Topeka ? Disputes with federal officials could cost Kansas $50 million to $75 million annually in federal Medicaid funds, Gov. Kathleen Sebelius said Friday.

Sebelius said the federal Centers for Medicare and Medicaid Studies is questioning some of Kansas’ policies on reimbursing doctors and hospitals who care for poor and disabled Kansans covered by Medicaid. States pay 40 percent of Medicaid costs and the federal government covers 60 percent.

One issue involves the Kansas University Medical Center hospital, which receives higher state reimbursements than other hospitals rates because it sees more indigent patients than other hospitals, and how Medicaid dollars flow through the institution.

Also at issue is the state’s compliance with federal rules on mental health services for children in foster care.

Sebelius said the Centers for Medicare and Medicaid Studies raised questions last year, holding up some Medicaid dollars. The federal agency has not made final decisions, and Sebelius wrote to federal Health and Human Services Secretary Tommy Thompson this week expressing concern.

“Some of this is very technical and a little bit difficult to explain,” Sebelius said at her weekly news conference.

She added: “Basically, there is a war between the centers for Medicaid services and states around the country. Practices, policies, procedures that have been long recognized, long in place, never questioned, are coming under question on all fronts.”