policy Priorities issued a report saying Alexander was wrong because any savings actually resulted from more than $400 million Rhode Island received in federal stimulus money in 2009 and the shifting of some costs previously paid by the state to the federal government.

      Rhode Island’s current Health and Human Services secretary, Steven Costantino, asked The Lewin Group, a consulting firm, to do a less-partisan analysis after Carcieri left. According to that group’s estimates, the waiver itself saved $23 million over three years, or $7.6 million annually, Costantino said.

      In addition, the deal also provided a $42.7-million windfall for the state over the same three years because the federal government started sharing the costs of some health services, he said.

      Total savings per year: just under $22 million.

  • 1/20/13- Americans For Prosperity PA urges Pennsylvania “Let’s Not Double-Down on a Failing Medicaid Program” and reference Gary Alexander within the write up:

     

      “The federal government seeks to entice Pennsylvania and other states into expanding their programs by promising to pay all the upfront costs during the initial years and then pulls back in the outlying ones. However, this promise is not altogether true. The head of the Pennsylvania Department of Public Welfare, Gary Alexander, testified before a congressional committee last month that the expansion would cost $222 million to the state taxpayers in administrative and other costs during the first year, $378 million the second year and $364 million the third year, rising to an estimated $883 million by fiscal year 2020-21.”

     

    (Via BDN) David Bohrer | U.S. Chamber of Commerce Maine Gov. Paul LePage appeared with Pennsylvania Gov. Tom Corbett at a U.S. Chamber of Commerce summit in April 2013. Gary Alexander, the consultant hired by LePage to analyze Maine’s Medicaid and welfare programs, stepped down as Corbett’s welfare chief in February 2013.

    (Via BDN) David Bohrer | U.S. Chamber of Commerce
    Maine Gov. Paul LePage appeared with Pennsylvania Gov. Tom Corbett at a U.S. Chamber of Commerce summit in April 2013. Gary Alexander, the consultant hired by LePage to analyze Maine’s Medicaid and welfare programs, stepped down as Corbett’s welfare chief in February 2013.

  • 2/4/13: Pennsylvania confirms that Gary Alexander is stepping down his $143,362-a-year post as that state’s Welfare Secretary by the end of the month:

     

  • 3/6/13-Alexander quickly lands a lucrative 4 month consulting gig in Arkansas, hired by the Republican controlled legislative budget panel in that state:

     

      The Arkansas News reported on Tuesday that the former secretary’s firm, Alexander Group LLC, was awarded a $220,000 contract to conduct an independent review as lawmakers there consider an alternative to the proposed Medicaid expansion.

       

      Alexander’s firm was chosen because of its national reputation, according to the report. In addition to serving in the Cabinet post in Pennsylvania, Alexander previously had served as secretary of Rhode Island’s Department of Health and Human Services.

      However, some members of the panel that hired Alexander’s firm had concerns about how independent Alexander would be in conducting the Medicaid expansion evaluation since their review found him to be critical of President Obama’s health care law while he was serving as Pennsylvania’s welfare secretary.

  • 8/3/13- The Alexander Group Reportlanguishes with the Arkansas legislature pending review, rather than be released publicly:
      Marty Garrity, director of the Bureau of Legislative Research, informs me that Alexander HAS completed a report for the $220,000 he was paid. He submitted it July 5. It’s substantial, maybe 75 to 100 pages, she said.

       

      It remains secret. It is classified as a legislative “working paper” until a committee of the Legislative Council reviews it. Alexander is expected to appear to talk about it when and if that day occurs. It’s currently in the hands of the executive committee of the council, co-chaired by Sen. Paul Bookout and Rep. John Edwards. I’ve been unable to get an indication so far of plans for release.

  • September 2013- Emails back and forth regarding the Alexander Group contract fly back and forth between LePage administration members, with an apparent lack of following an executive order issued by then Governor John Baldacci dated March 23, 2010 in regards to procurement review: 
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  • 9/16/13-DHHS Commissioner Mary Mayhew and Gary Alexander sign a no-bid $925,200 contract for the Alexander Group to perform similar analysis to the work done for Arkansas. It would be another two months (11/20/13) before this would be made known publicly.

    Within the contract are specific dates as to when information by the consultant would be released, specific work to be performed by the Alexander Group, and that the group is required to maintain a Liability Insurance policy to protect against lawsuit costs.

    Completion of the final report is to be by 3/15/14.

