Federal authorities are investigating cases that cost the state’s Medicaid program more than $250,000 where someone is suspected of assuming a false identity that enabled them to falsely secure welfare benefits.
Medicaid Inspector General Steven Anderson revealed to lawmakers Wednesday two new cases that are expected to be prosecuted involving two people who took on the identity of a dead cousin and a dead citizen in separate cases to collect $268,000 in Medicaid benefits.
Anderson said the overall loss in benefits in both cases, including Social Security, food-assistance and low-income energy assistance, totaled more than $550,000. He detailed those cases for the Senate Committee on Government Efficiency on Wednesday.
Anderson said one woman received $214,000 in Medicaid benefits after she took on the name of a late cousin and applied for various benefits. She also married someone using her dead cousin’s identity, he said.
He said she “fraudulently” received $112,000 in Social Security disability benefits, $13,000 in low-income energy assistance program benefits, $27,000 in food assistance benefits and the $214,000 from the Medicaid program.
Anderson said the scheme unraveled when she failed to tell Social Security about her marriage, which later disqualified her from those benefits as well as others.
He also pointed to another case where an individual assumed the identify of a deceased U.S. citizen and received $161,000 in federal benefits, including $54,000 in Medicaid.
He said the person is suspected of not being a U.S. citizen.
The person was caught when they tried to apply for a passport and a driver’s license. He said efforts were underway to learn whether that person voted.
Those were the newest Medicaid fraud cases revealed publicly on Wednesday to the committee.
He also briefed the committee on another case involving the loss of more than $126,000 in Medicaid funds paid to a woman living in Missouri but who still received assistance from the state’s Medicaid program known as KanCare.
Republican state Sen. Renee Erickson of Wichita, chair of the Government Efficiency Committee, asked Anderson how that could have occurred if the state checks a beneficiary’s eligibility yearly.
Anderson said the state’s verification is often limited to only sending a letter asking a beneficiary if their status changed. He described it as a “passive review.”
“A majority of reviews are done under passive review of, ‘Hey, if there’s a problem, let us know, otherwise you’re good, you’re going to stay on the program,’” he said.
“If the letter went to a dead address or went to somebody else and they pitched in the trash or whatever, they would have never got it, they would have never responded to it,” Anderson said.
“The other thing that does happen, though, is they may contact the person via email or some other way and say, ‘Hey, we have you living at this address in Kansas. Is that true?’” he said.
He said the state does nothing to verify the claim unless they suspect the beneficiary is lying about where they live.
“Otherwise they have no reason to check it, and they don’t.”
