Senate committee advises and consents to Cindy Bradshaw as Medicaid executive director

The State Senate committee voted to advise and consent to Cindy Bradshaw's appointment as executive director of the Division of Medicaid; the appointment "is effective 10/10/2024," the chair told the committee.

Bradshaw, who told the committee she worked about 15 years in the private insurance sector at Blue Cross and Blue Shield and UnitedHealthcare before joining the Department of Finance and Administration in 2012, described her recent roles in state government: managing the state and school employees health insurance plan and workers' compensation programs, then handling Medicaid eligibility and the unwinding process beginning in April 2023. She said the governor later asked her to step in as executive director.

The committee pressed Bradshaw on program oversight and federal funding. Senator McMahon said he was "concerned about some fraud that's taking place or I believe that's taking place in Medicaid, not necessarily with providers but recipients," and asked what percentage of cases the agency reviews annually. Bradshaw said the agency "does have an an office of program integrity, and they, do multiple things," including using data analytics to screen claims, recouping payments when providers file claims incorrectly and referring suspected fraud to the attorney general's office. She said she did not have specific annual review counts available at the hearing and offered to "circle back" with that information.

On the limits of review, Bradshaw told the committee certain checks are constrained by federal rules: "we do have some limitations, that have historically been in place that are mandates from CMS on certain things we have to just take an attestation on," citing examples such as pregnancy or marital status where attestations are used and deeper investigation is restricted. She said she was "optimistic and somewhat encouraged" that the new state administration may allow more stringent use of resources.

Senator Boyd urged the agency to look beyond individual agency budgets and "help us make sure that the dollar you're looking out for is the taxpayer's dollar and just not your agency dollar," arguing some programs currently paid with state dollars might qualify for a federal Medicaid match. Bradshaw said the agency is pursuing several efforts, including identifying school-based services that could be run through Medicaid (an RFP to establish an audit trail and vendor is in development) and working with child protection services and out-of-state providers to bring those providers into Mississippi's Medicaid network, including coordination with Youth Villages.

Committee members also asked about national shifts that could affect state funding. Bradshaw said Washington is considering options to cut costs, including reductions to the provider tax and possible reductions in the FMAP for expansion states, and warned of the budgetary impact: "Currently, our federal match is 76.9%" and "just 1% reduction in that FMAP equates to about $83,000,000 for the state."

The committee chair said the nominee's peer review "came back clean." Senator Boyd moved to advise and consent; the committee approved the nomination on a voice vote, recorded as "aye," and the nomination was reported out to the Senate floor. Chair congratulated Bradshaw and said he did not anticipate problems with passage on the floor.