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Senator seeks stronger oversight
Published 1/7/2009 in News : Politics
By CHRIS GREEN
TOPEKA (HNS) -- A top Republican in the Kansas Senate wants a change in how the state protects against wasteful spending in a health care program that serves needy Kansans.
Senate Majority Leader Derek Schmidt, R-Independence, says he will push for legislation this session that would give lawmakers supervision over the watchdog post for the state's $2.4 billion Medicaid program.
The move would shift a Medicaid inspector general position away from the Kansas Health Policy Authority, the state agency primarily responsible for administering Medicaid, to the Kansas Legislative Division of Post Audit.
Under the proposal, the inspector general would retain its independence and authority but answer to the Legislature's chief auditor rather than the Health Policy Authority or its executive staff, Schmidt said.
Schmidt's request comes in the aftermath of a legislative audit last month that found $13 million in "suspicious" Medicaid claims being paid out by the state in fiscal year 2006. Lawmakers are scheduled to begin their 90-day session Monday.
Using data-mining techniques, legislative auditors identified more than $10 million in claims for more than 10,000 clients who appeared to exceed program income limits in last month's report. Another $700,000 went to clients whose social security numbers didn't seem valid.
Other findings showed $500,000 in suspicious claims filed by apparently deceased individuals and 519 clients who received prescriptions for controlled substances, such as heavy painkillers or stimulants, from five or more doctors in one year.
Kansas taxpayers are responsible for covering 40 percent of the health program while the federal government picks up the remaining 60 percent.
State Health Policy Authority officials said they were already working run a "tighter program" in a news release issued last month in response to the audit.
The agency also contended that much of the audit covered a period before the Health Policy Authority took oversight of Medicaid, that the facts didn't point to serious allegations of fraud.
It also attributed some problems found in the report to missing bits of information or data-entry errors, mistakes agency officials said they've already started to address.
"We were pleased that the LPA found no evidence to suggest any of them are them result of unethical or intentionally criminal behavior," Marcia Nielsen, the Health Policy Authority's executive director, said in a written statement at the time.
In an interview, Schmidt said he was disturbed that the agency's response to report seemed to find fault with the auditors' efforts.
He also said he was concerned that the Health Policy Authority had declined to fill its vacant inspector general position in November, citing budget constraints.
The Legislature had created the post in 2007 and Schmidt was a chief backer of the legislation establishing it. The first inspector general served about a year on the job before resigning, he said.
Schmidt said the situation pointed to the need for the inspector general position to be housed outside the Health Policy Authority, so it could be truly independent in trying to ferret out fraud, waste or inefficiency.
He said that eliminating or reducing erroneous or false payments in the state's Medicaid programs alone isn't going to significantly ease the growing crunch the program is putting on the state's budget.
But it's a good place to begin, Schmidt said.
"You should start with trying to stop payments that you know are not supposed to be paid," Schmidt said. "Surely, there's a consensus on that notion."
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