    Payment for the work would come from the following sources:

      1. State General Funds $454,875.17
      2. Dedicated/ Special Revenues $276,644.83
      3. Federal Funds $193,680.00
      4. TANF $69,120.00
      5. Medicaid Admin (et al) $124,560.00
    View this document on Scribd
  • 9/25/13- Maine Governor Paul LePage signs off on the contract:

     

      Alexander’s hiring has also put LePage on the defensive. In December, the governor sought to distance himself from the no-bid contract, telling WABI-TV in Bangor, “I don’t know, I didn’t hire him (Alexander), DHHS did … I don’t know much about what they did, so.”

       

      Emails obtained by the Press Herald through a Freedom of Access Act request show that the governor personally endorsed the contract.

      On Sept. 25, Mayhew notified LePage’s assistant that the contract had been finalized. In a hand-written note atop the email, the governor wrote, “Go for it!”

  • 11/18/13- The Alexander Group presents its $220,000 report, dated 7/5/13, to the state of Arkansas. 
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  • 11/20/13-It is announced that Maine is partnering with the Alexander Group “to assist in Medicaid program improvements and to bolster existing efforts in program integrity”:

     

    Mayhew fields  questions from Maine media regarding the $900k+ Alexander Report, while Gary Alexander stands silently by.

    Mayhew fields questions from Maine media regarding the $900k+ Alexander Report, while Gary Alexander stands silently by.

      The work will include a study of the optional Medicaid expansion that has been offered to the state as part of ObamaCare. The study will include an assessment of the financial impact of Medicaid expansion in both the short- and long-term, as well as the impact on other state priorities, including those currently served by MaineCare. The study will also consider potential areas of flexibility for the state, which may include requests for additional flexibility from the federal government to manage MaineCare by state rules instead of federal regulations.

       

      DHHS and the Alexander Group will undertake a complete assessment of all welfare systems within DHHS to determine how program reforms and additional flexibility can add efficiency, improve patient outcomes and achieve cost savings. A focus of this work will be reducing waitlists and providing appropriate services for the elderly and disabled.

      “We are excited about the opportunity to work with such a knowledgeable group of experts,” said Mary Mayhew, the Commissioner of DHHS. “In the constantly shifting landscape of the Affordable Care Act and ever-changing rules from Washington, it will be extremely helpful to have someone with significant Medicaid experience lending a hand to our program reform efforts.”

    It is learned that Sam Adolphsen, a former staffer at the Maine Heritage Policy Center who now works in the governor’s administration, will be one of the state’s designees to work with the Alexander Group. Adolphsen’s background is in business administration, not social services or health care. He would be named in the contract as the person responsible for the monitoring the performance. In 2014, he would be promoted twice more within DHHS and be named DHHS chief operating officer in May 2014.

  • 12/10/13- The 126th Legislature’s Health and Human Services committee meet to discuss multiple DHHS management failures, including the state’s bungled MaineCare rides system, Riverview’s decertification with resulting loss of federal funds, and the no-bid $1 million contract to the Alexander Group. From a media advisory:

     

    •  

        “For the price of Governor LePage’s Tea Party crony, the state could have hired 23 people at Riverview— and we’d be one step closer toward getting recertified and recuperating the $20 million we’ve already lost,” said Craven. “Decisions like these do nothing to help the people of Maine or the financial health of our state.”

    • The committee will have the opportunity for the first time, to examine the nearly $1 million, no-bid contract the LePage Administration signed with Gary Alexander from the Alexander Group. The contract includes the issuance of a five part study reviewing the impact of expanding the state’s health insurance program, Medicaid under the terms of the Affordable Care Act. The first study was due on December 1 but Alexander missed the deadline and to date has not submitted the report as stipulated in the nearly $1 million contract.

       

  • 12/19/13- “LePage fends off accusation of ‘cronyism’ in hiring controversial welfare consultant” (BDN)

     

      LePage said he has met with Alexander just three times: One of those meetings took place in 2010, when LePage offered the Rhode Island conservative the job as Maine’s commissioner of the Department of Health and Human Services, which the governor said Alexander turned down for salary reasons.

       

      LePage subsequently hired Mary Mayhew, a Democrat who lobbied for the Maine Hospital Association, as DHHS commissioner.

      LePage said Thursday that he also has met with Alexander twice since then; once in March and once more recently, after Alexander’s firm was hired on a nearly $1 million sole-source contract awarded by Mayhew in September.

