Investigation of Medicare Chief Exposes Underside of Washington

One of the consultants, Marcus Barlow, had served as Ms. Verma’s spokesman when she ran a consulting firm in Indiana. But the White House, objecting to Mr. Barlow’s disparaging statements about Mr. Trump during his election campaign, reportedly blocked him from the C.M.S. communications director post, the investigation found. So Ms. Verma hired Mr. Barlow on a contract that paid him for full-time work at a rate more than double the $179,700 annual salary he would have been paid as a federal employee.

Working under three different contracts, Mr. Barlow earned more than $209 an hour for one, $225 an hour for another and $230 for yet another. Of the nearly $6 million in total consulting fees, more than $5 million went to the communications and public relations firm Porter Novelli. Pam Stevens, a freelance public relations consultant, earned more than $115,000 in nine months. Deloitte Consulting received nearly $689,000 for “strategic communications.”

The larger issue than the cost, critics inside and outside the government say, was the broad access that Ms. Verma granted to the private consultants, one of whom, Brett O’Donnell, “was awaiting sentencing for a felony conviction during the entirety of the time he consulted for C.M.S.” for lying to the Office of Congressional Ethics during an investigation into the misuse of taxpayer funds, the report said.

Ms. Stevens, who helped plan the Republican National Convention in 2016 and 2020, billed the government for arranging meetings for Ms. Verma with journalists and influencers, including at parties in journalists’ homes in Washington. She brokered interviews by AARP The Magazine and on The Christian Broadcasting Network, pressed for spreads in Washingtonian, Capitol File and Good Housekeeping, and tried unsuccessfully to persuade Glamour to name Ms. Verma a Woman of the Year. Ms. Stevens was paid nearly $300 an hour plus expenses. At one point she tried, also unsuccessfully, to be reimbursed for the $131 she spent on a floral arrangement she sent to Fox News.

Among the expenditures detailed in the report is nearly $3,000 billed to C.M.S. by Ms. Stevens for organizing a “girls’ night” party for Ms. Verma at the home of Susan Page, the Washington bureau chief for USA Today. Ms. Page was tapped last month to moderate the debate in October between Vice President Mike Pence and Senator Kamala Harris of California, the Democratic vice-presidential nominee.