Medicaid Inspector General Issues Report on HCBS Waiver Program

Topeka, Kan. — Kansas Medicaid Inspector General Steven D. Anderson today released a report examining the Kansas Medicaid program, concluding that the agency responsible for administering the home and community based services (HCBS) program lacks an effective system for tracking the redetermination of beneficiaries in the HCBS program.
The audit looked at the HCBS program administered by the Kansas Department of Health and Environment (KDHE) and Kansas Department for Aging and Disability Services (KDADS) for a period of 40 months from January 1, 2018 through April 30, 2021.The number and types of findings identified during the audit indicate control weaknesses, which could place Kansas waivers at risk.
In addition, the audit found that 2,854 individuals identified as being enrolled in an HCBS waiver, but who did not have any HCBS claims filed on their behalf for a total of 12 months or more during the audit period. The amount of payments made to managed care organizations contracted to provide services to these beneficiaries totaled more than $193 million.
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 report was submitted to Kansas Attorney General Derek Schmidt, Secretary of Health and Environment Janet Stanek, KDHE Medicaid Director Sarah Fertig, Secretary of Kansas Department for Aging and Disability Services Laura Howard and the members of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.
The report is 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.