  • 1/6/14- In a PPH Op-Ed, Maine is warned by PA state auditor Eugene DePasquale about Alexander:

     

      “Alexander served as secretary of Pennsylvania’s Department of Public Welfare for just two years. He came to us from Rhode Island and was touted as an efficiency expert who would save our state millions in Medicaid dollars. Instead, we experienced just the opposite.

       

      For example, under Alexander’s leadership, 89,000 children were removed from our health care programs, and his agency’s mismanagement of the contract to pay home care workers could cost taxpayers as much as $7 million per year.

      In November 2013, my department released the full results of our independent audit of the mismanagement of the home care worker contract during Alexander’s tenure. What we found should serve as a warning to Maine taxpayers and policymakers.”

  • 1/10/14- DHHS claims that per the Alexander Group Report, Medicaid Expansion could cost Maine $807 Million or more, with MaineCare enrollment potentially growing by nearly 100k new enrollees in the first two years alone.

     

      “This report highlights the fact that Maine’s General Fund is on track to be consumed by the MaineCare program, even without expanding eligibility,” said Gary Alexander. “Expanding eligibility for MaineCare to the able-bodied residents of working age will place at risk existing commitments Maine has to their traditional Medicaid recipients: those who are disabled and those who are elderly.”

       

      “This study reinforces the unsustainable costs associated with MaineCare expansion and the importance of returning the program to one that cares for its most vulnerable,” said Maine Department of Health and Human Services Commissioner Mary Mayhew. “We cannot, in good conscience, ask the taxpayers of Maine to foot this very large bill to care for able-bodied adults. We must prioritize spending to ensure that the elderly and people with development disabilities who are on wait lists—sometimes for more than two years—get the critical services they need first and foremost.”

  • 1/14/14- Bangor Daily News prints a scathing editorial, “Taxpayers foot the bill for LePage manifesto on Medicaid expansion”, blasting both the LePage administration and the so-far released portions of the Alexander Group Report.
  • 1/14/14- Gary Alexander appears to speak about his report before HHS Committee, accompanied by associate Erik Randolph and DHHS Commissioner Mayhew. He speaks very little to either the committee members or the Maine press, deferring to Mayhew.

     

     

     

    Democrats on the HHS Committee had the following response:

      Fundamental flaws in the controversial Alexander report on Medicaid in Maine were exposed today during a hearing on its findings in the Legislature’s Health and Human Services Committee.

       

       

      HHS Chairs Sen. Craven and Rep. Farnsworth question DHHS Commissioner Mary Mayhew during public hearing. Also pictured, Sen. Colleen Lachowicz (D-Waterville)

      HHS Chairs Sen. Craven and Rep. Farnsworth question DHHS Commissioner Mary Mayhew during public hearing. Also pictured, Sen. Colleen Lachowicz (D-Waterville)

      The controversial report used inflated and inaccurate poverty data; nearly doubled the amount of people that would receive care under the law; and failed to factor in the economic activity and savings offsets the state would see from accepting federal health dollars to cover more Mainers, according to lawmakers and economic and healthcare experts.

      “The research was skewed. Governor LePage got what he paid for,” 
      said Rep. Dick Farnsworth of Portland, the House chair of the HHS committee. “We are looking at getting to real data that will give us real insight. We do not find it in these results which have become campaign talking points masquerading as a report.”

       

      “The report recommendations are not a surprise. This is nothing more than a campaign plan for Governor LePage. Unfortunately, the taxpayers of Maine paid for it,” said Senator Margaret Craven of Lewiston, the Senate chair of the HHS committee. “Let’s get beyond campaign issues and move on to the real issues — like getting 70,000 Mainers including 3,000 veterans access to life-saving health insurance.”

      Farnsworth noted that the governor spent nearly $1 million in taxpayers dollars for the Alexander Group report when reliable data from independent sources confirms savings.

      Governor Paul LePage awarded the controversial consultant Gary Alexander the $1 million no-bid contractlast September despite Alexander’s record of mismanagement and failed policies in Pennsylvania. As the head of the Pennsylvania Department of Public Welfare, Alexander cost Pennsylvania taxpayers $7 million and took healthcare away from 89,000 children.

      During the hearing, non-partisan representatives from both the Maine Hospital Association and from Maine Equal Justice Partners echoed lawmakers concerns about the errors and assumptions in the report.

    No-bid contracts in Maine must meet certain criteria as noted in the state’s “Sole Source Justification Guidelines”:

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  • 1/15/14-Speaker of the House Mark Eves (D-N Berwick) and Senate Majority Leader Troy Jackson (D-Allagash) introduce a pair of Medicaid expansion bills to the HHS Committee:

     

     

    Speaker of the House Mark Eves and Senate Majority Leader Troy Jackson wait before presenting their bills before HHS Committee.

