Audit points to Medicaid loss
Insurance Commissioner Vicki Schmidt discounts report
The Office of the Inspector General’s audit of a Medicaid subsidy for assisted living facilities says the program is costing the state millions of dollars every year, but the state’s insurance commissioner says the audit “should be discounted nearly in its entirety.”
The audit had the goal of determining if there are issues with the legislative language that allows facilities to claim the benefits of being a Continuing Care Retirement Communities, if there are procedures to monitor registrations and if the Kansas Department of Insurance had ample measures to stop fraud, waste and the loss of federal matching funds.
The Office of the Medicaid Inspector General found a lack of clarity and enforcement in the program that it said led to more than $94 million in uncollected state taxes between July 1, 2020, and Aug. 31, 2023. The most significant cost is from retirement communities that the MIG alleged were improperly assessed as Continuing Care Retirement Communities.
CCRCs are any nursing homes that have different tiers of service available for the range of people who would live in a retirement community — from independent seniors to people who need skilled nursing or memory care. Continuing Care Providers are registered with the KDOI after undergoing a Quality Care Assessment.
Qualifying providers must meet at least one of these parameters:
● Have fewer than 46 skilled nursing beds.
● Provides for a high number of Medicaid recipients, with at least 25,000 days of nursing care for Medicaid
“This list represents a sample of the many expansions and new builds that are helping the Topeka area grow one building, one campus and one company headquarter at a time,” Howey said.
Following are the top 10 building projects submitted for approval in 2023.
Auburn/Washburn Middle School
A new school is being built at 2800 S.W. Auburn Road. This was the most expensive building project of the year. The project will cost $47,361,994, according to city documents. The new school will serve as a second Washburn Middle School that is expected to be completed for the 2025-2026 school year.
Shawnee County Courthouse renovation
The county renovated the courthouse located at 200 S.E. 7th St. The overall project was estimated to cost $14.48 million but was closer to $10 million. The renovation was paid using federal COVID-19 relief money. After the renovation is completed, the building will be more eco-friendly, and the HVAC system will be replaced.
Stormont Vail Cancer Center addition and renovation
Stormont Vail spent $8,927,713 to expand its cancer center at 1414 S.W. 8th
Ave. The expansion was completed at the beginning of the year and is now fully operational.
Let’s Help relocation
Topeka-based charity Let’s Help found a new location at 245 S.W. MacVicar Ave. and spent $6.5 million to move locations in 2023. Let’s Help had to leave its 200 S. Kansas Ave. location because of a project to replace the PolkQuincy Viaduct in downtown Topeka.
Topeka Collegiate
Topeka Collegiate, 2200 S.W. Eveningside Drive, is spending $6 million to expand the building. According to the school’s website, the renovations will help improve safety. Regular updates on the construction can be found on the school’s website.
Evergy
Evergy spent $5.5 million to renovate the second floor of its building at 800 S. Kansas Ave.
Great Plains United Methodist Church
Department’s files reflect a CPA audit was provided with the renewal application, or within the extension granted by the Department to the applicant who sought additional time due to incongruity between annual renewal dates and the end of the provider’s fiscal year,” Schmidt said.
The audit also concludes that 24% of facilities are improperly given the reduced rate despite not meeting requirements for continuity of care. The MIG relied on financial statements, facility floor plans and provider websites to determine a facility has multiple types of care to determine whether a facility offered multiple levels of care. Schmidt said none of those methods are determinative of what a facility may offer.
Bill could implement audit’s suggestion
The Legislature is already considering implementing one recommendation to the report, which would transfer authority of registration of CCRCs from the Department of Insurance to the Kansas Department of Aging and Disability Services. The DOI agreed with that change
The Great Plains United Methodist Church spent about $4.9 million to build a new conference building located at 100 S. Kansas Ave.
Torgeson Electric Company HQ
Torgeson Electric is an employeeowned company that opened in Topeka. The company paid $4.5 million to construct a headquarters facility at 1400 N.W. Saline St.
Topeka Municipal Building
The city of Topeka spent $4 million to replace the HVAC in city hall, 215 S.E. 7th St.
Stormont Vail Cardiovascular Outpatient Center
Stormont Vail spent an additional $3,525,000 to renovate the Cardiovascular Outpatient Center, 1500 S.W. 10th Ave. The hospital received $100,000 from the Prairie Band Potawatomi Nation for the project, according to the hospital’s website. The expansion is to update with the latest advancements in cardiac care and to respond to a growing need in the region. when House Bill 2784 was in committee.
“The Department is not involved with quality care assessments performed through KDADS, with the Centers for Medicare and Medicaid Services, bed tax determination, nor any other aspect of CCRCs,” said Eric Turek, director of government and public affairs at the Kansas DOI. “It is more fitting for the registration and renewal authority to reside with KDADS, an agency that has substantial enforcement authority over these types of facilities.”
The bill sailed through both chambers with unanimous consent in the Senate and only one no vote in the House. But both chambers made minor amendments to the bill, so it’s now being put in a conference committee bill with a handful of other health care laws.
The Medicaid inspector general could be doing more of these types of audits in the future. Last week, the Senate approved a bill that would expand the scope of its auditing ability from just Medicaid to food and cash assistance programs in the state.
Senate Bill 488 passed in the Senate with a 22-8 vote but wasn’t heard in the House.