Audit claims Kansas taxpayers could save $22.5 million from one change in Medicaid

A recent audit claims the state of Kansas could save $22.5 million for taxpayers by changing how schools are reimbursed for school-based health care.

Kansas Medicaid Inspector General Steven D. Anderson told Newstalk KZRG:

“The state of Kansas is directly reimbursing schools for healthcare services provided to Medicaid beneficiaries, when that should be the responsibility of the MCOs,” Anderson said. “Kansans expect Medicaid services to be provided in the most cost-effective way, and the report’s recommendations would be a step in that direction.”

MCOs receive monthly payments from Medicaid for beneficiaries. Meanwhile, schools are receiving fee-for-service payments from the state to provide services to some of those beneficiaries in schools. The monthly payments to MCOs could be used to pay for those services. The state Medicaid program would also save money by ending the processing of fee-for-service payments by the Kansas Department of Health and Environment and contracted staff.

The audit also noted that one school used an invalid National Provider Identifier (NPI) on its claims in the Referring Provider field. The NPI was issued to a former director of business with no medical affiliation and was improperly used on claims for 77% of all beneficiaries. The school was paid a total of $390,542.98 for claims that contained the invalid NPI.

Additionally, the audit revealed that school Medicaid service providers are not subject to routine backgrounds. Of the 231 providers audited, only 72, or 31%, had proof of completed background checks at the time of the Inspector General’s request for records.

The report, online here, included 12 findings and 47 recommendations to improve the oversight and management of reimbursements to schools that provide medically necessary services to students, and if implemented, could save the state of Kansas millions each year.