    Speaker of the House Mark Eves and Senate Majority Leader Troy Jackson wait before presenting their bills before HHS Committee.

      Speaker of the House Mark Eves (D- N Berwick) presented his bill, LD 1578, “An Act To Increase Health Security by Expanding Federally Funded Health Care for Maine People”before the Health and Human Services Committee in a packed public hearing.

       

      The second bill that came up for public hearing yesterday before the HHS Committee was presented by Senate Majority Leader Troy Jackson. His bill, LD 1640, “An Act To Enhance the Stability and Predictability of Health Care Costs for Returning Veterans and Others by Addressing the Issues Associated with Hospital Charity Care and Bad Debt”, is designed to address the specific needs of Maine’s service members and other Mainers who find themselves excluded from the existing Affordable Care Act.

    Both bills would pass the Legislature, be vetoed by the Governor and have that veto sustained later in session.

  • 1/15/14- Weekly Address Of Governor Paul LePage: Maine Has An Obligation To Help Our Most Vulnerable And Pay Its Bills (MPW post)

     

      “This week our Administration provided Mainers and lawmakers The Feasibility of Medicaid Expansion under the Affordable Care Act. If Maine opts to expand Medicaid as it did 10 years ago, the report estimates it will cost the state more than $800 million—and that’s without additional risk factors. It does not include the hundreds of millions of dollars that will be shifted onto the middle class who buy their insurance. This will cause private insurance premiums skyrocket.

       

      The report also predicts between 31 and 36 percent of all Mainers will be receiving taxpayer-funded health care by 2023. In other words, for every three Mainers, one will be on Medicaid at the taxpayer’s expense.

      The funny thing is that the guy who wrote the report has been very successful in getting the federal government to work with states on improving its Medicaid program. So, why aren’t liberals listening to what he has to say?”

  • 1/20/14- It is first reported that DHHS officials worked with the Alexander Group in revising the report multiple times before it was released to the public:

     

      The document appears to have been edited to present a more seemingly detached analysis of the Medicaid expansion equations. The most politically sensitive passages were softened or removed outright:Sections outlining poor health care outcomes for those enrolled in Medicaid were trimmed or stricken, as were segments and a related appendix outlining the political breakdown of Medicaid expansion, noting “there appears to be a partisan pattern on how states are deciding to expand.”

       

      An initial version even suggested that considering expansion at all was a waste of time.

      Alexander originally wrote that, given the current level of spending on MaineCare, “there seems to be little point in talking about the expansion scenario that significantly increases costs and accelerates the cost growth rate.” That passage was removed in the final report. Other language changes in the report de-emphasize forecasts that may bring into question efforts by Republican LePage to create jobs and grow the state’s economy.

      The first draft calls the dramatic increase in Maine’s poverty rate “phenomenal.” The final report referred to the increased poverty rate as simply “one causal factor” driving Medicaid growth.

      The final version of the report thanked DHHS Commissioner Mary Mayhew and her entire staff, and made clear the impact the department had on the study. Alexander wrote that the department contributed not only data necessary for analysis, but recommendations on the report itself, which were included in the final draft.

  • 1/21/14- Maine media report multiple revisions were made between December 16 and January 10 to the report, with copies of four different versions linked.
  • 2/10/14- HHS Chair Rep. Richard Farnsworth puts forth LD 1794,“An Act To Cancel the No-bid Alexander Group Contract To Produce Savings in Fiscal Year 2013-14″. The bill would later pass the Democratic controlled 126th Legislature, but is vetoed by Governor LePage. That veto is later sustained.
  • 2/17/14- PPH reports that “officials at DHHS are weighing whether to defend Alexander’s Medicaid study or divert attention from it”:

     

      On Feb. 11, DHHS spokesman John Martins emailed Mayhew, Sam Adolphsen, the deputy finance director, and Nick Adolphsen, a legislative liaison. He discussed a memo from Erik Randolph, a member of the Alexander Group, that presumably defended the Medicaid study. Sam Adolphsen wrote Friday that he liked the memo, but questioned whether the agency should wait for the “next attack” to make it public.

       

      Martins replied: “We are succeeding on all fronts on getting the expansion message out and the focus on the (Alexander Group) report has died down.”

      Martins went on to request “quotable and reliable data” to support the administration’s claim that Medicaid expansion recipients could qualify for subsidies in the federal health care law. He noted that communications directors “across the state have been asked to do (newspaper opinion columns) regarding the impact of Medicaid spending on their programs.”

