堪萨斯州审计发现,医疗补助报销申请被普遍拒绝,医院成本为数亿,这促使人们呼吁进行监督改革。 Kansas audit finds widespread Medicaid claim denials, costing hospitals hundreds of millions, prompting calls for oversight reform.

堪萨斯州监察长在扩大授权下进行的第一次审计显示,该州医疗援助计划(KanCare)存在广泛的问题,包括在首次访问30天内经常拒绝医院报销,即使不相关的医院每年花费数以亿计的费用。 The Kansas inspector general’s first audit under expanded authority revealed widespread issues in the state’s Medicaid program, KanCare, including frequent denials of hospital claims within 30 days of initial visits—even when unrelated—costing hospitals hundreds of millions annually. 一个管理下的护理组织拒绝18亿美元的报销申请,其中70%与医院有关,高价值的报销申请被驳回比例过高。 One managed care organization denied $1.8 billion in claims, 70% hospital-related, with higher-value claims disproportionately rejected. 人们对联合保健公司使用其子公司拥有的专有系统表示关切,这引起了潜在的利益冲突,尽管国家官员说这种做法是标准且符合标准的。 Concerns arose over UnitedHealthcare’s use of a proprietary system owned by its subsidiary, raising potential conflicts of interest, though state officials said the practice is standard and compliant. 该部同意大多数建议,但警告说,限制一个组织的工具可能造成不平衡。 The department agreed with most recommendations but warned restricting one organization’s tools could create imbalance. 此次审计标志着加强堪萨斯州社会福利计划问责制的广泛监督的开始。 The audit marks the beginning of broader oversight to improve accountability in Kansas’ social welfare programs.