Medicaid Fraud in Kansas? Inspector General Reveals Dozens of Misconduct Emails Were Ignored
More than 200 emails sent to an unstaffed office at the Kansas Department of Health and Environment were ignored.
By Tim Carpenter
The state's new Medicaid inspector general revealed Monday an audit showing nobody in Kansas government read nearly 100 emails alleging fraud, waste, abuse in state-administered health programs from August 2017 to January, and that at least 42 were subsequently found to have merit.
Sarah Fertig, inspector general in the office of Attorney General Derek Schmidt, said more than 200 emails sent to an unstaffed office at the Kansas Department of Health and Environment were ignored. Among emails received during that 18-month period, Fertig said, 95 alleged or sought information on reporting misconduct involving Medicaid, MediKan and SCHIP programs.
Forty-two of the 95 emails contained information substantiated in whole or part once evaluated by the state, Fertig said.
"The majority of the unread complaints concerned family medical eligibility," Fertig said in the report. "A typical complaint alleged that a beneficiary was lying to the state about his or her income, residency or household composition in order to fraudulently gain or maintain state medical assistance."
Kansas established an office of inspector general in 2007, but there has been turbulence in the office's monitoring of health programs touching more than 400,000 Kansans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.
From 2014 to 2018, Republican Gov. Sam Brownback didn't assign staff to the office inspector general within KDHE.
In 2017, the frustrated Kansas Legislature voted to transfer responsibilities to the attorney general. Fertig wasn't confirmed as inspector general until January. Kansas Senate affirmation of her appointment by the attorney general prompted the benchmark audit to determine status of health fraud investigations in Kansas.
The audit said a KDHE administrative staff member monitored the agency's inspector general email account until departing the department in August 2017. The email address offered to Kansans who felt the need to report allegations of fraud remained active at KDHE following that employee's departure, but the emails were not monitored.
"We are reviewing internal processes to ensure recommendations related to the inactive email account identified are completed as quickly as possible," said Kristi Pankratz, spokeswoman at KDHE. "In addition, KDHE staff is reviewing each of the 42 complaints submitted to the inactive email account and ensuring they undergo a complete and thorough review."
It's not clear why the attorney general's office didn't take an active role in gathering public complaints after accepting the new role from KDHE in June 2017.
The audit report was forwarded to Schmidt, KDHE Secretary Lee Norman as well as Laura Howard, secretary of the Kansas Department for Children and Families. Information contained in the audit was sent to members of the Legislature's joint oversight committee.
Sen. Gene Suellentrop, a Wichita Republican and chairman of the House-Senate oversight panel, said the committee would discuss the audit during upcoming meetings Aug. 26 and 27 in Topeka.
"This will certainly be a significant topic on the agenda. There needs to be substantial improvement," he said.
Rep. John Carmichael, a Wichita Democrat on the House-Senate oversight panel, said he was surprised by scope of neglect, but not that complaints fell through cracks of the $3 billion Medicaid program managed by insurance companies.
"It is a classic example of nobody attending to the store," he said. "The magnitude of the neglect comes as a surprise."
Wichita Rep. Jim Ward, also a Democrat, said the key question for the attorney general would be: "Tell me what you're going to do to fix it."
Kansas originally established an office of inspector general within the Kansas Health Policy Authority. KHPA was abolished in 2011 and the inspector's job position was passed to KDHE. In 2014, Brownback nominated former state Rep. Phil Hermanson, a Wichita Republican, to be KDHE's inspector general for Medicaid.
Hermanson began drawing a KDHE paycheck despite questions about his background and qualifications. He resigned under pressure from that post at KDHE, and Brownback never filled the position. By the time Colyer took office as governor in 2018, the job had been formally passed to the attorney general's office.
(c)2019 The Topeka Capital-Journal, Kan.