Lisa Stuever, LeadingAge Kansas Reimbursement Specialist, met with KDADS Medicaid Audit personnel to discuss the increase in Medicaid Cost Report Audits that have been reported by LeadingAge Kansas members. They indicated that the increase that members are seeing is due to the department being fully staffed for the first time in many years.
Members should not feel like they have done anything wrong that has flagged them for audit (something we all worry about with the IRS). Rather, it is just your turn. The audits are usually done as desk audits, with several years selected. While never a fun time, this is a good time to review your record-keeping policies and procedures. If you have a difficult time finding invoices and showing how they were recorded in your accounting system, you might need to make some changes.
The KDADS audit staff provided Lisa with a document detailing Guidelines for Assisted Living/Residential Care Cost Allocations in Nursing Facilities. A copy of this document can be found here. While this is by no means a new document, it is good to review and have on hand to make sure allocations have been done properly.
Once an audit is completed, members have an opportunity to appeal any findings they disagree with. After that, any remaining adjustments will be adjusted through the Fiscal Agent, with payment adjustments through the MCOs. KDADS staff indicated that if these adjustments are large the payback can be negotiated through the KDADS financial commission.
If you have further questions about this process or need information about best practices, contact Lisa Stuever.
