Louisiana’s health department is withdrawing a request for the ethics board to determine if donations helping to pay for the rollout of Gov. John Bel Edwards’ Medicaid expansion comply with state ethics laws.
While Health and Hospitals Secretary Rebekah Gee told lawmakers recently that no request had been made of the ethics board, a Jan. 25 letter posted on the Board of Ethics website shows the health department asked for the opinion.
The request was revoked in a Feb. 1 letter, after the Department of Health and Hospitals received federal permission for the financial arrangement, which involves a private foundation collecting donations from health providers to help cover DHH’s administrative costs associated with the coverage expansion.
“I was not trying to obfuscate,” Gee said Wednesday. “In my mind, that was not a formal request because it had been pulled.”
The health agency’s request to withdraw the request will be considered by the ethics board Friday.
That means while the health agency has gotten clearance that the unusual financing arrangement conforms with federal regulations, DHH won’t get a determination on whether it is complying with Louisiana ethics restrictions on gifts and donations from people that do business with the state.
House Appropriations Committee Chairman Cameron Henry asked Gee about the issue last week as the House debated the health care budget for next year. Gee said no opinion request had been lodged with the board, by either her or her staff.
“At this point, what my executive counsel advised me was that it was not necessary to do so, so at this point we have not done so,” Gee replied to the questions.
But DHH Executive Counsel Stephen Russo was the one who filed both the January opinion request with the board and the February request to revoke it.
Gee said she thought she was answering a different question of whether her department had ever received an ethics opinion or was still seeking one.
“And the answer to that was no,” she said.
Russo said he concluded the department didn’t need ethics guidance because it had received federal approval, found two cases in which the ethics board allowed donations to go to an agency with fiscal problems and determined the ethics code didn’t apply in the situation.
Henry questioned why Gee didn’t provide the information to lawmakers.
“You hate to accuse someone of misleading the Legislature, especially when you’re on the House floor discussing any matter, but the fact that her executive counsel filed the request on her letterhead definitely causes you to pause and wonder why she did not tell us that an ethics opinion had been requested,” said Henry, R-Metairie.
The eligibility expansion under the Medicaid program begins July 1.
Amid continuing state budget gaps, DHH crafted an approach to handle startup expenses and enrollment that involves sign-up assistance — and direct donations — from health providers such as hospitals and managed-care plans that stand to benefit from the influx of new Medicaid funding. The Baton Rouge Area Foundation is collecting donation money. Gee said the foundation is sending the money to DHH — about $400,000 collected so far — without telling the agency which providers made donations.
Henry suggested an ethics opinion should be requested “out of an abundance of caution.”