Recommendation: We recommend the State train all staff members to properly verify providers are meeting the prescribed health and safety standards before making payments to those providers. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken...
Recommendation: We recommend the State train all staff members to properly verify providers are meeting the prescribed health and safety standards before making payments to those providers. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The KDHE Bureau of Facilities and Licensing respectfully submits the following corrective action plan, as it relates to planning, staffing, and CMS-MPD requirements. KDHE acknowledges the auditor?s recommendation to train staff of the need to verify providers are meeting H&S standards, prior to our permitting payments to those providers. Training will be incorporated into the following correction action plan, accompanied by additional steps we believe should be explored to further move our agency toward compliance. The KDHE-DHCF Audit Team will meet with appropriate State stakeholders to examine potential Medicaid program modifications that would assist our agency in establishing compliance with federal law. Teams to be engaged are 1) Bureau of Facilities/Licensing, 2) Policy, 3) KMMS, 4) KDADS, 5) Program Integrity, and 6) Quality. The intent of this conference is to investigate methods to ensure payments are not made to providers whose health and safety certifications are outdated, based on the annual CMS Mission and Priority Document (CMS MPD). A tentative meeting agenda is as follows: a. Educate staff on the cause of Finding 2022-002; b. Review federal regulations substantiating the need for policy/procedural changes; c. Brainstorm methods to become compliant with federal law; d. Research State law to identify any potential conflicts; e. Discuss drafting a new Medicaid policy requiring KDHE to have a current provider certification on file, prior to releasing payment to that provider; f. Examine the BOFL provider database and its potential to 1) notify surveyors of certifications nearing their expiration date and 2) interface with KMMS; g. Identify KMMS system changes needed to prevent payment to providers with outdated certifications, e.g., a system edit; h. Draft KMMS change order; i. Educate MCOs and providers (facilities); j. Assign follow-up duties among stakeholders Name(s) of the contact person(s) responsible for corrective action: Donna Wills Planned completion date for corrective action plan: Dates will vary dependent on our progress with tasks a-j, above. The initial planning meeting will be held no later than May 1, 2023.