      He concluded: “We haven’t lost anything – we have this (memo) ready for the next salvo – but I think if we have data, especially data that we can report as new, Commissioner, we can accomplish your message objective without tying it to the (Alexander Group) report.”

  • 2/18/14- Gary Alexander pens an article “Reisting the Medicaid Temptation” for the Galen Institute, which gets picked up by Washington Times:

     

    Maine Gov. Paul LePage takes a sip from a coffee mug displaying a "no new taxes" message, April 27, 2012. (AP Photo/Pat Wellenbach)

    Maine Gov. Paul LePage takes a sip from a coffee mug displaying a “no new taxes” message, April 27, 2012. (AP Photo/Pat Wellenbach)

      “In a day when governors and legislatures need more resources for priorities that benefit all citizens, such as education and transportation, the promising of a bigger stream of federal revenue may be too enticing to forgo.

       

      Yet a recent economic forecast and risk analysis we conducted for the state of Maine flatly contradicts that glowing assessment, suggesting that the hope of using Medicaid expansion to solve state budget woes is as empty as President Obama’s promise that “if you like your health care plan, you can keep it.”

      Ten-year projections made on the basis of current expectations reveal that even if the state were to expand Medicaid eligibility, Maine would continue to experience rising rates of poverty and increases in both median and per-capita income.”

  • 2/19/14- Weekly Address Of Governor Paul LePage: Medicaid Spending Is Consuming The General Fund (MPW post)

    lepage head 2

      “Medicaid now consumes 25 percent of all General Fund revenue. If liberals succeed in expanding welfare again, Medicaid will devour 45 percent of the General Fund.

       

      State government has already eliminated or reduced funding for education, law enforcement, economic development and protection of our natural resources. Quite simply, Medicaid is cannibalizing revenue from all other state agencies.

      That means the state cannot fully pay its 55 percent share of local education costs. It cannot hire more Maine State Troopers or repair National Guard facilities. The state cannot adequately promote fishing and hunting programs or conduct scientific marine research on Maine’s fisheries. The state cannot expand job-training opportunities or properly fund programs for environmental emergencies. Everything the State of Maine does is adversely impacted by Medicaid spending.”

  • 2/24/14- The LePage administration demanded that the communications directors supply public statements in regard to how expansion would adversely affect their budgets to back up the governor’s claims and then makes the requested statements public in bulk as part of a press release, entitled “Maine Agencies Cannibalized by Welfare Spending”
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  • 2/26/14- Senate Assistant Minority Leader Roger Katz (R-Augusta) presents his and caucus member Sen. Tom Saviello (R-Wilton)’s Medicaid expansion compromise bill including a three year “sunset provision” to HHS. The day before, the pair unveil their plan to members of their party during a caucus meeting and then take their pitch to the editorial boards of two of the state’s daily newspapers. The bill, LD 1487, “An Act To Implement Managed Care in the MaineCare Program” was carried over last July and as such, would need 2/3s vote as an emergency bill and to override a veto from Governor LePage, who is vehemently opposed to expansion. Democratic leaders praise the move:

     

    Senate Minority Leader Roger Katz (R-Kennebec)

    Senate Minority Leader Roger Katz (R-Kennebec)

      “We view the proposal as a step forward after months of debate over how to ensure more families can have access to a family doctor,”  said Speaker of the House Mark Eves of North Berwick. “Our priority has always been securing life-saving health care for 70,000 Maine people. While we have been skeptical of managed care programs in the past, we look forward to hearing the details of the Republican proposal. We will want to make sure that the emphasis is on quality treatment; not simply denying care.”

       

      “The people of Maine are counting on us to do right by them. They’ve put their faith and their trust in us and asked us to represent them to the best of our abilities,” said Senate Majority Leader Troy Jackson of Allagash. “Health care is a right, and lawmakers who get health care from the state should think twice before denying it to their constituents.”

    The bill would ultimately fail to get past Governor LePage, the fifth attempt to expand Medicaid in the 126th Legislative session.

