King informed Drew Snyder, interim Medicaid director, that she was retiring on Friday. King, who has been with the agency from 1991 and served as its CFO since 2010, has been with it since that time. Snyder wrote Tuesday that Margaret had played a crucial role in the transformation of the Mississippi Division of Medicaid to what it is today over the past 26 years. “I appreciate her willingness for her to stay on for a few weeks to ensure a smooth transition, and wish her all of my best.” However, many in the health care community believe that Medicaid today is in dire need of major reform. King, who has been the agency’s second in command for almost eight years, is responsible for a lot of this responsibility. Rob Church, an independent consultant in health care and former commissioner and CFO for Alabama Medicaid, said that Drew inherited an agency that needed updating and restructuring. “And the CFO is a central part of all the operations of this agency.” King, who was the CFO of Medicaid, was responsible for overseeing and appraising all financial matters at the agency. He also vetted dozens of contracts. The CFO must ensure that the agency is compliant with federal Medicaid regulations. He also has to regularly prepare financial reports and make them available to the agency. The Division of Medicaid has been subject to scrutiny from lawmakers and health care professionals in each of these areas over the years. The federal Centers for Medicare & Medicaid Cervices has required the agency to revise its $533 million hospital reimbursement formula. This was one of the most controversial issues for the agency. Hospitals around the state have claimed for years that the formula is too arbitrary and does not properly reimburse certain hospitals for the money they spend on Medicaid patients. Although the federal government accepted the argument, the Division of Medicaid continued to ignore their requests to modify the formula for many years. The Medicaid budget has risen steadily to nearly $1 billion in state money and more than $6 billion when federal match funds are added. Mississippi’s fiscally conservative Republican majority has made this a sticking point. They claim that Dzielak’s administration has failed to provide adequate explanations and financial data to lawmakers. House Medicaid Chairman Chris Brown (R-Nettleton) said that Brown was optimistic that the situation will change with the appointment of a new director. Brown spoke shortly after Dzielak resigned in December. King has been present at committee meetings and hearings, but the Medicaid director usually answers questions and presents. In December, Dzielak announced that the agency faced a $46million deficit for fiscal 2018. Dzielak said that the agency couldn’t reduce that deficit further, which frustrated many Republican lawmakers. We asked Dzielak if you knew that there would be a deficit appropriation. Was there anything you could have done to offset this deficit? He said that there is nothing we could do. This is false. Brown stated that there is always something we can accomplish. His most notable accomplishment since December when he took over the agency was slashing its deficit. Snyder and King presented a $26.4 million final appropriation request to the House Appropriations Committee in January. Snyder explained to the House committee that Snyder and King had proposed a final appropriation request of $26.4 million. This was accomplished by delaying or eliminating several small contracts and shifting the work to employees within the House. According to Matt Westerfield, spokesperson for Medicaid, the agency is currently reviewing all contracts within the agency.