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Medicaid Contractor Could be Fined $250,000 Per Day If It Misses June Target

TOPEKA, Kan. (AP) — The company processing Kansas Medicaid applications is days away from potentially facing millions in fines for inadequate performance that has frustrated state officials, health providers and patients for years.  Kansas officials told Maximus in January that it must improve by June 1 or pay retroactive penalties potentially exceeding $250,000 a day, the Wichita Eagle reported.  Maximus' contract calls for 98 percent accuracy on financial payments, but the contractor has been achieving 40 percent and falling behind on handling applications and cases.  Company officials expect to meet their June 1 performance target. But lawmakers and advocates are skeptical after years of missing or wrongly processed applications that cost providers money and patients time.  Application issues with the state's Medicaid program, KanCare, have sometimes caused nursing homes and other care facilities to not receive payments they're owed.  

Republican Representative Dan Hawkins, who chairs the legislative KanCare oversight committee, said he spoke with KanCare officials a few weeks ago.  "They said that although Maximus was doing a little better, they still weren't meeting the expectations of what they needed to," Hawkins said. "I know that they have been working on contingency plans if they don't meet those goals or those targets."   Democratic House Minority Leader Jim Ward said he hasn't heard anything suggesting Maximus has made significant improvements.  "I'm not expecting them to meet the mark," he said. "They had such a significant gap to close."  Maximus has "really made a good faith effort" to improve performance but will be fined if it falls short, said Jon Hamdorf, the state's Medicaid director.  "It's going to be a process," Hamdorf said. "We just want to make sure the individual folks in the program are not negatively affected."

 

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