  • 2/26/14- HHS Chairs Senator Margaret Craven and Rep. Richard Farnsworth pen a joint opinion piece for the Bangor Daily News, “Why the Legislature should cancel the Alexander Group contract”.
  • 2/26/14- DHHS Commissioner Mary Mayhew hosted a large media event in Governor LePage’s cabinet room with a variety of department heads dutifully taking their turns and standing to speak to the gathered Maine press about how their budgets were being “cannibalized” by the monies going into DHHS, as well as a new LePage assertion that “Medicaid Expansion is Bad for the Environment”. 
  • 4/9/14- “How the Koch brothers are killing Medicaid expansion in Maine”

     

      Opponents of accepting federal health care funding have taken a similar approach to health care policy as they have to public opinion in Maine. With every independent study confirming that expansion will boost the state’s economy while saving lives, they needed some way to muddy the waters. Luckily, they had the perfect candidate to stir up the bottom: former Pennsylvania Department of Public Welfare Secretary Gary Alexander.

       

      Alexander is no stranger to FGA (Foundation for Government Accountability) and ALEC. In 2011, ALEC’s newsletter featured Alexander’s Medicaid privatization ideas as the #2 way to “push back against ObamaCare.” In 2012, Alexander and Herrera headlined an anti-Medicaid expansion panel discussion at the American Enterprise Institute. In 2013, Alexander joined Herrera for a conference call with FGA supporters.

      “I thank you, Christie, and your great organization for organizing this,” said Alexander as they ended the call.“You guys are a tremendous repository for all of this information and I look forward to continuing to work with you as we solve the country’s most vexing problems.”

  • April 2014- The original contract is amended to give the Alexander Group an additional two months to complete the final portions of its report, pushing the target due date from May 15 to July 15.
  • 5/13/14- Although more than half of the monies being paid to the Alexander Group and a deadline looming in a few days for the final installment of the five part report to be released, the LePage administration says that only the previously released first portion has been received (“Despite paying welfare consultant more than $500,000, Maine has received only one section of 5-part study”):

     

      “To my knowledge, just the report we released in January has been delivered thus far,” John Martins, a DHHS spokesman, wrote in an email message Monday.

       

      Under the terms of the contract that report — the first of five Alexander was to deliver — was due on Dec. 1, 2013. The other portions were due as follows: two on Dec. 20, one on March 15 and the last on May 15.

      The report due Dec. 1 was delivered to DHHS on Dec. 16, but was withheld from the public for more than three weeks while LePage reviewed its contents.

  • 5/16/14- The long awaited and overdue second portion of the Alexander Group report is finally released. 
    View this document on Scribd
  • 5/17/14- Critics quickly respond to the newly released document (“LePage paid an expensive consultant to recommend what he already tried — and failed — to do”):

     

      One doesn’t have to read too far into the Alexander Group’s second report to the Maine Department of Health and Human Services to realize the state hasn’t gotten its money’s worth. Gov. Paul LePage’s administration spent $925,000 on a no-bid contract for the state welfare system consultant, yet it’s difficult to read the Alexander Group’s 228-page document and take it seriously.

       

      Based on the Alexander Group’s description of its work and characterization of its own members’ credentials, you’d expect a tremendously useful report with unique insight and innovative policy solutions to some of the genuine challenges facing Maine’s public assistance programs and the low-income people they serve.

      Instead, what Maine has received is essentially a research paper on the structure of the public assistance programs Maine DHHS administers, along with unoriginal policy recommendations that aren’t backed up by analysis.

  • 5/21/14-Maine Governor Paul LePage continues to tout the hiring of Gary Alexander and the report in his weekly address prepared the previous day, “Medicaid Expansion Has Been Disastrous For Other States”:

     

    “As we said over and over again, there is no free lunch. These states (Arkansas, California and Rhode Island) are facing enormous costs because of Medicaid expansion and ObamaCare. We did not want Maine to get stuck in that position. That’s why we hired a consultant to advise us on how best to manage all of our welfare programs.

    The consultant just released the bulk of his report, detailing what we are doing right and what we can do to improve our welfare programs. Before they could even read it, Democrats jumped up to attack the report. They just won’t face facts.

    Take time to read it before you go on the attack.”

    Bangor Daily News first breaks the story in an editorial, then discusses the apparent plagiarism within the newly released portion of the Alexander Group Report, with one of those from whom the work is lifted weighing in:

      “We don’t think professional standards would include excerpting significant chunks of text without quotation marks,” said Liz Schott, a senior fellow with the Center on Budget and Policy Priorities’ welfare reform and income support division and one of the report’s three authors. “They listed text and made it appear like their own, and, yes, that appears to be plagiarism.

       

      It starts with a list about advantages to subsidized work programs. Then, the Alexander Group discusses the experience of other states that have started subsidized work programs. For about two full pages, pages 110 and 111, the Alexander Group uses the CBPP’s work, virtually word or word.

