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Medicaid Inspector General Issues New Report

TOPEKA – (June 5, 2020) – Kansas Medicaid Inspector General Sarah Fertig today released a new report containing findings from a review of the Kansas Medicaid system’s list of active personal care attendants and whether the current system is properly excluding individuals who are barred by federal law from providing those services to Medicaid beneficiaries.

The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) has identified personal care services as a high-risk area for fraud, waste, abuse and illegal acts involving the Medicaid program. The review report cites lack of direct supervision in a person’s home, lack of uniform standards for personal care attendant qualifications and no requirement by Centers for Medicare and Medicaid Services (CMS) for states to enroll personal care attendants as providers as reasons for the high risk.

The report examines whether it is possible for any of the current 581 Kansas individuals and businesses listed on the HHS OIG exclusion list to provide personal care services to a Kansas Medicaid beneficiary despite the state and federal law and policies in place to prevent such an occurrence. The review found four HHS OIG-excluded individuals listed as “active” on the state’s AuthentiCare electronic verification system, and contains three recommendations for the Kansas Department of Aging and Disability Services (KDADS) to resolve the issues identified.

The report was submitted to Kansas Attorney General Derek Schmidt, Secretary of Health and Environment Lee Norman, KDADS Secretary 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 www.ag.ks.gov/medicaid-ig.

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