Topeka ? Legislative efforts to get a grip on rising Medicaid costs moved forward Wednesday when the Senate Ways and Means Committee approved a bill creating a position that would identify fraud, abuse and waste in the health care program.

As approved by the committee, the inspector general would be appointed to a four-year term by the attorney general and work in that office. The appointment would be subject to Senate confirmation.

Last year, a special Medicaid committee recommended the inspector general be appointed by the governor and be part of the new Division of Health Policy and Finance.

“The attorney general is the person who’s going to have more oversight and interaction with the inspector general,” Chairman Dwayne Umbarger said. “Any charges would be made by the attorney general, not the governor.”

Senate Majority Leader Derek Schmidt said the inspector general bill will be debated in a week or two with other measures dealing with Medicaid fraud and abuse. He headed the Medicaid committee that came up with the suggested legislation.

“They’re all part of a package of recommendations. It makes no sense to have them straggle across the floor,” said Schmidt, R-Independence.

Legislators long have worried about the rising costs of Medicaid and the prospects of fraud and abuse. Schmidt said one estimate indicates the state loses about $110 million a year in Medicaid payments wrongfully made.

Medicaid spends about $1.7 billion, mainly on medical care and nursing facilities, up from $678.1 million a decade ago. Add in-home services for the physically and developmentally disabled and for children with severe emotional disorders, and total spending is $2.2 billion. The federal government provides 60 percent of the money and the state pays the rest.

The number of Medicaid recipients averages around 215,000 per month and is expected to be as many as 300,000 over the next year. The greatest increase in numbers are children, but the biggest costs are for the aged and disabled.

One bill awaiting Senate action allows the attorney general’s office to file a civil lawsuit to recover Medicaid money wrongfully paid. Now, only criminal charges can be brought in such cases. Schmidt said a civil case is cheaper and would allow Kansas to participate in multistate cases.

Another bill in the Senate Judiciary Committee permits the state to seize property, money and other assets of value from those convicted of Medicaid fraud.

The inspector general wouldn’t have any power to prosecute, but would refer its findings to the attorney general, who investigates and prosecutes complaints of Medicaid fraud or abuse.

Eric Rucker, chief of staff in the attorney general’s office, said having the inspector general in that office makes sense.

“It will make for a more streamline flow of information,” Rucker said.

Sen. Jim Barone, D-Frontenac, amended the bill to expand the inspector general’s investigative authority to state employee health insurance. But Umbarger said that may be removed by the Senate.

“At this point, I’m very skeptical it will stay on the bill,” said Umbarger, R-Thayer. “We need to get through a year or two to see how it’s working before expanding the authority of the inspector general.”

Umbarger said another bill his committee will consider would allow Medicaid recipients to pick what services they need, with the state paying for what’s used. Now, the state could wind up paying for service a recipient receives but never uses.

“We think in the long run it potentially could save the state money,” he said.