Over Email, Federal Government Tells Utah It Can't Use Email to Communicate With Medicaid Recipients



Earlier this week, I wrote about the need for state-level flexibility in implementing Medicaid. I focused on the big picture—enrollment and eligibility standards and how they compare with federally mandated requirements—but as the following anecdote from Utah's governor suggests, states are constrained in what have to be incredibly frustrating ways even when it comes to what ought to be minor, easy-to-adjust operational details:

Utah officials waited for eight months to find out if the state would be allowed to use e-mail rather than paper to communicate with Medicaid recipients and save $6 million a year, he said.

"They sent us a denial by e-mail," [Utah's Republican Governor Gary] Herbert said. "The irony is rich." The state is continuing to pursue that Medicaid waiver and several others.

I'm not sure which is more absurd: That HHS said no, or that Utah had to ask in the first place. It's not particularly surprising, though, given the administration's overall track record on the issue. Health and Human Services Secretary Kathleen Sebelius sent states a letter earlier this month suggesting ways they could make Medicaid more efficient and less costly. But the administration's position on the matter essentially comes down to "don't make cuts; instead, do more with less." That's just not a workable solution. As Indiana's Republican Governor Mitch Daniels told a group of health reporters last week, the best practices suggested by HHS are "meaningless…people already copy each other. We don't need HHS's help to do it."

(Via PRI's John Graham.)

NEXT: That Would Be a Joint, Steve

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  1. I’m Gumby, dammit!

    1. Do you know what these are, boys and girls? They’re drums! Do you know where drums come from? From Africa! Do you know where these drums come from? Smokey Robinson was at the Apollo theater and left his van open in the back of the place. I ripped him off! I wonder how Smokey gonna sound wit’ no percussion!

      1. How does Smokey sound? Harmonizing together with me on ‘Sarah Smiles’, incredible.

      2. Sometimes it make me break out in a cold sweat!
        One two three four!

        Hot tub! Ha! Da!
        Ah-full of water!
        I say hot tub! Ha!
        Day! Ba! Very, very hot… Very hot! Da!
        Hot tub! Gonna get ya hot-a!
        Gonna make ya sweat! Hey! Say!
        Hot tub! Rub a dub in the hot tub!
        Rub a dub with me!

        Should I get in the hot tub?
        Will it make me sweat?
        Should I get in the hot tub?
        Will it make me wet?
        Well, well, well…

        Hot tub! Ah!
        Get in!
        Gonna get in the water!
        Gonna make me sweat! Ah!
        Here I go in the hot tub!


        Too hot in the hot tub! Ma!

        Burn myself!
        Make it cooler!
        Good God!
        Gonna make me…

        I’m gonna get in the hot tub..
        I’m gonna get in the hot tub..
        I’m gonna get in the hot tub..
        Ha! Lilin! Lidilin! Eh!
        A gonna make me sweat-ah!
        Dah! Gonna make me sweat!
        Gonna make me sweat-ah!
        Dah! Gonna get me in the hot tub!
        I can’t stand it!
        Here I go! I can’t stand it!

        Here I go in the hot tub!
        Gonna get in the hot tub!
        Gonna get it wet-ah!
        Good God!
        HHHIIIIGGHHH!! Ha!
        Good God!
        Rub a dub!
        In the hot tub!
        Rub a dub with me!
        Good God!
        Rub a dub in the hot tub!
        Gonna set me free!

  2. No one ever said the government is logical.

  3. aint that the truth !

  4. Sounds like when the IRS mails you a postcard telling you that it’s going to mail you a tax form booklet/your 1099-G/some other document in another two weeks.

    Yeah great, good to know.

  5. Yeah, why did they bother asking? Just start sending emails, dammit.

    1. They should do it anyway, if just to make the DHS look absurd in any attempts to crack down on it.

  6. Yeah, why did they bother asking? Just start sending emails, dammit.

  7. Wait, I thought the overall healthcare reform PLAN was to switch over to electonic data and communications. WTF?

    1. The government is nothing if not slippery and internally inconsistent.

  8. One the one hand, its completely stupid. On the other hand nobody (especially the agency lawyers) wants to see someone’s positive STD test accidentally forwarded to everyone on a Distribution List because someone typed the wrong email address and didn’t notice. I’m pretty sure that HIPAA prohibits transmission of private medical data by email unless fairly strict encryption standards are met. Its a bitch in the healthcare industry because even communication between 2 colleagues that has patient identifying information is covered. So you’re pretty much a slave to M$ and RIM, because they’re the only certified providers. So at least the Feds are making Utah follow the same standards as any private client.

