Legislators struggle with Medicaid oversight

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Posted: Friday, March 13, 2009 1:06 am

TOPEKA (AP) — A Senate committee wants to give the inspector general for the Medicaid program a new home to improve oversight of the program, but members couldn’t agree Thursday on where it should be.

The Ways and Means Committee tabled a bill moving the inspector general’s office from the Kansas Health Policy Authority to the Legislature’s auditing division.

The authority administers most of the $2.4 billion Medicaid program, which covers health care for the needy and is financed jointly by states and the federal government. The state created the inspector general’s office in 2007 to ferret out fraud and other potential problems within Medicaid and other medical programs.

The first inspector general, Robin Kempf, left the job in October 2008 after 13 months and has told the committee that the authority hindered her work. The authority disputes that but has asked the attorney general’s office to review its management of the office.

The committee also considered proposals to move the inspector general to the attorney general’s office and the Department of Administration before voting 6-5 to postpone a vote until Monday.

“I don’t have enough information in my brain,” said Sen. David Wysong, a Mission Hills Republican who sought the delay.

The debate about the inspector general’s future comes as Gov. Kathleen Sebelius awaits confirmation as U.S. secretary of health and human services, the official who oversees Medicaid for the federal government. But the Health Policy Authority isn’t under Sebelius’ direct control, and its board appoints the inspector general.

Committee members said they want to make sure the inspector general is independent and remains apolitical.

The bill would have the inspector general appointed by the 10-member committee that directs the work of the Legislature’s auditing division. The division has a reputation for avoiding politics, but critics of the bill noted that the division still reports to legislators.

Another option, suggested by Sen. Jean Schodorf, a Wichita Republican, was to have the governor appoint the inspector general but put the office under the attorney general.

But Sen. Vicki Schmidt, a Topeka Republican and a pharmacist, objected. She said not only is attorney general a political office, but locating the inspector general there will suggest any review of a Medicaid issue is a criminal investigation of health care providers.

Schmidt suggested having the governor appoint the inspector general and housing the office within the Department of Administration. Critics said her plan would still make the inspector general vulnerable to political influence.

The Health Policy Authority is watching the debate with some detachment. Executive Director Marcia Nielsen said the authority believes there’s value in keeping the inspector general where it is, to develop expertise on health care.

But, she added, “We would not fall on our sword over it.”

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