Kansas has agreed to repay another $18.5 million to the U.S. government after auditors found the state misspent money from the federal Medicaid program.
That makes $32.6 million the state has agreed to pay back this year. And the refund tally could grow, given that $135 million in federal aid has been under review.
Kansas earlier agreed to refund $14.1 million to compensate for incorrect billings detected by a series of audits by the Department of Health and Human Services Office of Inspector General.
The latest round of agreed paybacks will be made public today in a report released by the inspector general's office.
"It's a new figure independent from findings of previous reports," Laura Bradbard, a spokeswoman for the office, said Thursday.
Bradbard and auditors in the office declined further comment, saying it was too early to talk about the report. The state will have 30 days to file a formal reply.
Judy Holtz, another federal spokeswoman, said the audits of Medicaid spending in Kansas were similar to others taking place across the nation.
"There's a bunch of these in a variety of states, " she said.
Kansas officials most directly involved with the Medicaid audits were unavailable for comment Thursday.
But Luke Thompson, legislative liaison for the Kansas Health Policy Authority, confirmed the state has agreed it will reimburse the federal government for the new sum spelled out by the inspector general's office.
The authority will assume responsibility for the state's Medicaid program next week.
The recently empowered authority also will oversee HealthWave, the state's health insurance program for children in low-income families, and the health insurance program that covers state employees.
Federal auditors uncovered a bevy of problems with the way Kansas was distributing Medicaid money to public schools for health services.
An audit report released in February examined how Kansas billed Medicaid to pay for services for children with special needs. Investigators said a sample of 300 Medicaid claims from three school districts - Wichita, Kansas City and the Central Kansas Cooperative - in 2002 turned up 217 claims that shouldn't have been paid:
¢ Seventy-six claims lacked a required doctor's order for occupation and speech-language therapy services.
¢ One hundred thirty-nine claims lacked evidence that services had ever been rendered.
¢ Two claims lacked a required doctor's order for physical therapy.
Another audit showed the state was using Medicaid dollars to fund 12 months of services per year instead of the allowed nine months.
"We didn't pay for services that weren't provided. These were services that were received for 12 months," said Gavin Young, a spokesman at the state Division of Health Policy and Finance. "But the regulations say we can only pay for nine months' worth."
How that payback or the shift to a correct nine-month billing schedule will affect children receiving services - physical, occupational and speech therapies, mostly - remains to be seen.
Most of the audits examined payments made in fiscal years 1998 through 2003.
According to the audit report to be released today, "Kansas did not have adequate internal controls to ensure that it correctly developed the payment rate" for services.