Bryant’s policy director to head Medicaid; lawmakers’ reactions split

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Drew Snyder

Drew Snyder, the policy director to Gov. Phil Bryant, will take the reins of the Division of Medicaid as its interim executive director, the governor’s office confirmed Wednesday.

Snyder’s appointment comes just five days after the resignation of former Medicaid head Dr. David Dzielak, whose long run atop the biggest agency in the state had been marred in recent months by questions of mismanagement and special interests.

Bryant praised Snyder, saying he had a comprehensive understanding of the Division of Medicaid.

“Drew has a firm grasp on the issues that affect Medicaid and the beneficiaries it serves. His intellect and demeanor make him the perfect choice to guide the agency during this period of transition. I am happy he has accepted this appointment,” Bryant said in a press release Wednesday.

The post of state Medicaid director is a notoriously difficult one, with agency heads staying aboard for an average of two years, according to data from the National Association of Medicaid Directors. This is a function of the increasing size of the program and the increasing demands on controlling costs while improving care. 

At six years, Dzielak lasted nearly three times the national average. But his last year with the agency was marked by a string of controversial decisions, and in the end Dzielak, a Bryant appointee, had managed to frustrate lawmakers on both sides of the aisle.

Snyder’s appointment, which had been rumored since Dzielak announced his resignation Friday, has been received with praise by Republican lawmakers.

“(Drew) could bring a fresh outlook, new perspective and ways of thinking outside the box as opposed to someone from Dr. Dzielak’s background,” said Rep. Hank Zuber, R-Ocean Springs, who serves on the House Medicaid Committee.

Prior to joining the governor’s team in 2016, Snyder served for four years as an assistant secretary of state for policy and research under Delbert Hosemann. Before that, Snyder, who holds a bachelor’s in business from University of Mississippi and a law degree from University of Virginia, practiced law in Washington D.C., with a focus on pharmaceutical and medical device matters.

Snyder’s legal and government bonafides are a departure from Dzielak, his predecessor, who holds a PhD in Physiology and Biophysics and had a nearly three-decade career in research and academics at the University of Mississippi Medical Center before running the Division of Medicaid.

For some Republican lawmakers, Snyder’s business degree and policy background are among his biggest strengths. Last week, after Dzielak’s resignation, House Medicaid Chairman Chris Brown, R-Nettleton, said he had been frustrated with inefficiency and a lack of transparency under Dzielak. And he hoped the governor’s next appointee would be someone who could run the state’s biggest agency like a business. Medicaid’s budget, when federal funds are factored in, is more than $6 billion, almost equal to Mississippi’s entire state budget.

“Ultimately that’s what the job is — it’s running a $6 billion business,” Brown said. “And if it’s run like a business, data will be readily available.”

As interim executive director, Snyder will oversee an agency with almost 1,000 employees in its central office, 30 regional offices and 80 outstations.

“My immediate focus will involve gathering input from stakeholders on ways to transparently and efficiently fulfill Medicaid’s stated mission of responsibly providing access to quality health care to vulnerable Mississippians,” Snyder said in the press release.

On Wednesday, Brown said he was excited to work with Snyder, whom he said had already started on his new job.

“I spoke to Drew a few minutes ago, and I’ve already got him working on some things,” Brown said. “He called me and said, ‘I guess you heard the news.’ And I said, ‘Congratulations. Here’s what I need.’ He said he’d put it on his to-do list. So he’s already getting to work.'”

Rep. Jay Hughes, D-Oxford

Among legislators in both parties, Snyder has a reputation as a hard worker, willing to listen to lawmakers on either side and spend time on issues. Reps. Jay Hughes, D-Oxford, and Jarvis Dortsch, D-Jackson, praised him as “always accessible” and “courteous.”

But in the same breath both also admitted they were skeptical that Snyder has the experience necessary to manage the biggest budget in the state.

“I think the new director should be something far more than a political appointment of a staff member. It should be someone who has vast knowledge and understanding of medicine, poverty (and) costs and the direct connection between the three. There are real people and jobs behind the dollars and real consequences to the decisions,” Hughes said.

The question of what the resume of Medicaid’s executive director should look like has been a controversial one this year. In April, the governor signed a bill that removed an earlier requirement for the executive director to hold either a medical degree or a doctorate.

Presenting the bill, Rep. Becky Currie, R-Brookhaven, had argued that “we need as wide an applicant pool as possible. We realized the qualifications for the medical director were too strict.” But some Democrats pushed back, worrying that removing these qualifications would “water down” the applicant pool. Ultimately the bill passed, largely along party lines.

State law now requires the executive director of Medicaid to be either a doctor with administrative experience in a health program or hold a graduate degree in medical care administration, public health, hospital administration or the equivalent. In lieu of that, the executive director needs three years’ experience in policy development for Medicaid programs.

Snyder joined the governor’s office in 2014 to develop policy for Medicaid and other state agencies. And this insider knowledge of how the governor, who has direct oversight of Medicaid, sees the agency could be very helpful in charting the agency’s next two years.

In a House Medicaid Committee meeting Thursday, Dzielak signaled, in response to a question, that he would prefer to keep Medicaid employees in charge of determining who was eligible for the program. This marked the first public admission that he did not see eye-to-eye on that issue with Bryant, who had recently been weighing moving eligibility responsibilities to the Department of Human Services.

Hours later, the governor called Dzielak to his office and asked for his resignation, said several persons familiar with the conversation who spoke to Mississippi Today on condition that they not be identified. The appointment with the governor had been planned for over a week, as had the end result, those same people said. But this series of events foreshadowed Snyder’s appointment.

Some of Medicaid’s most vocal critics, however, have expressed optimism that Snyder’s appointment would signal a more open agency. The Mississippi Hospital Association has publicly feuded with Medicaid this year after the agency denied a managed care contract to Mississippi True, the plan championed by the association. But CEO Tim Moore said he’s looking forward to working with Snyder.

“We’re looking forward to starting a new day with the Division of Medicaid, working together on finding better solutions and more opportunities to bring a new healthcare delivery system to the state,” Moore said, citing several federal waivers that could bring increased funds to the state. “And we feel that Drew will be open-minded and willing to look at all the options.”