HARRISBURG - Claims by one of Gov. Tom Corbett's Cabinet nominees about the success of a signature health-care policy he worked on for the state of Rhode Island are not being backed up by officials there.

The conflicting statements by Corbett's nominee to be his secretary of Public Welfare, Gary Alexander, and officials under new Rhode Island Gov. Lincoln Chafee concern the amount of money saved through changes in that state's Medicaid program, which provides health care for the poor, disabled and elderly.

Alexander was secretary of Health and Human Services under Republican former Rhode Island Gov. Don Carcieri. Chafee, an independent, was sworn in Jan. 4 and replaced Alexander with his own nominee, a Democratic former state House representative, Steven Costantino.

Corbett announced his intention to nominate Alexander last month.

In papers he wrote and published online in recent weeks, Alexander said the changes saved Rhode Island $100 million or more over 18 months. In one paper, published by the Alexandria, Va.-based Galen Institute, Alexander said Rhode Island saved about $110 million through an agreement with the federal government called the "global waiver."

The agreement allowed Rhode Island greater freedom to use federal Medicaid funding in new ways and to pursue strategies to cut costs in return for spending limits that save the federal government money. Alexander called the strategy a "national model for Medicaid reform" as cash-strapped states look to balance their budgets.


However, a spokesman in Chafee's Health and Human Services Office said officials there do not know how Alexander came up with that number, and could not give their own.

"The secretary of Health and Human Services is currently reviewing the assumptions, accomplishments and savings projections associated with the global waiver," spokesman David Burnett said in a statement last week. "Without a detailed understanding of the author's assumptions, it is difficult to offer a comment on the veracity of the statements contained in the Galen Institute article."

Alexander declined an interview request. Through a Pennsylvania Department of Public Welfare spokesman, he said Monday that the dollar figures he used in the paper are all from Rhode Island state documents. Burnett said the agency had never used that number.

In a Jan. 20 online news article, Providence-based public radio station WRNI reported that the director of Rhode Island's Medicaid program, a former subordinate of Alexander, said there was very little in Alexander's report that was accurate. The Medicaid director, Elena Nicolella, did not give specifics, and did not return messages left at her office by The Associated Press.

An earlier version of the paper published several weeks ago by the Galen Institute carried an image of what appeared to be the Rhode Island state seal. Officials there, however, said it appeared that approval had not been given to use it. Galen Institute president Grace-Marie Turner said Tuesday she removed the image from the online paper in recent days at Alexander's request.

Alexander said through the Public Welfare spokesman that he authored the article when he was still the secretary of Rhode Island's Health and Human Services office.

Alexander's pursuit of the Global Waiver was unprecedented and politically charged. He got approval for it in the last days of President George W. Bush's administration.

John Robitaille, a former senior communications adviser to Gov. Carcieri and Rhode Island's GOP gubernatorial nominee who lost to Chafee in November, said he had not read Alexander's paper and could not corroborate Alexander's math, but called Alexander a smart and credible person.

"I'm not an accountant. I can just vouch for the guy and say it would be highly irregular for him to say it saved $100 million when it didn't," Robitaille said Tuesday.

Corbett has submitted Alexander's name to the state Senate as his nominee for the Department of Public Welfare. Senators are waiting on additional paperwork, including a statement of financial interest, from Alexander before they can begin the process of deciding whether to confirm him. 

The global waiver agreement with the federal government set a five-year, $12 billion cap on Rhode Island's Medicaid spending. One major goal under Carcieri was reducing the state's reliance on nursing homes to house elderly patients in favor of steering them toward less expensive at-home care.