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New Report Estimates $1.3 Million Overpaid by Kansas Medicaid


By Sam Bailey, Kansas Reflector


TOPEKA, Kan. — A new Medicaid report finds more than $1.3 million may have been overpaid to managed care organizations due to slow information provision, causing Kansas Medicaid programs to pay members after they left the state.

The attorney general’s office issued a news release Wednesday announcing the findings. The performance audit of the Kansas Department of Health and Environment was done by Medicaid inspector general Steven Anderson and covered Jan. 1, 2019 to Dec. 31, 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 in the news release. “Kansas taxpayers deserve to know that our Medicaid resources are being used efficiently.”

Currently, states contribute information on individuals enrolled in Medicaid to the Public Assistance Reporting Information System program. A report is then compiled quarterly to notify states whether an individual is enrolled in Medicaid and receiving benefits in another state.

KDHE would like to have the reports from the federal government on a monthly basis to aid in faster decisions, as “quarterly’s not very efficient,” Anderson said.

The report said while the department’s system has improved since 2019, “internal and external deficiencies that hinder KDHE’s ability to identify, verify and terminate Medicaid eligibility on a timely basis” still exist.

“For example,” it read. “A group of beneficiaries that were identified as moving out of Kansas were not properly processed, resulting in an estimated overpayment of $1,370,376.68 in capitation payment to MCOs.”

The news release also said the audit reported “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.”

KDHE secretary Janet Stanek said in the news release that she and Gov. Laura Kelly appreciate the partnership with the attorney general’s office to increase the efficiency of Medicaid.

“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,” Stanek said.