Review of Medicaid School-Based Services in Kansas – Application of Bundled Rates

EXECUTIVE SUMMARY:

Our objective was to determine whether Kansas claimed costs for Medicaid school-based health services consistent with the design of the bundled payment rates and pursuant to Federal regulations and the State plan.  Kansas did not reimburse school districts consistent with the payment rates' design or pursuant to Federal regulations or the State plan.  Although Kansas designed the monthly payment rates to reimburse school districts for a full year's costs over 9 school months, Kansas used these rates to reimburse the school districts for 12 months.  We recommended that Kansas refund $13.9 million to the Federal government and ensure that future claims for Medicaid reimbursement for school-based services are submitted pursuant to Federal regulations and the State plan.  Kansas concurred.