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After report, bipartisan calls for KanCare inspector general with greater powers

By Jonathan Shorman,

Republican and Democratic lawmakers are calling for a KanCare inspector general empowered to investigate the state’s Medicaid program.

The last inspector general resigned in 2014 amid questions over past behavior and the job was never again filled. But lawmakers are renewing calls for the oversight position, and potentially placing the individual in the attorney general’s office instead of under the Kansas Department of Health and Environment, which administers KanCare.

Talk of action comes after The Topeka Capital-Journal disclosed this week that the federal government had rejected a request from the administration to extend KanCare’s authorization by a year, from the end of 2017 to the end of 2018. Federal officials found numerous problems with the program.

Gov. Sam Brownback’s administration is downplaying the report – which found KanCare poses a risk to the health and safety of some participants – as a political attack on the governor.

An October on-site review of KanCare conducted by the Centers for Medicare and Medicaid Services found the program is “substantively out of compliance” with U.S. law and regulations. Kansas must formulate a corrective action plan by February 17, CMS officials say.

Both the House Health Committee chairman, Rep. Dan Hawkins, R-Wichita, and House and Senate Democratic leaders raised the possibility of reinvigorating the inspector general position. Hawkins has put forward a bill to locate the inspector general within the attorney general’s office.

A hearing on the legislation is scheduled for Monday.

“This should put an asterisk beside my bill to move the IG from KDHE to the A.G.’s office,” Hawkins said. “To me, this proves just how important it is because, you know, we’re here for just a short amount of time.”

The Legislature meets for about four months a year, he said, and the inspector general needs to be lawmakers’ “eyes and ears.” Hawkins wondered about whether the Legislature would have known of some of the problems if the inspector general position had been filled.

On Friday, House Minority Leader Jim Ward, D-Wichita, called for an inspector general as well as an ombudsman with greater powers. KanCare already has an ombudsman, but Ward doesn’t want the position located within KDHE.

“We should have an inspector general, a lawyer tasked to prosecute insurance companies if they’re not doing their job under the contract,” Ward said.

Senate Minority Leader Anthony Hensley, D-Topeka, also endorsed that approach.

“I think that is a necessary step in order for the Legislature to have some sort of oversight in this whole arena,” Hensley said.

Ward said the legislative KanCare Oversight Committee should meet more frequently and that Kansas should expand Medicaid, which would bring additional federal money into the state. He also said wants to move individuals with disabilities out of KanCare.

Lawmakers will have their first chance on Monday to question administration officials since disclosure of the letters. The Senate Public Health and Welfare Committee will hear from KDHE Secretary Susan Mosier on Monday, Sen. Vicki Schmidt, the committee chairwoman, has said.

Facing both Republican and Democratic lawmakers who feel furious about the report and a sense of whiplash after repeated statements that KanCare is working well, the Brownback administration has rushed to defend the program and minimize the findings of the federal officials.

In a Friday statement, Lt. Gov. Jeff Colyer, who spearheaded the creation of KanCare, urged Congress to look to states like Kansas as it works to repeal and replaced the Affordable Care Act. Kansas has implemented innovative solutions that have reduced costs and provided better services and health outcomes, he said.

“The success of KanCare has been outstanding and it should serve as a model program for states looking to modernize Medicaid,” Colyer said.


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