    From what I can tell, Utah would have to give everyone a computer with MS Exchange and a computer specific encryption security certificate to meet the regs. Even then they probably couldn’t because any info sent to the wrong patient and viewed would be a HIPAA violation as well.

    1. Good point, but why can’t Utah use email for non-sensitive information (like reminders about doctor’s appointments) and regular mail for HIPAA-covered stuff?

      1. Union USPS jobs. That’s why.

    2. Brett, I got your STD results by mistake…they aren’t good…

      1. Its cool. I know about the chlamydia. My girlfriend gave it to me for Christmas. Nurses have strange senses of humor.

  9. Maybe Medicaid would like for Utah to leave the program. Don’t be a pussy, Utah.

  10. I can’t believe so little coverage from Reason on what is unfolding in Wisconsin. Maybe it is just me, but this seems like a really big deal. A governor and state legislature are hopefully about to strip public employees of their right to collective bargaining. This could be a real seminal event in the fight againt big government. And Reason hasn’t had anything to say about it.

    1. They’re waiting for the France-like riots to make it more amusing.

    2. The dems who are supposed to vote on this are nowhere to be found; police have been ordered to find at least one so the vote can be taken.

    3. Flyover country… [yawn]

      1. What’s Kentucky? Paris?

          1. I stand corrected. Plus, it has the world’s tallest three story structure!

            1. It’s the 1,399th Wonder of the World.

          2. Is that near Scotland, PA?

          3. Is that near Metropolis (IL)?

            1. No. Cairo, IL. (pronounced Kay-Roh, BTW)

              1. Care-o.

                1. That’s what I said.

                  1. Cairo is my baby’s home.

              2. KY also has a Cairo/Kay-Roh.

                1. Illinois has Des Plaines. Pronounced des planes.

      2. Maybe Wisconsin doesn’t interest cosmortarians. But this is the state that put Russ Feingold in the Senate. Wisconsin and Minnisota are old time progressive socialist kind of states. If this can happen in Wisconsin, it can happen anywhere short of California, which is now nothing but Guatamala with a film industry and has ceased to bear any resemblence to an American state.

        1. Maybe you left your sense of humor at home today.

          1. No. I thought it was funny. You know me, I am always happy to shame cosmotarians.

        2. SugarFree is probably right. If it didn’t happen in the Northeast, LA/SF, or DC, it didn’t happen. Occasionally they’ll acknowledge Chicago, but only when they’re slumming.

          1. Hey, this is about me.

        3. Reason covers stories from “flyover country” all the time. Balko lives in Tennessee and Gillespie lives in Ohio.

          1. You’re right, that’s not such a fair accusation to level at Reason. I was really talking about most of the large media houses in the U.S., like ESPN.

          2. That is Sugar Free not me. I am just wondering why they are not covering this more. Maybe he who shall not be named (who I hear fucks sheep) threatened to sue them if they did.

          3. And Sullum lives in Dallas, which some people apparently consider flyover country.

        4. Wisconsin also has other awesome things happening right now.

        5. Ugh, this spam filter’s killing me. I was going to say that Wisconsin also has other awesome things happening, such as a bill to strip most public employees of the ability to unionize. Big protests by entrenched types.

          Google “Wisconsin protests” or something.

          1. And then I read upthread.

    4. Senate Democrats have left the state, so it doesn’t seem they will be voting on it today.

      Just imagine if this were Tea Partiers protesting something. The media would make it sound like they were evil and the world was ending.

      1. Looks like Wisconsin is going to have to take a page from Texas’ book.

        1. Does Wisconsin have Rangers?

          1. Walker, Wisconsin Ranger…

    5. civil rights are NOT subject to voting.

      1. Public employees have not civil right to orgainize.

        1. freedom of assembly

          1. not organize, collectively bargain. They have no right to that.

