Exclusive: Email crash impeded HHS response to coronavirus

As health department officials worked quickly to negotiate an emergency funding package to fight the spreading coronavirus outbreak on Feb. 23, they came to a frustrating realization: Their email system had crashed.

The outage in the Health and Human Services secretary’s office stretched on much of the day, with some messages delayed up to 11 hours, creating frustration and slowing the Trump administration’s coronavirus response.

The HHS officials soon discovered the culprit: An email test conducted by the team at the Centers for Medicare and Medicaid Services, a branch of the health department that hadn’t briefed HHS leaders or alerted the department’s chief information officer before sending thousands of messages through their shared system. Although it was a Sunday, top officials were negotiating with the White House over a soon-to-be-announced coronavirus funding plan and tackling other urgent decisions — which were interrupted by the email outage.

The previously unreported episode was the latest in a series of information technology snafus caused by the department’s Medicare branch dating back more than a year. This time, HHS decided to remove the agency’s control over its own email operations and launch an audit of its entire information technology infrastructure.

The episode has exacerbated tensions inside a department that’s already been split by intense fights between HHS Secretary Alex Azar and CMS chief Seema Verma while it strains to coordinate the government’s response to the viral outbreak.

"It's the same problem, the same behavior, but at the exact wrong time," said one official, arguing that CMS and Verma's failure to coordinate with HHS has been a persistent management problem.

Two people with knowledge of internal discussions said that Verma on Tuesday appealed to the White House to intervene and restore her oversight of CMS email operations, arguing that she needed full control to respond to the coronavirus outbreak.

CMS did not respond to repeated requests for comment.

The most recent conflict began on Feb. 27 – four days after the email outage – when HHS chief information officer Jose Arrieta wrote a bruising memo to Azar’s deputy, Eric Hargan, laying out the repeated IT problems at CMS.

“A series of incidents over the past 120 days suggest basic communication and coordination between CMS and HHS is lacking, thereby jeopardizing HHS’ mission and undermining public trust,” Arrieta wrote to Hargan. Arrieta also cited technical issues in Verma’s department, like a recent bug that exposed Medicare beneficiaries’ information, and other cybersecurity risks.

Hargan subsequently informed Verma that an audit of her agency’s IT operations was underway and that HHS had taken control of her agency's email operations.

POLITICO spoke with four individuals who confirmed the episode and described relevant documentation. They said the incident reflects the extent to which communication problems and discord continue to plague HHS, even while it confronts the unprecedented challenge posed by the coronavirus.

“The situation is unacceptable,” one health department official told POLITICO. “Different areas of the department had to step in and make sure there was oversight.”

HHS did not comment directly on the IT snafu, but a spokesperson released a statement saying, “CMS maintains strong internal protocols and protections, and is widely seen as a leader on these issues across the federal government. The HHS and CMS technology offices collaborate and coordinate regularly on IT infrastructure and cybersecurity issues, including on rigorous audits completed by CMS and external parties throughout the year.”

The tensions between Azar and Verma, whose agency is technically a part of HHS but often operates independently, came to light late last year when POLITICO reported that the two had spent much of 2019 battling over policy, personnel and even seats on the presidential plane. The feud nearly cost them their jobs, as the White House in December considered replacing one or both of them.

After separate meetings with Vice President Mike Pence and a joint encounter with then-acting chief of staff Mick Mulvaney, Azar and Verma tried to tamp down tensions. But when the coronavirus hit, Verma was left off the task force that Azar headed to stanch the outbreak — an omission that rankled her allies. Only after President Donald Trump chose Pence to replace Azar as leader of the response did Verma join the panel.

Within the health department, some Verma allies claim that the decision to crack down on her IT systems was another manifestation of her feud with Azar.

But three officials dismissed the notion that the move was a politically motivated reprisal, arguing that career officials were driving the audit and that CMS’s health IT operations had been heavily scrutinized for months.

"This isn't based on anything other than technical concerns," said one official with direct knowledge of the situation.

Indeed, IT problems have long plagued Verma’s department.

Last year, she rolled out long-awaited changes last year to Medicare’s website intended to help seniors shop for health plans. But advocacy groups immediately said that the overhaul — which two officials said was originally supposed to take about two years but Verma pushed to condense to about one — raised multiple red flags, such as CMS not providing enough time to test the system before open enrollment began.

Media outlets subsequently uncovered multiple glitches in the website, and bipartisan House leaders in December warned Verma about reports that the website was “confusing, generating incorrect results and inadvertently leading beneficiaries to select plans that may not best fit their needs.”

Taken together, health department officials say that the episodes warranted the unusual intervention, especially during the fight against a viral outbreak that's required a coordinated government response.

"When there’s a pattern like this, it needs to be addressed," said one official. "It should have been addressed before two weeks ago."

Daniel Lippman contributed to this report.