Medicaid:

Federal Oversight of Kansas Facility for the Retarded Inadequate

HRD-89-85: Published: Sep 29, 1989. Publicly Released: Sep 29, 1989.

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Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) termination and subsequent reinstatement of the Winfield State Hospital and Training Center, Kansas, in the Medicaid program, focusing on whether it: (1) improperly reinstated the facility; (2) obtained state certification for the facility prior to reinstatement; (3) satisfied Medicaid requirements for reinstatement; (4) improperly allowed federal funding to continue following the facility's termination; and (5) made a political deal with Kansas to ensure the facility's reinstatement.

GAO found that HCFA: (1) improperly reinstated the facility when deficiencies still existed; (2) did not obtain state certification or a new provider agreement prior to reinstatement; (3) failed to obtain adequate assurance that the deficiencies would not recur and exceeded its discretionary authority in authorizing reinstatement without such assurance; (4) improperly allowed federal funding to continue following termination; and (5) did not arrange a political deal with Kansas to reinstate the facility.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: Final regulations went into effect on April 1, 1992.

    Recommendation: The Secretary of Health and Human Services should issue regulations implementing the department's authority to inspect Medicaid facilities and terminate provider agreements.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Implemented

    Comments: Final regulations went into effect on April 1, 1992.

    Recommendation: The Secretary of Health and Human Services should strengthen internal controls for the approval of federal Medicaid payments.

    Agency Affected: Department of Health and Human Services

 

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