Topeka, KS (STL.News) Kansas Medicaid Inspector General Steven D. Anderson recently released three reports examining the Kansas Medicaid program related to fraud and efficiencies and making recommendations for improving the system.
The reports are:
- A review focused on explaining the difficulties that Kansans and other concerned people experience when trying to make a report of eligibility fraud and suggested recommendations for improving access to the proper points of contact.
- A review of the MediKan program that identified 912 MediKan beneficiaries who between January 1, 2018, to April 30, 2021, had exceeded the 12-month lifetime eligibility limit, resulting in state funds being used to pay medical claims for ineligible persons in the amount of $1,665,815.43.
- A review of capitation payments to Managed Care Organizations (MCOs) for deceased beneficiaries found that between February 2015 and September 2020 $1,313,175.55 in monthly capitation payments were made for the 25 beneficiaries whose dates of death preceded the payment dates and recoupment had not occurred.
- The Office of Medicaid Inspector General (OMIG) is required by K.S.A. 75-7427(k)(1) to make provision to solicit and receive reports of fraud, waste, abuse and illegal acts in such programs from any person or persons who shall possess such information.
The reports were submitted to Kansas Attorney General Derek Schmidt, Secretary of Health and Environment Lee Norman, KDHE Medicaid Director Sarah Fertig and the members of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.
The reports are available at https://ag.ks.gov/medicaid-ig.
To report suspected fraud, waste, abuse, or illegal acts involving the Medicaid, MediKan, or the State Children’s Health Insurance Program, citizens may use the online form at https://ag.ks.gov/medicaid-ig or call 785-296-8637.