The state’s Medicaid inspector general has launched an audit to determine whether Kansas is insuring women claiming to be pregnant who aren’t eligible for Medicaid benefits.
Steve Anderson notified lawmakers of the audit this week when he appeared before the joint legislative committee that oversee the state’s Medicaid program.
“We know from some prior investigations…we’ve had people that claimed to be pregnant when, in fact, they were not,” he said.
He said the goal of faking a pregnancy was to not only get Medicaid benefits but also to qualify for federal food-assistance benefits as well.
He said it’s easy to qualify for those benefits because the state accepts self-attestation of pregnancy for Medicaid eligibility.
“If you say you’re pregnant, you’re pregnant. It that’s hard,” he told lawmakers.
“They basically take your word for it,” he said.
He said the Centers for Medicare and Medicaid Services has approved the state’s ability to accept self-attestation for accepting a pregnant woman into the program.
Anderson told lawmakers that there were an “awful lot” of women who were 46 and older – some as old as 60 – who were claiming to be pregnant but had not filed any associated medical claims for care.
“If you’re 60 years old and you’re pregnant, you’re going to go see a doctor, I’m guessing,” Anderson said.
“My wife’s 61 and she assures me if that if she was pregnant at 61 she would be going to see a doctor,” he said.
Democratic state Rep. Barbara Ballard of Lawrence asked Anderson if a woman needs proof to qualify for the program and the benefits.
“They can question it, if they have good reason,” Anderson said of the state’s Medicaid administrators.
“That’s one of the things that we’re looking at is to see if they ever do question these geriatric pregnancies.
“From what we have seen so far, there is no questioning of somebody who might be dubious,” he said.
He said one investigation found an instance of a 42-year-old woman who claimed to be pregnant, but Medicaid had paid for a sterilization four years earlier.
“If the eligibility worker had looked back in her file even a little bit, they would have seen she would have had a tubal,” he said.
Among other things, Anderson wants to learn whether women enrolled in the program have pregnancy-related claims that confirm their pregnancy.
He also wants to know whether beneficiaries are moved from Medicaid’s pregnant women program to the appropriate Medicaid program based on eligibility standards.
There were 28,930 women enrolled in the program during calendar years 2023 and 2024, costing the state about $167.8 million during those two years.
The audit came after a Kansas woman reached a plea deal last year when it was discovered that she provided a forged letter from a doctor’s office and phony picture of a positive pregnancy test to support her claim of being pregnant.
She would not have been eligible for Medicaid or food assistance unless she was pregnant.
She was charged with multiple felonies, including providing false information and committing forgery to gain access to Medicaid benefits.
The individual agreed to a plea agreement that required her to pay $5,042 in restitution and additional court fees.
The Kansas Department for Children and Families first reported the allegations to the inspector general in 2022. Prosecutors reached a plea deal with the woman in 2024.
