21 June 2023
TOPEKA (KSNT) – A top Kansas official says the Kansas Medicaid program may have overpaid more than $1.3 million to managed care organizations for three years.
According to a press release sent out from the Kansas Attorney General’s Office, a performance audit of the Kansas Department of Health and Environment (KDHE) completed by the Medicaid Inspector General Steven Anderson found the possible overpayment that occurred between 2019 and 2021.
“It’s clear from our audit that the federal government and the state can do more to recapture these overpayments by quickly identifying and verifying Medicaid beneficiaries who move out of state, and then by removing them from the program,” Anderson said. “Kansas taxpayers deserve to know that our Medicaid resources are being used efficiently.”
The AG’s office said the audit reviewed eligibility determinations for Medicaid recipients that had moved out of Kansas but were still enrolled in the Kansas Medicaid program. The audit covered a period of time starting on Jan. 1, 2019 and running through to Dec. 31, 2021.
The audit found that speed was an issue as information on people who have moved to new states was not received as quickly as claimed, according to the AG’s office. The audit also found some control weaknesses, policy issues and gaps in guidance or protocols for coordinating the assessment and collection of any overpayments related to out-of-state residency that Kansas needs to improve.
“Governor Kelly and I appreciate the ongoing partnership with the Attorney General’s Office to further our mutual goal of making the Medicaid program more efficient,” KDHE Secretary Janet Stanek said. “We agree that with the limited state and federal information sources available to the Medicaid program, challenges remain in the timely determination of whether or not a Medicaid beneficiary has moved out of state is very difficult with the information sources available to us. We would welcome the opportunity to gain more tools to help in that work but will continue to adjust protocols and policies within our control related to overpayments.”
The report ended with the conclusion that the KDHE has external factors and internal deficiencies that hinder the agency’s ability to identify, verify and terminate Medicaid eligibility on a timely basis, according to the AG’s office.
You can read through the full report from the Kansas Medicaid Inspector General on this recent audit by looking through the document below:
Eligibility Audit Report June 2023 by Matthew Self on Scribd