TOPEKA — The Kansas House sought Monday to tighten oversight of the state’s privatized Medicaid program by pushing toward filling a long-empty position meant to provide scrutiny.
House Bill 2047 advanced on a voice vote with bipartisan support, bringing the measure a step closer to passing the House and moving to the Senate.
“It should have been with us all along,” Rep. Sydney Carlin, D-Manhattan, said of the inspector general job at the heart of the bill. “We need this position.”
Republican and Democratic lawmakers alike had been calling for an inspector general in recent months. The position isn’t new, but the last person who held it resigned in 2014 amid questions over past behavior.
Renewed conversations about the empty position cropped up after The Topeka Capital-Journal reported in January that a federal agency rejected Kansas’ request to extend KanCare authorization by a year, to the end of 2018.
The bill under consideration would transfer the inspector general role housed within the Kansas Department of Health and Environment to the Attorney General’s office in an effort to ensure independence.
“It’s imperative that we improve oversight,” said Susan Concannon, R-Beloit. “We need to move it away from the agency and have it independent.”
A positive step?
Concannon argued the bill will help the state address the concerns of the federal Centers for Medicare and Medicaid and assist in checking for any fraud or abuses related to KanCare at any level.
The inspector general position in its new form would have an annual salary equal to that of a district court judge. The attorney-general would appoint someone to the job, but the choice would be subject to Senate confirmation.
Duties carried out by the inspector general as described in the bill would include investigating fraud, waste and abuse, auditing state programs, and monitoring compliance with terms of contracts between state agencies and organizations that make claims payments.
The Centers for Medicare and Medicaid had reviewed Kansas’ program on-site in October and concluded the state is “substantively out of compliance” with U.S. law and regulations.
Two amendments to the bill proposed by Democrats both failed.
Rep. Cindy Holscher, D-Overland Park, sought to fold in a Senate bill that establishes an independent ombudsman position to replace the current one housed within the Kansas Department for Aging and Disability Services.
“Right now, the problem is the ombudsman is internal,” Holscher said. “These people who have appeals, they need an advocate, and right now, there’s not one in place for them.”
Concannon, who voted against that amendment, said she was concerned about its potential to undermine the bill as a whole by increasing expenses.
“We really needed to keep the bill clean in order to get it passed,” she said. “We’re just going to have to take baby steps in putting some of these oversight items in place.”
House Minority Leader Jim Ward, D-Wichita, urged lawmakers to give the Legislature oversight whenever the state wants to alter details of its state waivers from federal regulations. Ward said this could prevent changes to KanCare that ultimately harm health care access for people who need it.
“My amendment would have made the Legislature an equal partner in developing Medicaid policy,” Ward said.
Rep. J.R. Claeys, R-Salina, was among those who voted for the bill, but opposed Ward’s amendment.
“I think there are roles for the Legislature to have when it comes to oversight, but usually it’s after the fact,” Claeys said. “The pre-emptive stuff is something I generally don’t favor.”
Meanwhile, the House took final action to pass a bill allowing a pilot program on cultivation, processing and distribution of industrial hemp.
A collection of farm organizations have thrown their support behind the measure, spearheaded by Rep. Willie Dove, R-Bonner Springs. The proposed legislation would let universities with agricultural science degree programs take up hemp research.
The measure puts regulatory control — such as licensing matters — in the hands of the Kansas Department of Agriculture. Law enforcement agencies had expressed some concern about opening the door for industrial hemp cultivation in Kansas because of its similarity to marijuana varieties that contain more tetrahydrocannabinol and are used illegally.