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KDHE says seven-year school Medicaid recoupment stems from numerator error; Wichita district officials say lack of data access prevented earlier detection
Summary
KDHE and Wichita Public Schools told the Legislative Budget Committee that a seven‑year lookback recoupment of roughly $11.21 million resulted from an administrative-claiming numerator error tied to billed versus paid claims.
State and local officials told the Legislative Budget Committee on Aug. 15 that an administrative claiming error in school-based Medicaid cost settlements requires recoupment of previously paid amounts after a seven-year lookback.
Janet Stanek, secretary of the Kansas Department of Health and Environment (KDHE), and Deanna Beard, Medicaid coordinator for USD 259 (Wichita Public Schools), both described the same root cause: the numerator used in KDHE’s paid-claims calculation for school administrative claiming was based on billed claims rather than paid claims, which produced materially different ratios and led to an overpayment calculation over a seven-year period.
KDHE said the department’s fiscal intermediary, Gainwell, and its consultant PCG used incorrect numerator data during the calculation. KDHE described the…
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