Stronger Medicaid oversight debated

? As Gov. Kathleen Sebelius waits to become U.S. secretary of health and human services, some Kansas officials are debating whether state oversight of its Medicaid program is strong enough.

The debate focuses on the inspector general’s office, created in 2007 within the Kansas Health Policy Authority to ferret out potential problems in Medicaid. The first inspector general left in October and has told legislators the authority hindered her work.

Some legislators worry that the inspector general isn’t independent enough. The Senate Ways and Means Committee plans to vote Thursday on a bill to move the office to the Legislature’s auditing division.

The authority, which was founded in 2005, contends it has managed the inspector general’s office properly but has asked the attorney general for a review.

Joe Tilghman, the chairman of the authority’s board, has questioned whether moving the inspector general’s office will improve oversight.

Sebelius spokeswoman Beth Martino said: “If closer examination is warranted to ensure the Medicaid program is functioning as it should, the governor supports that effort.”

If Sebelius is confirmed by the U.S. Senate to become HHS secretary, she would oversee the Medicaid program nationwide.

The governor hasn’t been a central player in the debate over Kansas’ inspector general. She appoints three of nine voting members of the authority’s board, and four of her Cabinet secretaries are nonvoting members. The board hires the inspector general.

“That’s a substantial difference from HHS, which is a Cabinet agency, with appointment by the president,” said authority spokesman Peter Hancock.

The scrutiny came after a legislative audit described $13 million in “suspicious claims” paid by Medicaid in 2005 and 2006, before the authority took over the bulk of the program. In one case, auditors said, the program paid a doctor $941 for a Cesarean section when the patient was an 8-year-old boy.

“Somewhere along the way, it got mired and sidetracked,” said Senate Majority Leader Derek Schmidt, an Independence Republican. “We didn’t quite get some of the mechanics of the office right.”

The Health Policy Authority said the audit showed a relatively small amount of unusual Medicaid payments in the past and the issues aren’t systemwide.