State Medicaid director Mary Mayhew getting bashed as senators consider her confirmation

Mary Mayhew’s quest to be confirmed as Florida’s new Medicaid director is facing intense criticism and sharp questioning over her past as a health care leader in Maine.

Although her nomination as head of the state Agency for Health Care Administration advanced Thursday in a divided vote, Mayhew had to explain a federal audit that showed her former Maine agency did not follow federal rules on reviewing the deaths of 133 developmentally disabled residents.

Sen. Kevin Rader, a Palm Beach County Democrat, likened Gov. Ron DeSantis’ decision to put Mayhew in charge of the state agency that oversees Florida’s $28 billion Medicaid program to the equivalent of putting Bernie Madoff, a convicted financial swindler, in charge of a bank.

“This is really one of the worst confirmations of someone that I can imagine in the United States,” Rader said.

But Mayhew, who led Maine’s Department of Health and Human Services for more than six years, defended her role in providing Medicaid and other medical services in her former state, while acknowledging some of the state’s shortcomings.

“Government is not perfect. I’m not perfect. But what you get from me as a leader is one who will continually be focused on who we serve, how we serve them and whether we are serving effectively. I will ask questions every single day,” she told the Senate budget panel that oversees health care spending.

Rader grilled Mayhew over a 2017 audit from the U.S. Department of Health and Human Services. After leaving Maine, Mayhew served briefly as President Donald Trump’s Medicaid director in the federal agency before DeSantis appointed her to her Florida job in January.

The federal audit said Maine “failed to demonstrate that it has a system to ensure the health, welfare, and safety of the 2,640 Medicaid beneficiaries with developmental disabilities” who were covered by the state’s program.

The audit highlighted the deaths of 133 developmentally disabled residents in Maine’s system, noting nine of the deaths “were unexplained, suspicious, and untimely, and corrective action could have been taken or preventable causes could have been identified for some of these beneficiary deaths.” Another 32 deaths lacked “enough information for us to make a determination of whether the deaths were unexplained, suspicious, and untimely,” the federal auditors said.

Mayhew acknowledged that the deaths were not “timely investigated” by her former agency as required under the state’s Medicaid agreement with the federal government. But she said all of the deaths were reviewed by the Maine Attorney General’s Office and “none of the deaths were as a result of abuse and neglect.”

Mayhew said she rejected any assertation that her Maine agency “failed across the board to protect and provide safeguards” to residents under its care.

But Rader questioned why Florida could not find a Medicaid director “who doesn’t have a background of actually breaking federal and state requirements.”

He was one of three Democratic senators who opposed advancing Mayhew’s nomination on Thursday. But one Democrat and five Republican senators supported her.

“Is there a perfect person anywhere in this country that could solve the problems of this state for the people who need it? There is not,” said Sen. Ed Hooper, a Pinellas County Republican who supported Mayhew. “I believe this lady needs to have a chance to do the best she can for the 21 million folks who live here.”

Mayhew did get support from the major health care lobbying groups, including hospitals, nursing homes and other entities.

Mayhew’s nomination next heads to the Senate Health Policy Committee. Ultimately, Mayhew’s confirmation must be approved by the full Senate by the end of the legislative session in early May.

Prior to serving as the head of Maine’s major health care agency, Mayhew worked as a lobbyist for the hospital industry. She ran unsuccessfully for the Republican nomination for governor in Maine last year. She was appointed as the federal Medicaid director last October.

More details on Mayhew’s controversial past in Maine are available here.