    Rep. Mike Michaud, who is running for Governor against LePage as the Democratic nominee, takes to Twitter to blast the administration:

    Maine Democratic Party also responds:

    Another victim is quoted:

      LaDonna Pavetti, vice president for the family income support division of the Center on Budget and Policy Priorities, said Wednesday morning that in her experience, what the Alexander Group did went far beyond normal or acceptable. The BDN found that pages of the Alexander report appeared nearly verbatim from the Center on Budget and Policy Priorities’ earlier study.

       

      “I have never seen this,” said Pavetti. “It’s literally two pages of text [that were copied]. It’s not a small piece of text.”

  • 5/23/14-Portland Press Herald publishes the examples of plagerism (“Compare The Alexander Group report and its plagiarized sources”) with an example identically lifted from Jacqueline Kauff’s 2008 report, “Assisting TANF Recipients Living with Disabilities to Obtain and Maintain Employment”.

     

    The silence of LePage’s supporters is questioned, with millions of dollars cited as examples (“Bill Nemitz: As money goes to waste, LePage supporters’ silence is deafening”) and a quote from Alexander regarding the plagiarism charges:

      “Yes, there are footnoting problems with the report that escaped our review process, but there was no intention to plagiarize,” Alexander said in an email to the Portland Press Herald late Wednesday. “The report does provide credit to the work of others but unfortunately not in the proper format. We regret the error. We will be resubmitting a corrected report.”

     

    Late in the afternoon, LePage issues a terse statement on the Alexander Group’s plagiarism scandal:

      “I am gravely concerned about these accusations and we will get to the bottom of it. Upon learning of this information today, we have taken immediate action and suspended all payments to the Alexander Group. We will continue to look into these accusations and will take further action, including termination of the contract, if warranted.”

     

    Democrats quickly weigh in.

      Senate President Justin Alfond (D-Portland): “Mainers have been swindled by Gary Alexander and for six months, Governor LePage and his Republican lawmakers have looked the other way,” said Senate President Justin Alfond of Portland. “Undoubtedly, this discredited report is an embarrassment for the LePage administration. And Governor LePage’s request to suspend payments is small change compared to the fleecing of our state’s coffers. I urge my Republican colleagues to join me in demanding a full refund from the Alexander Group. We should not be paying premium pricing for pulp fiction.”

       

      Speaker of the House Mark Eves: “Maine taxpayers deserves a full refund. It’s not enough to suspend payments for this flawed and controversial contractor. It’s fraudulent work. No amount fraud should be tolerated. The contract should be canceled like we have been saying since day one. This has been an egregious waste of taxpayer dollars meant only to boost the Governor’s election campaign.”

      Rep. Richard Farnsworth (D-Portland), House chair of the Health and Human Services Committee and sponsor of LD 1794: “This so-called report from the Alexander Group has been a debacle from the moment the governor secretly gave this nearly $1 million no-bid contract to his Tea Party crony. The taxpayers should not have to pay a single cent for this miserable piece of work, let alone a half million dollars. The people of Maine deserve a full refund. This is not simply an oversight on the part of the Alexander Group and the administration, it is an ethical failure.”

      HHS Committee member Senator Colleen Lachowicz (D-Waterville): “Friday afternoon of Memorial Day weekend news. I’m sure the administration wants this to get lost in the weekend. But remember this: there were concerns right from the beginning about how this contract was granted. The Alexander Group has never turned in anything on time. And now plagiarism. We had a bill to cancel payments for this ill advised contact because it has been first and foremost a political contract that has produced political documents. Not a wise use of our tax dollars. We couldn’t get a veto proof vote on that bill. And now this.”

       

      HHS Committee members Rep. Drew Gattine (D-Westbrook) and Rep. Deb Sanderson (R-Chelsea) listen to testimony during the public hearings for LDs 1815, 1820, 1822 and 1842.

      HHS Committee members Rep. Drew Gattine (D-Westbrook) and Rep. Deb Sanderson (R-Chelsea) listen to testimony during the public hearings for LDs 1815, 1820, 1822 and 1842.


      HHS Committee member Rep. Drew Gattine (D-Westbrook):
       “As I’ve said numerous times, this all started with the procurement, which was illegal, done in secret and never should have moved forward. Gary Alexander and his “group” have no experience as consultants and our DHHS was the first state agency to ever hire them. They never would have won a competitive procurement and never should have been given a contract.”
  • 5/24/14- Much more plagiarism within the newly released portion of the Alexander Group Report discovered (“Mike Tipping: ‘LePlagiarism’ far more extensive than previously believed”):

     

      A new analysis of the report by a plagiarism detection expert shows that many additional, lengthy sections were lifted verbatim from other sources with little or no attribution. It’s now clear that Alexander was dishonestly passing off the work of others as his own.

