The state of Kansas could save approximately $22.5 million each year, a performance audit conducted by Kansas Medicaid Inspector General Steven D. Anderson recently revealed. According to the report, a change to how schools are reimbursed through Medicaid for school-based healthcare services could save the state millions each year. The audit revealed that having Managed Care Organizations (MCOs) reimburse schools for healthcare services rather than the state of Kansas reimbursing schools for Medicaid services would net significant taxpayer savings.
“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.
The report was submitted to Kansas Attorney General Kris W. Kobach, Secretary of the Kansas Department of Health and Environment Janet Stanek, Commissioner of the Kansas State Department of Education Dr. Randy Watson, and the members of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.
Original source can be found here.