            1. You have a right to kill me. You have a right to do that, but you have no right to judge me

      2. Re: OhioOrrin,

        civil rights are NOT subject to voting.

        Yes they are:…..ights.html

    6. Ann Althouse, who teaches at UW in Madison, has some great pictures of the protests. Can’t these fucking morons come up with any analogy other than Hitler? Do they have any other move?…..union.html

      1. Wait, I thought only Tea Party types invoked Godwins via signage and crude speech…

        1. Wer’e the ones that can spell better then the Tea Partie morons.

      2. Great link, John. The pics and comments are gold.

        That goose? If you cut it open you can get all the gold eggs out all at once.

        For reals.

        1. Some of the regulars at Althouse are pretty good. They have a couple of house liberal trolls that make Tony look thoughtful.

      3. Amartel said…
        And as usual the tools brought their Hitler posters. They pretend they don’t like him but he occupies their thoughts, constantly. Wonder why.

        2/16/11 7:26 PM


        1. But where are the goddamn giant puppets? How can you have a protest without goddamn giant puppets?

          1. There’s a poster of the governor being lynched, but it looks like an abandoned game of hangman.

      4. Indigo Red said…
        In the last photo there’s a colorful sign that says, “I AM THE FUTURE // I NEEN QUALITY TEACHERS”.

        ‘NEEN’? Forget the future, we neen quality teachers now.

        1. I believe “neen” is a variant of the Dutch word for no.

      5. Maguro said…
        On the positive side, Hitler was a big choo-choo supporter, so maybe there’s still hope for garage’s 59mph bullet train to Milwaukee.

        2/16/11 8:15 PM

        I have to stop. Hahaha

      6. Well, he’s bad, and he’s right wing. And Hitler was right wing. Well, right of Stalin, anyway, which is the centerpoint for most of the old left anyway.

  11. Hey look — US Debt causes Global Warming. I have a chart to prove it!

  12. I’m assuming this relates to HIPAA regulations?


    Check out Niall Ferguson, someone who actually is educated and errudite destroy the morons on MSNBC, all of whom are products of elite American higher education. It is so pathetic on the MSNBC hosts’ part, you almost feel sorry for them.

    1. Is that the video where the hosts keep implying that anything good that comes of the revolt is thanks to Obama? All while the professor keeps explaining how effed up the administration has been on this?

      1. Yup. They are all begging him to say something good about BO. And Ferguson, who is hardly a conservative, just keeps destroying Obama. It is great.

      2. Anything good that comes out of anything is thanks to Obama.

        1. I got to number 8 before I started laughing uncontrollably

          8.The White House and federal government are respecting the Freedom of Information Act

          1. But it feels like it must be true.

        2. Gotta justify that Peace Prize, I guess.

      3. This reminds me a bit of the NYT article about the protests in Wisconsin where the Labor Law Professor keeps talking about Republican governors while never mentioning Jerry Brown.

        “I’m sure we’re going to hear more from other states where Republican governors are trying to heap the entire burden of the financial crisis on public employees and public employees’ unions,” said William B. Gould IV, a labor law professor at Stanford University and a former chairman of the National Labor Relations Board.

        “I think it’s quite possible that if they’re successful in doing this, a lot of other Republican governors will emulate this,” Mr. Gould added.

        I was wondering how many times he could utter the word “Republican”.

        1. Andrew Cuomo is a Repubican?

        2. The NYT is written entirely so that a certain breed of liberal can feel better about themselves. So you have to read everything in that light. This story is laying the groundwork for liberals to tell themselves that public workers were unfairly blamed for the coming governmental bankruptcies and that is why the public turned on them.

        3. “”I’m sure we’re going to hear more from other states where Republican governors are trying to heap the entire burden of the financial crisis on public employees and public employees’ unions,””

          That is where the money goes.

    2. While it’s always good to see MSNBC bozos get schooled, I’m not sure what Ferguson’s point was. Is he saying the US should have intervened (more than usual, that is) on behalf of the Mubarak regime?

  14. Awesome. They were all nearly speechless with embarrassment. They really did seem to think that Obama was responsible for the relative peace happening over there.

  15. “They sent us a denial by e-mail,” [Utah’s Republican Governor Gary] Herbert said. “The irony is rich.”

    The irony got lost among the dumbasses at the HHS.

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