Phase II Findings: Error Rate Methodology Pilot
Executive Summary, I. Introduction, II. Methodology, III. Measuring Improper Payments in Nine States, IV. Findings and Next Steps, V. Recommendations, Appendices: Appendix A: Arkansas, Appendix B: Colorado, Appendix C: Illinois, Appendix D: Ohio, Appendix E: Record Review Worksheet, Appendix F: Data Entry Form, Appendix G: Telephone Discussion Guide, Appendix H: Arizona, Appendix I: California, Appendix J: Kansas, Appendix K: Nebraska, Appendix L: New Hampshire
Appendix J: Kansas
Kansas has a State-administered child care program. There are 105 counties with 6 regional offices and 39 county offices. The Kansas Association of Child Care Resource and Referral agencies has 16 members.
Improper Payment Process
Kansas does not define improper payments through statute, but through the Kansas Economic and Employment Support Manual, Section 11000, Incorrect Benefits. Definitions of errors are defined as follows:
Agency error is defined as:
Instances of agency error which may result in a claim include, but are not limited to, the following: The provider's time sheet was incorrectly keyed into Kansas Cares or the provider was otherwise assigned an incorrect payment; Payments continued to be made to a provider after the termination date or end date of the purchase of service agreement; Misapplication of policy.
Provider error is defined as:
Instances of provider error which may result in a claim include, but are not limited to, the following: Nonwillful withholding of information from a failure on the part of a provider to report a change which affects eligibility for payment and/or the amount of payment when: The worker has reason to believe that the provider did not understand responsibilities; and there was no oral or written misstatement by the provider, or Willful withholding of information such as: Misstatement (oral or written) made by the provider in response to oral or written questions from the agency; Consistent failure by the provider to report a change which affects eligibility and/or amount of payments; Failure by the provider to report the receipt of a payment which he knows, or should know, represents an incorrect issuance.
Fraud error is defined as:
A fraud error is a willful error which has been found to be fraud in accordance with the provisions in 11200. If the provider is found guilty of civil or criminal child care fraud by a court of appropriate jurisdiction, recoupment, which may include debt set-off, will be initiated by the local Fraud Unit.
No specific funding is available at this time for further development of the improper payments monitoring process and the State is looking to address improper payments with existing resources. Kansas identifies improper payments through a variety of methods, including:
- Notification or complaints from the public;
- Exception reports generated from automated systems;
- Review of attendance sheets in the field; and
- Audits based on department request, field staff review, or complaints.
The State has an audit division and quality assurance unit. The State did two child care quality assurance reviews during the past year. One focused on in-home care because it was believed to be more error prone than other types of care. The review did not support this belief. The second focused on field staff adhering to State policy and procedures in the area of social services child care. Results are in process at this time.
Automation
Kansas Cares is a mainframe system, transferred from Wyoming during the late 1980s or early 1990s. Kansas made extensive modifications and it has some sharing of information with the Temporary Assistance for Needy Families and Food Stamps system and the licensing system. Kansas Cares processes some of the eligibility determination automatically, but workers perform most of the eligibility calculations off-line and enter the results into the system. However, Kansas Cares computes rates to ensure accuracy. The system will pay the lesser rate between the provider maximum, State, and private pay rates.
Kansas is installing a new Electronic Benefits Transfer (EBT) system that will handle all aspects of billing. Given that the providers will no longer be sending in the attendance sheets, Kansas will establish a system of random audits of providers.
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