Corporate Compliance

OIG: Kansas should refund $13.9 million

Healthcare Auditing Weekly, February 21, 2006

The OIG has recommended that Kansas refund $13.9 million to the federal government to repay noncompliant claims for school-based health services.

The OIG audited to determine whether Kansas followed state and federal regulations when it claimed costs for Medicaid school-based health services. Specifically, the OIG wanted to determine whether reimbursements were consistent with the design of bundled payment rates.

The OIG concluded that although Kansas designed the monthly payment rates to reimburse school districts for a full year's costs over nine school months, Kansas used these rates to reimburse the school districts for 12 months.

To conduct the audit, the OIG

  • reviewed applicable Medicaid regulations

  • interviewed officials and reviewed policies to determine how Kansas processed claims

  • analyzed the methodology that Kansas used to develop the payment rates

  • analyzed the data in the Medicaid Management Information System to determine the service months for which Kansas used the rates to reimburse school districts

  • identified the federal Medicaid reimbursement made to Kansas for fiscal years 1998 through 2003

      Click here to read the audit report, "Review of Medicaid School-Based Services in Kansas-Application of Bundled Rates," (A-07-04-0 1003) issued January 30, 2006.

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