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Medicaid Inspector General Releases Eligibility Audit


 The Kansas Medicaid program may have overpaid more than $1.3 million to managed care organizations from 2019 to 2021, according to a performance audit of the Kansas Department of Health and Environment conducted by Medicaid Inspector General Steven Anderson.
 The performance audit reviewed eligibility determinations for Medicaid recipients that had moved out the state of Kansas but were still enrolled in the Kansas Medicaid program. The number and types of findings identified that the federal information source state Medicaid programs rely on to identify members that have moved to other states does not provide the information as quickly as states need it to avoid paying for members who have moved. The audit also identified some control weaknesses, policy issues, and gaps in guidance or protocols for coordinating the assessment and collection of any over payments related to out-of-state residency that Kansas needs to improve.
 The report concluded that KDHE, the agency responsible for administering the Medicaid program, has external factors and internal deficiencies that hinder KDHE’s ability to identify, verify, and terminate Medicaid eligibility on a timely basis.
 The reports are available for viewing here.

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