       

      Sometimes, as with the Center on Budget and Policy Priorities paper, the source is mentioned, but it’s not made obvious that content was copied wholesale. This is the case on Page 134 of the latest report, which references a paper by Mathematica Policy Research and then uses text from that document nearly verbatim without acknowledging the quotation.

      Similarly, on Page 43 of the MaineCare report, a footnote reads, “Most information modified from Pewstates.org information on the states,” but what isn’t noted is that most of the text on the next four pages was lifted from a specific article on Pew’s Stateline news service.

      In several other cases, no attribution is given at all. This is true of portions of the reports copied wholesale from policy papers published by the Kaiser Family Foundation, the Commonwealth Fund and the University of Southern Maine’s Muskie School of Public Service, as well as text taken from a number of Maine government documents.

     

    Examples of where Alexander simply copied his own work done in the Arkansas report are shown as well.

    Later that afternoon, Governor LePage suspends payment to Alexander.

  • 5/28/14- Senate President Justin Alfond and Speaker of the House Mark Eves send a letter to Governor LePage, demanding that the state’s contract with the Alexander Group be cancelled immediately and that the monies already paid to the consultant be recouped.

     

      “From day one, the Alexander contract has been highly questionable. The no-bid contract received no public review, no opportunity for legislative oversight and no adequate vetting of this contractor. Worse, it used federal funds intended to help struggling families and hungry children. This is truly a case of egregious fraud, waste and abuse of taxpayer dollars.”
    View this document on Scribd

    They also wrote to Republican leaders:

    View this document on Scribd

    Senate Minority Leader Mike Thibodeau (R-Waldo) issued a statement saying he had reached out to LePage’s office and had been, “reassured they are taking these allegations very seriously, are taking appropriate steps to look into their validity, and considering the appropriate course of action going forward.”

    HHS Chair Rep. Richard Farnsworth weighs in:

      “This so-called report from the Alexander Group has been a debacle from the moment the governor secretly gave this nearly $1 million no-bid contract to his Tea Party crony. The taxpayers should not have to pay a single cent for this miserable piece of work, let alone a half million dollars. The people of Maine deserve a full refund. This is not simply an oversight on the part of the Alexander Group and the administration, it is an ethical failure.”

     

    Gary Alexander and DHHS Commissioner Mayhew react to questions from HHS Committee member Rep. Peter Stuckey (D-Portland), 1/14/14.

    Gary Alexander and DHHS Commissioner Mayhew react to questions from HHS Committee member Rep. Peter Stuckey (D-Portland), 1/14/14.

    Later that same day, it is learned that the contract itself will be scrutinized by federal authorities:

     

      Gerry Petruccelli, a University of Maine Law School professor who has specialized in business and contract law, said Wednesday the language in the contract between Alexander and the state was “fuzzy” enough that the state may have little legal recourse.

       

      Meanwhile officials with the Centers for Medicare and Medicaid Services in Boston referred all questions on the use of federal funds to pay Alexander to the Office of the Inspector General.

      John Martins, a spokesman for DHHS confirmed Wednesday, that of the $501,760 that Alexander had already been paid about half of it or $249,185 was federal funds.

      Phil Coyne, Assistant Special Agent in Charge of the federal OIG, HHS regional office in Boston saidinvestigators would be reviewing the state’s contract with the Alexander Group to determine if the federal funds used to pay the consultant were used appropriately.

    The governor’s press secretary responded:

    lepage sots angry self

      “Could there be a coincidence that Democrats are pushing out these letters days before their convention?” she wrote. “The governor will not allow politics to interfere with getting to the bottom of these allegations. As the governor has stated previously, he immediately suspended payment one week ago (Wednesday, May 21 upon learning of these claims), proper follow up is being conducted looking into the validity of these accusations, and appropriate action will be taken, including and up to termination of the contract, if warranted.”

       

      Bennett’s statement did not specifically address whether the state had protections within the contract to recoup its money.

    LePage went on the record as well:

      On Tuesday, the governor released a statement to the Portland Press Herald, saying, “I will take every action we can. I am not happy about this.”

       

      He added that the state may attempt to reclaim the $500,000 it has already paid The Alexander Group.

      “It’s all a matter of the extent of what the damage is,” he said.

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