Office of the Medicaid Inspector General

The Office of Medicaid Inspector General (OMIG) was transferred to the Attorney General’s Office in June 2017. The duties of the OMIG are to establish a full-time program of audit, investigation and performance review to provide increased accountability, integrity and oversight of the Kansas Medicaid program (KanCare), the MediKan program, and the State Children’s Health Insurance Program (SCHIP), and to assist in improving state agency and program operations and help deter and identify fraud, waste, abuse, and illegal acts related to those programs.1


1. K.S.A. 75-7427(b)(1)

News Highlights

Medicaid Inspector audit identifies more than $16 million in program waste

Dec 12, 2023, 12:35 PM by Danedri Herbert
TOPEKA – (December 11, 2023) – Kansas Medicaid Inspector General Steven D. Anderson released an audit that revealed more than $16 million in overpayments to Medicaid program providers.

" Medicaid funds should be used by the people who really need them, and eliminating waste ensures our most vulnerable receive the care they need and that taxpayers have confidence that their dollars are spent wisely," Kobach said.

The report notes continued issues in the financial oversight of the Kansas Medicaid program. The audit concluded that the Kansas Department of Health and Environment (KDHE), the agency responsible for administering the Medicaid program, has control weakness placing Medicaid monies at risk. The report identified significant compliance and control gaps within the Transitional Medicaid Program, or TransMed.  Medicaid beneficiaries are limited to only 12 months of continuous TransMed coverage, but the audit identified 9,322 beneficiaries who were enrolled in TransMed during the audit period that had 13 months or more of continuous TransMed coverage. The performance audit focused on 2,322 beneficiaries who had unallowed coverage prior to the COVID-19 Public Health Emergency. The report identified $16,326,364.59 in payments wasted on ineligible persons as of June 2022. 

The audit also noted that a lack of consumer education about the TransMed program presents a barrier its beneficiaries who are working towards transitioning to better employment and higher wages, but fear losing Medicaid coverage. Lack of ease of use was identified on the KanCare website when an attempt was made to locate information on the TransMed program. A prior report issued by the Office of Medicaid Inspector General (OMIG) yielded similar findings and recommendations. 

“Our report included several findings and recommendations intended to improve the effectiveness and efficiency of KDHE’s administration of the TransMed Program.” Anderson said. “I am pleased to note that KDHE leadership acknowledged and agreed with the majority of the findings and recommendations and are taking steps to implement the changes.”

The Office of the Medicaid Inspector General is required by state statute to solicit and receive reports of fraud, waste, abuse and illegal acts in such programs.

The report was submitted to Kansas Attorney General Kris W. Kobach, Secretary of Health and Environment Janet Stanek, and the members of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight.

The report is available at here.

To report suspected fraud, waste, abuse, or illegal acts involving the Medicaid, MediKan, or the State Children’s Health Insurance Program, citizens may use the online form at https://ag.ks.gov/medicaid-ig or call (785)296-5050. 
 
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Reporting

To report suspected fraud, waste, abuse, or illegal acts involving the Medicaid, MediKan, or SCHIP programs, please click here to use our online contact form or call 785-296-8637. You may also send information by mail to the address at the bottom of the page.

Citizens may report to the OMIG concerns about suspected fraud, waste, abuse, or illegal acts involving KanCare, MediKan, or SCHIP. All complaints received by the OMIG concerning those programs are reviewed by OMIG staff and may become part of an audit or investigation.

The identity of any person submitting a report concerning fraud, waste, abuse, or illegal acts involving the KanCare, MediKan, or SCHIP programs shall remain confidential unless that person consents in writing to the disclosure of their identity. All information received by the OMIG about suspected fraud, waste, abuse, or illegal acts shall not be made public unless:

  • Release of the information would not result in the identification of the person who provided the information;
  • the person or persons who provided the information to be disclosed consent in writing prior to its disclosure;
  • the disclosure is necessary to protect the public health; or
  • the information to be disclosed is required in an administrative proceeding or court proceeding and appropriate provision has been made to allow disclosure of the information without disclosing to the public the identity of the person or persons who reported such information to the Inspector General.1

1. K.S.A. 75-7427(k)(1)

Annual Reports

Audit Reports

Audit ReportsIssued OnTypeSize
24-03
This report contains findings and recommendations from our performance audit of the processing of Continuing Care Retirement Communities (CCRC) and Continuing Care Provider (CCP) applications. The au...
April 02, 2024PDF1.92 MB
24-02
This report contains observations and findings from our performance audit of the Kansas Department of Health and Environment’s (KDHE) management of the Transitional Medical Program (TransMed) for the...
December 08, 2023PDF927.53 KB
24-01
This report contains findings from our performance audit of the Kansas Department of Health and Environment’s (KDHE) process for beneficiaries with multiple Medicaid ID numbers. This audit was comple...
November 29, 2023PDF663.40 KB
Interim Report
This is the Interim Report concerning School Reimbursements and Background Investigations.
October 31, 2023PDF5.03 MB
23-01
This report contains findings from our performance audit of the Kansas Department of Health and Environment’s (KDHE) process for discontinuing Medicaid eligibility when a beneficiary is no longer a r...
June 21, 2023PDF2.05 MB

The OMIG is not authorized to act as a private attorney or investigator and cannot directly assist in resolving individual complaints about the programs within the OMIG’s jurisdiction.

Contact

Office of the Medicaid Inspector General
120 SW 10th Ave., 2nd Floor
Topeka, KS 66612-1597
(785) 296-5050

Fraud & Abuse

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