The ranking Democrat on the Senate Finance Committee is demanding to see the communications of the Trump administration’s top Medicaid official to determine whether she is violating her ethics agreement by handling Medicaid waiver requests from states that paid her former consulting company, SVC Inc.

In a letter dated Jan. 19 to the general counsel of the Department of Health and Human Services obtained by TPM, Sen. Ron Wyden (D-OR) is requesting an investigation into the potential conflicts of interest of Seema Verma, the administrator of the Centers for Medicare and Medicaid Services (CMS), particularly her handling of waiver requests from Arkansas, Kentucky, and Iowa.

“Recent statements by governors representing multiple states indicate that Administrator Verma has personally and substantially participated in waivers submitted to CMS by states that were clients of her previous consulting business,” Wyden wrote.

Unless Verma sought and received special permission from the Office of Government Ethics to work on those state cases, Wyden said, she is in violation of the pledge she made when she was appointed last year. Wyden has demanded that HHS hand over by Jan. 27 any ethics waivers granted to Verma.

“I request that you immediately investigate whether Administrator Verma’s actions comply with her agreements and the Federal ethics requirements,” Wyden wrote.

Responding to TPM’s questions about these allegations, an HHS spokesperson said that Verma received a “limited authorization” from the Office of Government Ethics last spring that mandates her recusal from “personal and substantial participation on the Medicaid Section 1115(a) waivers for newly eligible adults in Indiana and Kentucky as well as the managed care waiver for Iowa.”

As to Wyden’s question, whether she has honored that recusal, the spokesperson said they are “in the process of reviewing his concerns.”

The ethics inquiry from Capitol Hill comes as Verma and her team at HHS move aggressively to grant states permission to impose work requirements and other restrictions on their Medicaid populations—the first time such measures have ever been allowed in the program’s history. The first state to win such approval was Kentucky, where state officials openly say they expect the new rules to remove nearly 100,000 people from the Medicaid rolls.

Kentucky submitted the waiver in the summer of 2016, when it had no chance of acceptance from the Obama administration, which maintained red lines on both work requirements and charging poor people premiums for their health insurance. Because Verma, as a health care consultant, was “an architect” of Kentucky’s waiver application, she formally recused herself from handling its approval once confirmed to run CMS.

Yet Kentucky Gov. Matt Bevin (R) said in a press conference last week announcing the waiver approval that Verma did contact him directly regarding the Medicaid waiver. “We received this information from Health and Human Services, specifically from CMS. The Administrator at CMS, Seema Verma, who is the one who oversees this for the US, is the one who contacted. That cabinet at the federal level is the one who contacted our cabinet at the state level. That’s the methodology.”

“Going back to her confirmation process I’ve been concerned about these conflicts of interest,” Wyden told TPM on Thursday. “I feel strongly about it.”

Read the full letter below: